Possibility of using laser spectroscopy for the intraoperative detection of nonfluorescing brain tumors and the boundaries of brain tumor infiltrates

Utsuki, Satoshi; Oka, Hiroyuki; Sato, Sumito; Suzuki, Sachio; Shimizu, Satoru; Tanaka, Satoshi; Fujii, Kiyotaka

doi:10.3171/jns.2006.104.4.618

Cited by 73 publications

(61 citation statements)

References 8 publications

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“…One advantage of these methods compared to the laser method is that they allow for detection of fluorescence over the entire area observed by the microscope. When irradiating excitation light with a laser, the scope of irradiation is narrow and allows for detection of fluorescence only within the narrow area observed by the microscope (Haj-Hosseini et al, 2010;Utsuki et al, 2006). Laser methods, however, do have benefits over systems incorporated into microscopes.…”

Section: Excitation Light and Fluorescent Observationmentioning

confidence: 99%

Intraoperative Photodynamic Diagnosis of Brain Tumors Using 5-Aminolevulinic Acid

Utsuki¹,

Oka²,

Fujii³

2011

Diagnostic Techniques and Surgical Management of Brain Tumors

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Diagnostic Techniques and Surgical Management of Brain Tumors 228 2. 5-ALA metabolic pathway 2.1 5-ALA metabolism in normal cells 5-ALA is a substance that naturally exists in the body. In the first stage, 5-Ala is produced via the condensation of glycine and succinyl-CoA by ALA synthetase (ALAS) in the mitochondria. This process receives negative feedback from heme, which is the endproduct. 5-ALA is actively transported via cytoplasm. In the next step, porphobilinogen (PBG) is created from ALA via ALA dehydratase. The actions of PBG deaminase (PBGD) and uroporphyrinogen III synthase compress 4 PBG molecules, effectively cyclizing a tetrapyrrole chain and producing uroporphyrinogen III. Uroporphyrinogen III is converted by uroporphyrinogen decarboxylase into coproporphyrinogen III, which is exposed to coproporphyrinogen oxidase in the mitochondrial intermembrane space. Decarboxylation and oxidation of the propionic side chains of the vinyl groups' rings A and B ultimately form protoporphyrinogen IX in the cell nucleus. PpIX is synthesized from protoporphyrinogen IX via protoporphyrinogen oxidase activity, and heme is synthesized via the uptake of iron into the tetrapyrrole structure by ferrochelatase in the mitochondrial membrane ( Fig.

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Section: Excitation Light and Fluorescent Observationmentioning

confidence: 99%

Intraoperative Photodynamic Diagnosis of Brain Tumors Using 5-Aminolevulinic Acid

Utsuki¹,

Oka²,

Fujii³

2011

Diagnostic Techniques and Surgical Management of Brain Tumors

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“…Recently, a quantitative determination method for fluorescence involving spectroscopic analysis has been developed, which allows more precise visualization of the fluorescence from tumor tissue. 22 Regarding the specificity of PDD for glioma surgery, new techniques allowing more specific accumulation of fluorescent dyes in tumors need to be developed. We have found several glioma antigens that are strongly expressed in glioma tissues, but not in the normal brain.…”

Section: Application Of 5-ala In Fluorescence-guided Glioma Surgerymentioning

confidence: 99%

“…8-1 6 Although still in the clinical research stage, there have also been some attempts to differentiate infiltrative tumors from the normal brain tissue using fluorescent dyes and excitation lights. [17][18][19][20][21][22] This article provides an outline of the navigation systems that provide information about the anatomical and functional locations in the brain during surgery, and of a fluorescent imaging technique which biologically identifies malignant brain tumors, with reference to our experience.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Navigation and Fluorescence Imagings in Malignant Glioma Surgery

Toda

2008

Keio J. Med.

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“…However, PPIX fluorescence is not observed in all tumors when 5-ALA is administered [3,4]. There is no method of ascertaining preoperatively whether PPIX fluorescence of the tumor tissue will be observed until exposure to an excitation light of the ultraviolet region during tumor resection.…”

Section: Introductionmentioning

confidence: 99%

“…Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection using 5-aminolevulinic acid (5-ALA) is among the most useful tools for determining the removal area for infiltrating tumors like gliomas [1][2][3][4]. However, PPIX fluorescence is not observed in all tumors when 5-ALA is administered [3,4].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Prediction of Whether Intraoperative Fluorescence of Protoporphyrin IX Can Be Achieved by 5-Aminolevulinic Acid Administration

Utsuki¹,

Oka²,

Kijima³

et al. 2012

IJCM

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Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection, using 5-aminolevulinic acid (5-ALA), is among the most valuable tools for determining tumor removal area. However, PPIX fluorescence is not necessarily achieved during an operation visually even when 5-ALA is used, and we do not know until tumor exposure to the excitation light of the ultraviolet region whether PPIX fluorescence has been achieved. When a particular biopsy and frozen section diagnosis is made, the reason for lack of PPIX fluorescence in the tissue cannot be judged. We do not know whether the tumor fails to fluoresce or no fluorescence is seen because it is not the main body of the tumor. We investigated whether the presence or absence of tumor fluorescence could be predicted by examining urinary porphyrin before surgery, at the time of intraoperative fluorescence diagnosis using 5-ALA. The urine of brain tumor patients 2 hours after 5-ALA administration was irradiated with a 405 ± 1 nm laser light. The patients were divided into a fluorescent urine group and negative fluorescent urine group. Red fluorescence was observed in response to the 405 ± 1 nm laser beam for all tumors in the fluorescent urine group. Clear red fluorescence was not observed even with 405 ± 1 nm laser beam irradiation in any tumors in the negative fluorescent urine group. Preoperative prediction of the intraoperative fluorescence of PPIX can be achieved by observation of urine 2 hours after 5-ALA administration with exposure to a 405 ± 1 nm laser light.

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Possibility of using laser spectroscopy for the intraoperative detection of nonfluorescing brain tumors and the boundaries of brain tumor infiltrates

Cited by 73 publications

References 8 publications

Intraoperative Photodynamic Diagnosis of Brain Tumors Using 5-Aminolevulinic Acid

Intraoperative Photodynamic Diagnosis of Brain Tumors Using 5-Aminolevulinic Acid

Intraoperative Navigation and Fluorescence Imagings in Malignant Glioma Surgery

Preoperative Prediction of Whether Intraoperative Fluorescence of Protoporphyrin IX Can Be Achieved by 5-Aminolevulinic Acid Administration

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