title: Fluorescence-guided resection of metastatic brain tumors using a 5-aminolevulinic acid-induced protoporphyrin IX: pathological study.
abstract: We performed a pathological study to identify the locus of production of protoporphyrin IX (PPIX) in human metastatic brain tumors. Patients with metastatic brain tumors (n = 11) received 1 g of 5-aminolevulinic acid (5-ALA) perorally 2 h before undergoing surgery. The target region was exposed to laser light with a peak wavelength of 405 +/- 1 nm and an output of 40 mW. Tissue samples from the tumor bulk and surrounding areas were examined by histological and fluorescence methods. Of the 11 tumors, 9 manifested PPIX fluorescence in the tumor bulk and peritumoral brain tissue. Our findings indicate that PPIX fluorescence can be observed in peritumoral edematous areas that are free of neoplastic cells, because PPIX produced by neoplastic cells leaks into the surrounding edematous area.
authors: Department of Neurosurgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. utsuki@med.kitasato-u.ac.jp
authors: Satoshi
authors: S
authors: Utsuki
authors: Norio
authors: N
authors: Miyoshi
authors: Hidehiro
authors: H
authors: Oka
authors: Yoshiteru
authors: Y
authors: Miyajima
authors: Satoru
authors: S
authors: Shimizu
authors: Sachio
authors: S
authors: Suzuki
authors: Kiyotaka
authors: K
authors: Fujii
mesh_terms: D000622:Aminolevulinic Acid / Q000378:metabolism; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D008856:Microscopy, Fluorescence; D019635:Neurosurgical Procedures / Q000379:methods*; D017319:Photosensitizing Agents; D011524:Protoporphyrins
chemical_list: D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX