Comparison of fluorescein sodium, 5-ALA, and intraoperative MRI for resection of high-grade gliomas: A systematic review and network meta-analysis

Fluorescein-guided resection of newly diagnosed high-grade glioma: Impact on extent of resection and outcome

“…Notwithstanding, a reliable conclusion whether FL-guidance is equivalent to 5-ALA guidance cannot be drawn directly. This question was addressed in the 2022 network meta-analysis by Naik et al., who showed that FL-guided and 5-ALA-guided techniques have similar beneficial effects on EOR and OS ( Naik et al., 2022 ).…”

“…The same applies to various tumors of different etiologies that manifest in the human central nervous system by disturbing the intrinsic blood brain barrier (BBB) ( Mazurek et al., 2020 ; Cavallo et al., 2018 ; Schebesch et al., 2016 ; Ahrens et al., 2022 ). Some authors have even concluded that the still off-label FL dye is non-inferior to the established and approved fluorescence marker 5-aminolevulinic acid (5-ALA) with regard to the extent of resection (EOR), progression-free survival (PFS), and overall survival (OS), although these conclusions are based on different levels of evidence ( Zeppa et al., 2022 ; Naik et al., 2022 ). In a retrospective monocentric analysis, Hansen et al.…”

“…However, data on the clinical benefits of FL-guided resection in patients with HGG are sparse. The publications available so far only comprise a limited number of patients or have substantial limitations due to selection bias or insufficient quality of the data ( Naik et al., 2022 ).…”

Forging the Frontiers of Image-Guided Neurosurgery—The Emerging Uses of Theranostics in Neurosurgical Oncology

“…Furthermore, a brief cost benefit analysis suggested that image-guided surgery, iMRI, and 5-ALA FGS in particular, are associated with increased costs compared to conventional surgical resections, and therefore further research and randomized controlled trials will be needed in order to determine whether these modalities should be offered as standard of care for resection of brain tumors ( Fountain et al, 2021 ). A more recent frequentist network meta-analysis was published identifying 23 studies with 2,643 patients comparing 5-ALA, sodium fluorescein, and iMRI, to no image guidance for the resection of HGGs ( Naik et al, 2022 ). This study found that image guidance using iMRI, fluorescein, and 5-ALA led to greater rates of GTR, improved PFS, and OS compared to no image guidance.…”

Editorial: Women in elite sports and performance enhancement: 2021

“…According to the UNESCO Institute for Statistics, less than 30% of the world's researchers are women. In sports science and sports medicine research, underrepresentation and under-participation of women have been a matter of debate for a long time now (Naik et al, 2022). However, it is only recently that the field has recognized the imbalance between genders and taken measures to overcome this unfair situation.…”