Review
Oncology
Andrea Bianconi, Marta Bonada, Pietro Zeppa, Stefano Colonna, Fulvio Tartara, Antonio Melcarne, Diego Garbossa, Fabio Cofano, Andreas F. Hottinger, Nimish Mohile
Summary: This systematic review aimed to evaluate the reliability of fluorescence-guided surgery in low-grade gliomas and identify the best fluorophore for highlighting tumor boundaries. The current evidence does not support the routine use of 5-aminolevulinic acid or sodium fluorescein in low-grade glioma surgery. New molecules and techniques show promising results but require further clinical validation.
Article
Clinical Neurology
Jonathan T. Elliott, Dennis J. Wirth, Scott C. Davis, Jonathan D. Olson, Nathan E. Simmons, Timothy C. Ryken, Keith D. Paulsen, David W. Roberts
Summary: The study focuses on adding an optimized secondary illuminant adapter to improve the usability of blue-light mode without degrading tumor contrast. The color of the secondary illuminant had opposing effects on color rendering index and tumor-to-background color contrast, but providing surgeon control of intensity allowed for real-time balance. The addition of a secondary illuminant may mitigate surgeon complaints about the dark operative field under blue light, while maintaining improved color rendering index without sacrificing tumor contrast.
WORLD NEUROSURGERY
(2021)
Article
Oncology
Evgenii Belykh, Liudmila Bardonova, Irakliy Abramov, Vadim A. A. Byvaltsev, Talgat Kerymbayev, Kwanha Yu, Debbie R. R. Healey, Ernesto Luna-Melendez, Benjamin Deneen, Shwetal Mehta, James K. K. Liu, Mark C. C. Preul
Summary: Surgical resection is the primary treatment for gliomas, but there is a lack of comparative effectiveness information for different fluorescent dyes used for intraoperative tumor visualization. This study analyzed the effectiveness of fluorescein sodium (FNa), 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX), and indocyanine green (ICG) fluorescence in various glioma models and found that wide-field imaging is equally efficient for highly malignant gliomas with all three dyes, while confocal microscopy improves diagnostic accuracy and can better detect low concentrations of PpIX and FNa in low-intermediate grade gliomas.
FRONTIERS IN ONCOLOGY
(2023)
Review
Radiology, Nuclear Medicine & Medical Imaging
Sanjit Shah, Natalie Ivey, Abhijith Matur, Norberto Andaluz
Summary: Recent advances in tumor visualization have improved the extent of resection and reduced morbidity and mortality in central nervous system tumor surgery. This study systematically reviewed and analyzed the use of 5-aminolevulinic acid (5-ala) and sodium fluorescein as intraoperative fluorophores for tumor visualization. The findings suggest that both fluorophores have the potential to enhance tumor visualization and improve the extent of resection.
Review
Clinical Neurology
Emily J. Smith, Kavita Gohil, Charee M. Thompson, Anant Naik, Wael Hassaneen
Summary: This meta-analysis demonstrates that fluorescein-guided surgery improves GTR rates of HGGs compared to non-fluorescence guided surgery, while showing similar GTR rates compared to reported 5-ALA-guided resection rates.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Michael Muether, Mohammed Jaber, Timothy D. Johnson, Daniel A. Orringer, Walter Stummer
Summary: Using a logistic regression model, the study found a strong correlation between enhancement on preoperative MRI and the likelihood of visible fluorescence during surgery in patients with intermediate-grade glioma. The research provides a robust method for predicting 5-ALA-induced fluorescence in patients with grade II and grade III gliomas with high accuracy.
Article
Multidisciplinary Sciences
David Black, Sadahiro Kaneko, Anna Walke, Simone Koenig, Walter Stummer, Eric Suero Molina
Summary: This study investigated autofluorescence in different grades of gliomas and identified new spectral features that can enhance the quantitative precision and sensitivity of fluorescence. Additionally, certain indicators such as the ratio (620/634) and the PpIX peak blue-shift were found to be significantly associated with WHO grade, fluorescence visibility, and PpIX contribution, serving as potential quantitative biomarkers for evaluation.
