title: Fluorescence-guided resection of gliomas.
abstract: BACKGROUND
  Malignant gliomas remain associated with a poor prognosis despite both surgical treatment and radiochemotherapy.Previous studies have shown that complete resection of contrast-enhancing tumours is achieved in less than 20-30% of patients. 5-aminolevulinic acid (5-ALA) is a pro-drug that leads to accumulation of fluorescent protoporphyrins in malignant gliomas. The fluorescence can be visualized intraoperatively by use of a modified microscope. The Department of Neurosurgery at Aalborg Hospital has recently adopted this new technique as the first centre in Denmark. Our preliminary results are presented as a retrospective case series.
  
  
  METHODS
  All patients who had undergone 5-ALA fluorescence-guided surgery due to suspected malignant glioma were included. Patients received a standard preoperative dose of Gliolan. All patients had a postoperative cerebral magnetic resonance imaging scan done within 72 hours to determine their postoperative resection status.
  
  
  RESULTS
  To date, 13 patients have undergone fluorescence-guided surgery. Total resection was achieved in 54-70% of the patients depending on the inclusion criteria. Total or near total resection was achieved in 92% of patients.
  
  
  CONCLUSIONS
  The small numbers in our case series do not allow for direct comparison to be made, but show that our results on postoperative resection status fall within the range reported in other studies on the efficacy of 5-ALA. The literature offers mounting evidence in support of the role of aggressive cytoreductive surgery in patients with malignant gliomas.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Department of Neurosurgery, Aarhus University Hospital, Aalborg Hospital, Denmark. cortnumx@hotmail.com
authors: Søren
authors: S
authors: Cortnum
authors: René Johannes
authors: RJ
authors: Laursen
mesh_terms: D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000601:surgery*; D005260:Female; D005453:Fluorescence; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D018365:Neoplasm, Residual; D018242:Neuroectodermal Tumors, Primitive / Q000601:surgery*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D011184:Postoperative Period; D011524:Protoporphyrins / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid