| Autor: |
Stogowski, Piotr, Adamski, Stanisław, Wasilewski, Wojciech, Liczbik, Oskar, Wiśniewski, Jakub, Kurlandt, Patryk, Kloc, Wojciech |
| Zdroj: |
Folia Neuropathologica; 2023, Vol. 61 Issue 4, p460-460, 1/2p |
| Abstrakt: |
High-grade gliomas (HGGs) are characterized with poor prognoses. Surgical resection is the standard first line treatment. Patient outcomes depend heavily on the extent of surgical resection (EOR). Several methods such as neuronavigation and intraoperative magnetic resonance imaging (iMRI) were applied for enhancement of HGG visualization, especially at tumor borders. Conventional image-guided surgery is limited by brain shift in case of neuronavi-gation and high cost and time-consuming use in case of iMRI. Other techniques to maximize the EOR include visualization of the tumor with fluorescent dyes. 5-aminolevulonic acid (5-ALA) is an increasingly utilized intraoperative fluorescent imaging agent for patients with HGG. It enhances visualization of HGG tissue. 5-ALA is a natural metabolite in the human body that is produced with the hemoglobin metabolic pathway. Exogenous 5-ALA acts like a prodrug that is administered orally and accumulates in brain tumor cells. Then it is metabolized to protoporphyrin IX (PpIX) which florescent after exhibition with blue light. That red light fluorescence of tumor can be observed by the surgeon via operating microscope and guide through the resection. This guidance could be especially useful at the tumor boundaries because of infiltrative-growth pattern of HGGs. Utilization of 5-ALA was found to be associated with a greater extent of resection in HGG surgeries, as well as longer OS and PFS. Authors report utility of 5-ALA in clinical setting, future perspectives for 5-ALA as diagnostic agent and intraoperative photodynamic therapy with 5-ALA as a promising therapeutic approach in HGGs. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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