REVIEW  FLUORESCENCE IN NEUROSURGERY 

Journal of Neurosurgical Sciences 2019 December;63(6):619-24

DOI: 10.23736/S0390-5616.19.04854-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

State of the art of fluorescence guided techniques in neurosurgery

Giuseppe LA ROCCA ^{1, 2} ✉, Giuseppe M. DELLA PEPA ¹, Grazia MENNA ¹, Roberto ALTIERI ^3,4, Tamara IUS ⁵, Alessandro RAPISARDA ¹, Alessandro OLIVI ¹, Giovanni SABATINO ¹

¹ Institute of Neurosurgery, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy; ² Unit of Neurosurgery, Mater Olbia Hospital, Olbia, Italy; ³ Department of Neurological Surgery, G. Rodolico Policlinic University Hospital, Catania, Italy; ⁴ Division of Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy; ⁵ Unit of Neurosurgery, Department of Neuroscience, Santa Maria della Misericordia University Hospital, Udine, Italy

Achieving a safe and extensive neoplasm resection can be considered the main goal of brain tumor surgery. This paper is first aimed at providing an overview of the evolution of those tools serving the purpose. From the dawn of neurosurgery to the present days, major innovations have followed one another. However, those techniques may frequently lack of an instant biological feedback on the true extension and the infiltration of the tumor. Intraoperative fluorescence modalities could indeed fill this gap. Fluorescence guided surgery will be therefore introduced and discussed in this context. Our focus will be on the most common fluorescence techniques used in neurosurgery, namely 5-aminolevulinic acid, sodium fluorescein and in indocyanine green. Mode of action, strengths and weaknesses and level of evidence of each modality will be discussed.

KEY WORDS: Glioma; Brain neoplasms; Aminolevulinic acid; Indocyanine green; Fluorescein; Survival