5-Aminolevulinic acid fluorescence guided resection of malignant glioma: Hong Kong experience
Publication in refereed journal

替代計量分析
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其它資訊
摘要Background
5-Aminolevulinic Acid (5-ALA) induced fluorescence is useful in guiding glioma resection. The extent of 5-ALA accumulation is beyond gadolinium contrast enhancement.1,2 Supratotal resection may be achieved, potentially granting patients with better survival.
We present our experience on 5-ALA guided glioma resection in Chinese ethnics.
Method
Sixteen Patients ingested 5-ALA (Gliolan, Medas Germany) 20 mg/kg·m2 4 h before surgery. The tumor resection was guided by fluorescence with neurosurgical microscope. Patient was monitored for general condition, especially for new neurological deficits. Postoperative MRI served as the assessment for extent of resection (EOR).
Result
High grade glioma was confirmed in 12 cases, low grade glioma in three and one inflammation. 5-ALA was used in ten patients with known malignant glioma, and in six patients with presumed diagnosis of malignant glioma. Fifteen cases had positive fluorescence. The intensity was strong in eight and moderate in seven cases. MRI suggested total resection was achieved in 9 patients, near total resection in two and five had subtotal resection. EOR was associated with duration between ingestion of 5-ALA and timing when microscope was brought in for visualization of fluorescence (p = 0.038). Two patients suffered from temporary visual field defects. One patient developed hemiparesis after surgery.
Conclusion
5-ALA is a useful intra-operative guidance for resection. It increases the percentage of total removal of the tumor. It should be used within the window period of the action (4–12 h).
出版社接受日期28.06.2017
著者Danny Tat Ming Chan, Hsieh Yi-Pin Sonia, Wai Sang Poon
期刊名稱Asian Journal of Surgery
出版年份2018
月份9
卷號41
期次5
出版社Elsevier
出版地Hong Kong
頁次467 - 472
國際標準期刊號1015-9584
電子國際標準期刊號0219-3108
語言英式英語
關鍵詞5-Aminolevulinic acid, Malignant glioma, Fluorescence guided surgery, Protophophrin IX, Extent of resection

上次更新時間 2021-29-07 於 00:02