Intraoperative Fluorescence Detection of Malignant Gliomas Using 5-Aminolevulinic Acid
2003 年 53 巻 2 号 p. 109-113
詳細
2003 年 53 巻 2 号 p. 109-113
Background and Aims : Complete surgical resection of glioma is difficult due to its characteristic infiltrative proliferation. However, as the extent of resection directly affects the prognosis of the disease, we evaluated a fluorescent technique using 5-aminolevulinic acid (ALA), an intrinsic precursor of Hem, for accurate intraoperative distinction of tumor cells from normal brain tissues.
Methods : We performed intraoperative fluorescent tumor detection after administration of ALA using ALA-induced protoporphyrin IX (PpIX) as a guide in 11 patients who were preoperatively suspected to have glioma, starting in November, 2001. The extent of removal of the tumor was evaluated using contrast-enhanced MRI, and the localization ALA-induced PpIX in the resected tissues was analyzed histopathologically.
Results : Tumor tissues could be identified in 9 of the 11 patients, including subcortical areas invaded by the tumor, and the findings were useful in their resection. ALA-induced PpIX was localized in the cytoplasm of tumor cells, with no uptake being noted in normal tissue.
Conclusions : Intraoperative fluorescent tumor detection using 5-ALA was useful for increasing tumor resection, and can be performed as a useful diagnostic tool for resection of brain tumors.