SCIENTIFIC REPORTS
(2021)
Article
Biochemistry & Molecular Biology
Akihiro Inoue, Takanori Ohnishi, Masahiro Nishikawa, Hideaki Watanabe, Kosuke Kusakabe, Mashio Taniwaki, Hajime Yano, Yoshihiro Ohtsuka, Shirabe Matsumoto, Satoshi Suehiro, Daisuke Yamashita, Seiji Shigekawa, Hisaaki Takahashi, Riko Kitazawa, Junya Tanaka, Takeharu Kunieda
Summary: This study analyzed the relationship between CD44 expression and magnetic resonance imaging (MRI)-based invasiveness of recurrent glioblastoma multiforme (GBM). High-invasive GBM showed significantly higher CD44 expression and was associated with worse survival. In addition, the study investigated the relationship between 5-aminolevulinic acid (5-ALA) spectroscopy-based tumor invasiveness and CD44 expression.
Review
Medicine, General & Internal
Antonio D'Ammando, Luca Raspagliesi, Matteo Gionso, Andrea Franzini, Edoardo Porto, Francesco Di Meco, Giovanni Durando, Serena Pellegatta, Francesco Prada
Summary: SDT shows promise as a treatment for malignant gliomas, combining low-intensity ultrasound waves with sensitizing compounds to enhance immunogenicity, increase apoptotic rates, and reduce angiogenetic potential in tumor cells. Preclinical studies have confirmed its anti-tumoral properties and first clinical trials are set to begin recruiting patients. Further investigations are needed to explore the clinical applications of SDT for intracranial gliomas.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Francesco Acerbi, Francesco Restelli, Camilla de Laurentis, Jacopo Falco, Claudio Cavallo, Morgan Broggi, Julius Hoehne, Karl-Michael Schebesch, Marco Schiariti, Paolo Ferroli
Summary: The study evaluated the current practice of fluorescence-guided techniques in neuro-oncological surgery in Europe and found that 5-ALA is still the preferred fluorescent dye for resection of high-grade gliomas, while SF is gaining attention as a cheaper and more ductile alternative.
JOURNAL OF NEUROSURGICAL SCIENCES
(2021)
Article
Biochemical Research Methods
Doruk Cakmakci, Gun Kaynar, Caroline Bund, Martial Piotto, Francois Proust, Izzie Jacques Namer, A. Ercument Cicek
Summary: This study demonstrates that identifying informative regions in the HRMAS NMR spectrum and using them for tumor margin assessment improves prediction power. By using the ERETIC method to normalize the spectra and training models to predict quantities of metabolites, the performance of tumor margin assessment is enhanced. Furthermore, a novel region between 7.97 ppm and 8.09 ppm is identified as a new candidate for a glioma biomarker.
Article
Biology
Mikael Marois, Jonathan D. Olson, Dennis J. Wirth, Jonathan T. Elliott, Xiaoyao Fan, Scott C. Davis, Keith D. Paulsen, David W. Roberts
Summary: A system for rapid hyperspectral imaging during neurosurgery has been developed, which can acquire data from 64 spectral channels simultaneously. The system uses a birefringent spectral demultiplexer to split incoming light and redirects it to different sections of a large format microscope sensor. This new device is an important advance in achieving real-time quantitative imaging of fluorophore concentration for guiding surgery.
COMMUNICATIONS BIOLOGY
(2023)
Review
Oncology
Rosa Sun, Hadleigh Cuthbert, Colin Watts
Summary: Gliomas are aggressive CNS tumors, difficult to treat due to their infiltrative nature. The extent of surgical resection is crucial for improved outcomes. 5-aminolevulinic acid aids surgeons in visualizing cancerous tissue, leading to better prognosis. While practical limitations exist, new advancements in fluorescence-guided surgery aim to enhance tumor-brain interface recognition for improved surgical outcomes.
Article
Oncology
David J. McCracken, Alexander J. Schupper, Nikita Lakomkin, James Malcolm, David Painton Bray, Constantinos G. Hadjipanayis
Summary: To aid in the resection of brain tumors, adjuvant technologies such as fluorescence-guided surgery have been developed. 5-aminolevulinic acid (5-ALA) is a fluorescent substance that accumulates in tumor cells, improving visualization. 5-ALA fluorescence-guided surgery can increase the extent of tumor resection and improve patient survival.
