Use of 5-ALA fluorescence guided endoscopic biopsy of a deep-seated primary malignant brain tumor: Technical note

Rainer Ritz, Guenther C. Feigl, Martin U. Schuhmann, André Ehrhardt, Soeren Danz, Susan Noell, Antje Bornemann, Marcos S. Tatagiba

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

The introduction of fluorescence-guided resection of primary malignant brain tumors was a milestone in neurosurgery. Deep-seated malignant brain tumors are often not approachable for microsurgical resection. For diagnosis and therapy, new strategies are recommended. The combination of endoscopy and 5-aminolevulinic acid-induced protoporphyrin IX (5-ALA-induced Pp IX) fluorescence-guided procedures supported by neuronavigation seems an interesting option. Here the authors report on a combined approach for 5-ALA fluorescence-guided biopsy in which they use an endoscopy system based on an Xe lamp (excitation approximately λ = 407 nm; dichroic filter system λ = 380-430 nm) to treat a malignant tumor of the thalamus and perform a ventriculostomy and septostomy. The excitation filter and emission filter are adapted to ensure that the remaining visible blue remission is sufficient to superimpose on or suppress the excited red fluorescence of the endogenous fluorochromes. The authors report that the lesion was easily detectable in the fluorescence mode and that biopsy led to histological diagnosis.

Original languageEnglish (US)
Pages (from-to)1410-1413
Number of pages4
JournalJournal of Neurosurgery
Volume114
Issue number5
DOIs
StatePublished - Jan 1 2011

Keywords

  • 5-aminolevulinic acid
  • Biopsy
  • Deep-seated glioma
  • Hydrocephalus
  • Photodynamic diagnosis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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