BACKGROUND: Fluorescein sodium salt is widely used in medicine as fluorescein isothiocyanate and commonly named fluorescein (FL). This fluorophore has been used as a fluorescent tracer for many applications, especially in ophthalmic surgery. It was initially used in neuro-oncology in 1948 to control tumor resection margins. After a transient disuse, it has recently had a second spring with the development of dedicated filters for operating microscopes, although it is still under evaluation in clinical use. The aim of this study is to contribute to the investigation according to which FL-guided surgery for high-grade glioma (HGG) is related to better rates of gross total resection (GTR) and so to a better outcome. METHODS: We retrospectively analyzed 23 cases of patients with new diagnosis of HGG, operated on in our unit by intraoperative FL use with a filter system directly integrated into an operative microscope (group 1). Fluorescence was compared with histology by biopsies carried out both in the fluorescent areas and in the periphery of fluorescent areas. Group 1 was matched with a control group of 25 patients with HGG operated on in our unit during the last 2 years without FL guidance (group 2). RESULTS: No side effects occurred related to FL. Histology and intraoperative neuronavigation showed strong correspondence with fluorescent and nonfluorescent areas. GTR rate was significantly higher in group 1 (82.6%) than in group 2 (52%). CONCLUSIONS: Intraoperative fluorescein-guided surgery showed safety and feasibility. Our and other studies suggest an improvement of GTR rate in HGG than nonuse.
BACKGROUND:Fluorescein sodium salt is widely used in medicine as fluorescein isothiocyanate and commonly named fluorescein (FL). This fluorophore has been used as a fluorescent tracer for many applications, especially in ophthalmic surgery. It was initially used in neuro-oncology in 1948 to control tumor resection margins. After a transient disuse, it has recently had a second spring with the development of dedicated filters for operating microscopes, although it is still under evaluation in clinical use. The aim of this study is to contribute to the investigation according to which FL-guided surgery for high-grade glioma (HGG) is related to better rates of gross total resection (GTR) and so to a better outcome. METHODS: We retrospectively analyzed 23 cases of patients with new diagnosis of HGG, operated on in our unit by intraoperative FL use with a filter system directly integrated into an operative microscope (group 1). Fluorescence was compared with histology by biopsies carried out both in the fluorescent areas and in the periphery of fluorescent areas. Group 1 was matched with a control group of 25 patients with HGG operated on in our unit during the last 2 years without FL guidance (group 2). RESULTS: No side effects occurred related to FL. Histology and intraoperative neuronavigation showed strong correspondence with fluorescent and nonfluorescent areas. GTR rate was significantly higher in group 1 (82.6%) than in group 2 (52%). CONCLUSIONS: Intraoperative fluorescein-guided surgery showed safety and feasibility. Our and other studies suggest an improvement of GTR rate in HGG than nonuse.
Authors: Giuseppe Catapano; Francesco Giovanni Sgulò; Vincenzo Seneca; Giuseppina Iorio; Matteo de Notaris; Giuseppe di Nuzzo Journal: Neurosurg Rev Date: 2018-01-30 Impact factor: 3.042
Authors: Shuang Hu; Homan Kang; Yoonji Baek; Georges El Fakhri; Anren Kuang; Hak Soo Choi Journal: Adv Healthc Mater Date: 2018-05-02 Impact factor: 9.933
Authors: Rimas V Lukas; Derek A Wainwright; Erik Ladomersky; Sean Sachdev; Adam M Sonabend; Roger Stupp Journal: Oncology (Williston Park) Date: 2019-03-13 Impact factor: 2.990
Authors: James L Ross; Lee A D Cooper; Jun Kong; David Gutman; Merete Williams; Carol Tucker-Burden; Myles R McCrary; Alexandros Bouras; Milota Kaluzova; William D Dunn; Duc Duong; Constantinos G Hadjipanayis; Daniel J Brat Journal: Sci Rep Date: 2017-11-15 Impact factor: 4.379
Authors: Giuseppe Palmieri; Fabio Cofano; Luca Francesco Salvati; Matteo Monticelli; Pietro Zeppa; Giuseppe Di Perna; Antonio Melcarne; Roberto Altieri; Giuseppe La Rocca; Giovanni Sabatino; Giuseppe Maria Barbagallo; Fulvio Tartara; Francesco Zenga; Diego Garbossa Journal: Technol Cancer Res Treat Date: 2021 Jan-Dec