MURAGAKI Yoshihiro
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Visiting Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Role of neurochemical navigation with 5-aminolevulinic acid during intraoperative MRI-guided resection of intracranial malignant gliomas.
Journal Formal name:Clinical neurology and neurosurgery
Abbreviation:Clin Neurol Neurosurg
ISSN code:18726968 (Electronic)03038467 (Linking)
Volume, Issue, Page 130,pp.134-139
Author and coauthor YAMADA Shinobu†, MURAGAKI Yoshihiro, MARUYAMA Takashi, KOMORI Takashi, OKADA Yoshikazu
Publication date 2015/03
Summary OBJECTIVE:
To evaluate the role of the neurochemical navigation with 5-aminolevulinic acid (5-ALA) during intraoperative MRI (iMRI)-guided resection of the intracranial malignant gliomas.
METHODS:
The analysis included 99 consecutive surgical cases. Resection of the bulk of the neoplasm was mainly guided by the updated neuronavigation based on the low-field-strength (0.3T) iMRI, whereas at the periphery of the lesion neurochemical navigation with 5-ALA was additionally used.
RESULTS:
In total, 286 tissue specimens were obtained during surgeries for histopathological examination. According to iMRI 98 samples with strong (91 cases), weak (6 cases), or absent (1 case) fluorescence corresponded to the bulk of the lesion and all of those ones contained tumor. Out of 188 tissue specimens obtained from the "peritumoral brain," the neoplastic elements were identified in 89%, 81% and 29% of samples with, respectively, strong (107 cases), weak (47 cases) and absent (34 cases) fluorescence. Positive predictive values of the tissue fluorescence for presence of neoplasm within and outside of its boundaries on iMRI were 100% and 86%, respectively.
CONCLUSION:
Neurochemical navigation with 5-ALA is useful adjunct during iMRI-guided resection of intracranial malignant gliomas, which allows identification of the tumor extension beyond its radiological borders.
DOI 10.1016/j.clineuro.2015.01.005
Document No. 25615582