RESUMEN
In this paper, we present a review of current literature on the application of intraoperative fluorescence diagnosis and fluorescence spectroscopy using 5-aminolevulinic acid in surgery for various types of brain tumors, both alone and in combination with other neuroimaging methods. Authors' extensive experience with these methods allowed them to develop a set of clinical guidelines for the use of intraoperative fluorescence diagnosis and fluorescence spectroscopy in surgery of brain tumors.
Asunto(s)
Ácido Aminolevulínico , Neoplasias Encefálicas/patología , Glioma/patología , Monitoreo Intraoperatorio/métodos , Neuroimagen/métodos , Procedimientos Neuroquirúrgicos , Fármacos Fotosensibilizantes , Neoplasias Encefálicas/cirugía , Glioma/cirugía , Humanos , Microscopía Fluorescente , Guías de Práctica Clínica como Asunto , Espectrometría de FluorescenciaRESUMEN
The visual evaluation of the degree of GBM resection based upon postoperative enhanced MRI is still difficult. It is explained by intricate complex of tumor residual fragments, blood cells, hemostatic tissues and perifocal edema that located in the postoperative area. We introduce the new software-based method for postoperative MRI data's objective estimation. Five independent specialists had examined 16 patients' MRI data (including 12 GBM and 4 patients with noninfiltrative intracerebral tumors) and tested the method's specificity and sensitivity against the enhanced residual tumor (ERT). Our software determines the 100% sensitivity and specificity against hemostatic agent Surgicel, the high recurrence rate of results while estimating the volume of ERT (0,14 ± 0,02 cm³) and low considerable time (5,21 ± 0,14 min). The software was can be used both daily practice and research of malignant glioma management.