5-Aminolevulinic Acid Fluorescence-guided Resection of Glioma: A Single-centre Experience
Invited conference paper presented and published in conference proceedings

香港中文大學研究人員

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摘要Objectives:
To investigate outcomes of resection of brain lesions using 5-aminolevulinic acid (5-ALA, Gliolan) and their correlation with extent of resection (EOR).

Methods:
A total of 15 patients underwent 16 Gliolan-assisted surgeries. All patients ingested Gliolan 3 to 4 hours prior to surgery, at a dosage of 20 mg/kg. Neurosurgical microscope with violet-blue excitation was used to visualise the red fluorescence. Duration from ingestion of Gliolan to adoption of the microscope was recorded. Resection was guided by fluorescence until no residual. The patients were monitored for general condition, especially new neurological deficit. Postoperative magnetic resonance imaging served as the gold standard for EOR.

Results:
The mean age of the cohort was 48.31 years. Gliolan was given to a recurrent high-grade tumour in 10 cases and to six without known pathological diagnosis. There were 13 high-grade gliomas, two low-grade gliomas, and one inflammation. The patients ingested 5-ALA at a mean of 3.93 hours before microscope was brought in for fluorescence, which was perceivable in 15 surgeries. Intensity was graded as ‘strong’ in eight cases and ‘moderate’ in seven. Intensity was associated with presence of necrosis in tumour. Total resection was achieved in seven (43.75%) cases. Strong fluorescence did not contribute to a higher incidence of total resection (P=0.608, Fisher’s exact test). EOR was correlated with time between ingestion and visualisation of 5-ALA (P=0.045, r=0.535). Three patients encountered new neurological deficit after surgery.

Conclusion:
5-ALA is an effective agent in assisting tumour excision. Careful selection of the patients is essential to avoid surgically induced deficit.
著者Hsieh Yi Pin Sonia, Chan Tat Ming Danny, Poon Wai Sang
會議名稱23rd Annual Scientific Meeting of The Hong Kong Neurosurgical Society
會議開始日25.11.2016
會議完結日26.11.2016
會議地點Hong Kong
會議國家/地區香港
會議論文集題名Hong Kong Medical Journal
系列標題Controversies in Neurosurgery
出版年份2017
月份6
卷號23
期次Suppl 3
出版社Hong Kong Academy of Medicine Press
頁次30 - 30
國際標準期刊號1024-2708
語言英式英語
關鍵詞5-Aminolevulinic Acid Fluorescence-guided Resection, Glioma

上次更新時間 2018-02-11 於 17:05