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Biomed Res Int. 2014;2014:207974. doi: 10.1155/2014/207974. Epub 2014 May 21.

Fluorescence-guided surgery and biopsy in gliomas with an exoscope system.

Author information

1
Department of Neurosurgery, Hospital de la Ribera, Carretera Corbera km1, 46600 Alzira, Valencia, Spain.
2
Department of Pathology, Hospital de la Ribera, Alzira, Spain.

Abstract

BACKGROUND:

The introduction of fluorescence-guided resection allows a better identification of tumor tissue and its more radical resection. We describe our experience with a modified exoscope to detect 5 ALA-induced fluorescence in neuronavigation-guided brain surgery or biopsy of malignant brain tumors.

METHODS:

Thirty-eight patients with a suspected preoperative diagnosis of high-grade astrocytoma were included. We used a neuronavigation device and a high-definition exoscope system with a built-in filter to detect 5-ALA fluorescence in all cases. Thirty patients underwent craniotomy with tumor resection and 8 underwent frameless stereotactic brain biopsy.

RESULTS:

Histopathological diagnosis confirmed the presence of high-grade gliomas in 34 patients. Total resection was achieved in 23 cases and subtotal in 7. No relevant complications related to the administration of 5-ALA were detected.

CONCLUSIONS:

The use of the exoscope in 5-ALA fluorescence-guided tumor surgery has twofold implications: during brain tumor surgery it can be considered a valuable tool to achieve a more radical resection of the lesion, and when applied to a biopsy of a suspected brain high-grade glioma, it decreases the possibility of a negative biopsy.

PMID:
24971317
PMCID:
PMC4055357
DOI:
10.1155/2014/207974
[Indexed for MEDLINE]
Free PMC Article

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