REVIEW  FLUORESCENCE IN NEUROSURGERY 

Journal of Neurosurgical Sciences 2019 December;63(6):661-9

DOI: 10.23736/S0390-5616.19.04766-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

5-ALA fluorescence on tumors different from malignant gliomas. Review of the literature and our experience

Andrea BOSCHI, Alessandro DELLA PUPPA ✉

Department of Neurosurgery, Careggi Hospital, University of Florence, Florence, Italy

INTRODUCTION: Fluorescence guided surgery with 5-aminolevulinic acid (5-ALA) is a well-established technique for improving resection of malignant cerebral glioma. In recent years, this technique is being increasingly applied off label to other brain tumor entities such as Low-grade glioma, meningioma, metastases, lymphoma and other central nervous system tumors. In this paper We collected all the data of 5-ALA guided surgery in “not malignant glioma” in literature compared to our experience.
EVIDENCE ACQUISITION: We searched the PubMed/Medline database all clinical series reporting 5-ALA guided-surgery in not malignant glioma. We reviewed all data also showing our experience.
EVIDENCE SYNTHESIS: Fluorescence guided surgery with 5-ALA might be helpful not only in high-grade glioma but also in other brain tumor especially in Low grade glioma with a suspect of anaplastic spot, meningioma with bone invasion or parenchymal infiltration, ependymoma, lymphoma and pediatric tumors.
CONCLUSIONS: Due to the relatively few number or clinical studies, prospective clinical trials are needed to increase the overall level of evidence concerning the usage of 5-ALA in CNS tumors different from high-grade glioma. Furthermore, a greater us of new tools such as, spectroscopy or confocal microscope or the use of combination of other fluorescence could make more effective this technique.

KEY WORDS: Aminolevulinic acid; Fluorescence; Brain neoplasms; Glioma; Meningioma