Article
Clinical Neurology
Naokado Ikeda, Motomasa Furuse, Gen Futamura, Seigo Kimura, Naosuke Nonoguchi, Shinji Kawabata, Masahiro Kameda, Kunio Yokoyama, Toshihiro Takami, Masahiro Kawanishi, Yoshinaga Kajimoto, Toshihiko Kuroiwa, Masahiko Wanibuchi
Summary: This study verifies the characteristics of fluorescence-guided surgery using the ORBEYE (ORB), a 3-dimensional digital exoscope. The results show that ORB provides better visibility and higher energy compared to conventional microscopes, but caution should be taken due to potential photobleaching of weak fluorescent tissues and short focal length.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Michael Muether, Raphael Koch, Matthias Weckesser, Peter Sporns, Wolfram Schwindt, Walter Stummer
Article
Oncology
Bastian Zinnhardt, Michael Muether, Wolfgang Roll, Philipp Backhaus, Astrid Jeibmann, Claudia Foray, Cristina Barca, Christian Doering, Bertrand Tavitian, Frederic Dolle, Matthias Weckesser, Alexandra Winkeler, Sven Hermann, Stefan Wagner, Heinz Wiendl, Walter Stummer, Andreas H. Jacobs, Michael Schaefers, Oliver M. Grauer
Editorial Material
Clinical Neurology
Michael Muether, Walter Stummer
Article
Oncology
Michael Schwake, Michael Muether, Ann-Katrin Bruns, Bastian Zinnhardt, Nils Warneke, Markus Holling, Stephanie Schipmann, Benjamin Brokinkel, Johannes Woelfer, Walter Stummer, Oliver Grauer
Summary: This study reports on the combination of 5-ALA fluorescence-guided resection and intracavitary thermotherapy with superparamagnetic iron oxide nanoparticles for the treatment of recurrent high-grade gliomas. The results show that this treatment option provides a promising approach to improve local tumor control, but further refinements are needed to decrease side effects, especially cerebral edema.
Article
Critical Care Medicine
Michael Muether, Wolfram Schwindt, Rolf Michael Mesters, Jens Minnerup, Paul Stracke, Markus Holling, Heinz Wiendl, Walter Stummer
Summary: Andexanet alfa can cause heparin resistance, leading to catastrophic events. Regulatory bodies have issued warning notices to avoid concurrent use of heparin with andexanet alfa.
NEUROCRITICAL CARE
(2022)
Article
Oncology
Malte Traeger, Leonille Schweizer, Eilis Perez, Simone Schmid, Elisabeth G. Hain, Carsten Dittmayer, Julia Onken, Kohei Fukuoka, Koichi Ichimura, Ulrich Schueller, Lasse Duehrsen, Michael Muether, Werner Paulus, Christian Thomas, Marielena Gutt-Will, Philippe Schucht, Theoni Maragkou, Jens Schittenhelm, Franziska Eckert, Maximilian Niyazi, Daniel F. Fleischmann, Mario M. Dorostkar, Petra Feyer, Sven-Axel May, Dag Moskopp, Harun Badakhshi, Cornelia Radke, Jan Walter, Felix Ehret, David Capper, David Kaul
Summary: DNA methylation profiling improves diagnostic accuracy and risk stratification in adult intracranial ependymoma. Gross total resection (GTR) and postoperative radiotherapy may represent key factors in determining the outcome of EPN-PFB patients.
Article
Medicine, General & Internal
Arturo Silvero Isidre, Hendrik Friederichs, Michael Muether, Marco Gallus, Walter Stummer, Markus Holling
Summary: Adding an MR neurosurgical simulation module to an undergraduate neurosurgical hands-on course can significantly improve the satisfaction of medical students. The positive feedback from medical students encourages the adoption of disruptive technologies into medical school curricula.
MEDICINA-LITHUANIA
(2023)
Article
Medicine, General & Internal
Michael Schwake, Emanuele Maragno, Marco Gallus, Stephanie Schipmann, Dorothee Spille, Bilal Al Barim, Walter Stummer, Michael Muether
Summary: This study compared facet-sparing and facetectomy approaches for treating lumbar spine dumbbell tumors. The results showed that the facetectomy approach was superior to facet-sparing in terms of local tumor control, achieving a higher rate of complete resection.
MEDICINA-LITHUANIA
(2022)