The use of the YELLOW 560nm surgical microscope filter for sodium fluorescein-guided resection of brain tumors: Our preliminary results in a series of 28 patients

Agents for fluorescence-guided glioma surgery: a systematic review of preclinical and clinical results

“…Sixty-four studies describe the clinical use of fluorescent agents [1, 3, 5, 6, 9, 11, 13–16, 22–26, 28–31, 33–35, 37, 38, 40–42, 44, 49, 52–54, 58, 64–66, 69, 71, 74, 75, 78, 80–82, 84–87, 89, 92, 94, 97–101, 105–107, 109, 110, 113, 115, 118]. Three ways of labeling tumor cells were identified in the literature: (1) passive, (2) metabolic, and (3) molecular labeling.…”

“…Eleven papers described the use of fluorescein as a fluorescent agent in glioma surgery [1, 11, 23, 38, 52, 54, 64, 65, 71, 86, 92]. All were observational studies including patients with HGG.…”

“…It is excited at a wavelength of 460–500 nm and has an emission spectral range of 540–690 nm. As this is within the spectrum of visible light, fluorescein is used with [1, 23, 27, 38, 54, 71, 86, 120] or without a filter on the surgical microscope [11, 52, 64, 65, 92]. …”

“…Nine studies showed that upon administration of fluorescein, GTR can be achieved in 79–84% of patients [1, 11, 23, 38, 52, 54, 71, 86, 92]. Studies comparing the use of fluorescein to conventional white light surgery showed a GTR-rate of 30–55% in the latter group [11, 52, 92].…”

“…Studies comparing the use of fluorescein to conventional white light surgery showed a GTR-rate of 30–55% in the latter group [11, 52, 92]. The use of a special filter integrated into the microscope resulted in an even higher GTR rate of 80–100%; this integrated filter allowed for more accurate delineation at the tumor border and required less fluorescein for visualization (3–8 mg/kg with filter instead of 20 mg/kg without filter in the microscope) [1, 23, 27, 38, 54, 71, 86, 120]. …”