Open AccessFluorescence-Guided Surgery for High-Grade Gliomas: State of the Art and New Perspectives
Author(s) -
Giuseppe Palmieri,
Fabio Cofano,
Luca Francesco Salvati,
Matteo Monticelli,
Pietro Zeppa,
Giuseppe Di Perna,
Antonio Melcarne,
Roberto Altieri,
Giuseppe La Rocca,
Giovanni Sabatino,
Giuseppe Barbagallo,
Fulvio Tartara,
Francesco Zenga,
Diego Garbossa
Publication year - 2021
Publication title -
technology in cancer research and treatment
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 63
eISSN - 1533-0346
pISSN - 1533-0338
DOI - 10.1177/15330338211021605
Subject(s) - medicine , indocyanine green , resection , neurosurgery , sodium fluorescein , gross examination , radiology , pathology , surgery , fluorescence , fluorescein , physics , quantum mechanics
High-grade gliomas are aggressive tumors that require multimodal management and gross total resection is considered to be the first crucial step of treatment. Because of their infiltrative nature, intraoperative differentiation of neoplastic tissue from normal parenchyma can be challenging. For these reasons, in the recent years, neurosurgeons have increasingly performed this surgery under the guidance of tissue fluorescence. Sodium fluoresceine and 5-aminolevulinic acid represent the 2 main compounds that allow real-time identification of residual malignant tissue and have been associated with improved gross total resection and radiological outcomes. Though presenting different profiles of sensitivity and specificity and further investigations concerning cost-effectiveness are need, Sodium fluoresceine, 5-aminolevulinic acid and new phluorophores, such as Indocyanine green, represent some of the most important tools in the neurosurgeon’s hands to achieve gross total resection.