![]() |
JOURNAL TOOLS |
eTOC |
To subscribe |
Submit an article |
Recommend to your librarian |
ARTICLE TOOLS |
Publication history |
Reprints |
Permissions |
Cite this article as |

YOUR ACCOUNT
YOUR ORDERS
SHOPPING BASKET
Items: 0
Total amount: € 0,00
HOW TO ORDER
YOUR SUBSCRIPTIONS
YOUR ARTICLES
YOUR EBOOKS
COUPON
ACCESSIBILITY
REVIEW FLUORESCENCE IN NEUROSURGERY
Journal of Neurosurgical Sciences 2019 December;63(6):648-55
DOI: 10.23736/S0390-5616.19.04738-6
Copyright © 2019 EDIZIONI MINERVA MEDICA
language: English
Fluorescein-guided resection of gliomas
Akshay V. SAVE 1 ✉, Brian J. GILL 1, Randy S. D’AMICO 1, Peter CANOLL 2, Jeffrey N. BRUCE 1
1 Department of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA; 2 Department of Neuropathology, Columbia University Irving Medical Center, New York, NY, USA
Standard of care in the management of high-grade gliomas includes gross total resection (GTR) followed by treatment with radiation and temozolomide. GTR remains one of the few independent prognostic factors for improved survival in this disease. Sodium fluorescein is an organic fluorophore that has been studied as a surgical adjunct to improve the likelihood of achieving GTR in gliomas. Though sodium fluorescein does not selectively accumulate in glioma cells, it allows for real-time identification of regions of blood brain barrier breakdown, corresponding to the contrast-enhancing cores of high-grade gliomas. In addition to its high predictive value for identifying pathologic tissue, use of fluorescein has been shown to improve rates of GTR. In stereotactic needle biopsies, it helps reduce procedure time by rapidly confirming the presence of diagnostic tissue. Furthermore, in non-enhancing, low-grade gliomas, it labels focal regions of vascular dysregulation that have been correlated with high-grade features. Fluorescein has also been shown to be significantly less expensive than other contemporary surgical adjuncts such as intraoperative ultrasound, intraoperative MRI, and the recently FDA approved fluorophore, 5-aminolevulinic acid (5-ALA). Here, we review the current literature on the effectiveness of fluorescein as a surgical tool in the resection of gliomas.
KEY WORDS: Fluorescein; Glioma; Surgical procedures, operative