Fluorescence-guided Surgery and Biopsy in Gliomas with an Exoscope System

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2014 Jun 28

PMID 24971317

Citations 25

Authors

Jose Piquer

Jose L Llacer

Vicente Rovira

Pedro Riesgo

Ruben Rodriguez

Antonio Cremades

Affiliations

Soon will be listed here.

Abstract

Background: The introduction of fluorescence-guided resection allows a better identification of tumor tissue and its more radical resection. We describe our experience with a modified exoscope to detect 5 ALA-induced fluorescence in neuronavigation-guided brain surgery or biopsy of malignant brain tumors.

Methods: Thirty-eight patients with a suspected preoperative diagnosis of high-grade astrocytoma were included. We used a neuronavigation device and a high-definition exoscope system with a built-in filter to detect 5-ALA fluorescence in all cases. Thirty patients underwent craniotomy with tumor resection and 8 underwent frameless stereotactic brain biopsy.

Results: Histopathological diagnosis confirmed the presence of high-grade gliomas in 34 patients. Total resection was achieved in 23 cases and subtotal in 7. No relevant complications related to the administration of 5-ALA were detected.

Conclusions: The use of the exoscope in 5-ALA fluorescence-guided tumor surgery has twofold implications: during brain tumor surgery it can be considered a valuable tool to achieve a more radical resection of the lesion, and when applied to a biopsy of a suspected brain high-grade glioma, it decreases the possibility of a negative biopsy.

Citing Articles

Second-Generation Wide-Field Visualization Devices for 5-ALA-Induced Fluorescence and Concepts for Validation in Neurosurgery-A Systematic Review.

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Sodium fluorescein and 5-aminolevulinic acid fluorescence- guided biopsy in brain lesions: a systematic review and meta-analysis.

Gomes F, Ferreira M, Larcipretti A, Freitas B, Andreao F, Turpin J J Neurooncol. 2024; 170(1):11-29.

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Comparative analysis of exoscope-assisted spine surgery versus operating microscope: A systematic review.

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Exoscopic Microsurgery: A Change of Paradigm in Brain Tumor Surgery? Comparison with Standard Operative Microscope.

Di Cristofori A, Graziano F, Rui C, Rebora P, Di Caro D, Chiarello G Brain Sci. 2023; 13(7).

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Boaro A, Moscolo F, Feletti A, Polizzi G, Nunes S, Siddi F Brain Spine. 2022; 2:100926.

PMID: 36248169 PMC: 9560703. DOI: 10.1016/j.bas.2022.100926.

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