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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

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