Technical Principles for Protoporphyrin-IX-Fluorescence Guided Microsurgical Resection of Malignant Glioma Tissue

Stummer, Walter; Stepp, Herbert; Möller, G; Ehrhardt, André; Leonhard, Martin; Reulen, H. J.

doi:10.1007/s007010050206

Cited by 231 publications

(148 citation statements)

References 13 publications

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“…The exhibited fluorescence has a shoulder peak at about λ = 500-530 nm and is referred to as autofluorescence. Detection of PpIX during operation is conventionally performed using surgical microscopes with added fluorescence detection modalities [3,4] . The fluorescence microscopes are designed to pass the fluorescence in the visible optical region above the excitation spectrum to the operator [5] thus the fluorescence observed by the operator is expected to be directly correlated to the PpIX fluorescence.…”

Section: Introductionmentioning

confidence: 99%

Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery

Haj‐Hosseini

Richter

Hallbeck

et al. 2015

Photodiagnosis and Photodynamic Therapy

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Section: Introductionmentioning

confidence: 99%

Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery

Haj‐Hosseini

Richter

Hallbeck

et al. 2015

Photodiagnosis and Photodynamic Therapy

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“…Malignant glioma (Schoenfeld et al, 1988), oral cavity cancer, colonic and gastrointestinal dysplasia (Stummer et al, 1998a), peritoneal endometriosis (Stepp et al, 1998), lower urinary tract tumours (Hillemanns et al, 2000), bladder cancer (Kriegmair et al, 1999), malignant mucosa in head and neck cancer ( Kriegmair et al, 1996) and basal and squamous cell carcinoma (Betz et al, 1999), all demonstrate eminent PpIX synthesis and specific accumulation. Our results show a direct correlation between total PBGD (nuclear and cellular), its enzymatic activity and PpIX accumulation.…”

Section: Discussionmentioning

confidence: 99%

Differentiation-dependent photodynamic therapy regulated by porphobilinogen deaminase in B16 melanoma

et al. 2004

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Protoporphyrin IX (PpIX) synthesis by malignant cells is clinically exploited for photodiagnosis and photodynamic therapy following administration of 5-aminolevulinic acid (ALA). The expression and activity of the housekeeping porphobilinogen deaminase (PBGD) was correlated to PpIX synthesis in differentiating B16 melanoma cells. Differentiation was stimulated by two inducers, butyrate and hexamethylene bisacetamide (HMBA), both of which promote the formation of typical melanosomes and melanin, as well as morphological changeover. A marked decrease in total PBGD activity and PpIX synthesis was observed following stimulation by butyrate, while HMBA induced an opposite effect. In contrast, ferrochelatase levels remained unchanged. Photodynamic inactivation of the cells undergoing differentiation was largely dependent on the PpIX accumulation, which was modulated by the two inducers butyrate and HMBA. Fluorescence immunostaining with anti-PBGD antibodies revealed a major PBGD fraction in the nucleus and a minor fraction in the cytosol. This nuclear localisation pattern was confirmed by expression of PBGD fused to green fluorescence protein. We suggest that efficient photodynamic therapy of cancer facilitated by ALA administration can be enhanced using combined therapeutic modalities.

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“…The intensity of excess normal white light can easily be reduced to 25%. The photobleaching effect is relevant mainly at the tumor margins where PpIX concentrations are low [41].…”

Section: Fluorescence Imaging Instrumentationmentioning

confidence: 99%

Review of Neurosurgical Fluorescence Imaging Systems for Clinical Application

Kim

Lee

Yoo

et al. 2016

Journal of the Optical Society of Korea

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A number of fluorescence imaging techniques for use in the surgical removal of glioma have been developed over the course of the long history of neurosurgery. Various biomarkers, biochemical agents, and detection systems for glioma have also been developed. This review focuses on 5-aminolevulinic acid (5-ALA), which is used to detect glioma. Numerous forms of fluorescence-guided surgery use 5-ALA, which is helpful to the surgeon. The surgical microscope system is the observational method generally used with 5-ALA, while the loupe, endoscope, and exoscope are simpler alternatives. A system is needed for minimal resection and other issues that arise during neurosurgery. Such an enhanced system should be able to detect low-grade tumors and provide information on microinvasive diseases, resulting in an improved survival rate and better surgical skills. Development of systems that fulfill certain needs would help protect the brain function of the patient and broaden the use of such systems in neurosurgery.

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Technical Principles for Protoporphyrin-IX-Fluorescence Guided Microsurgical Resection of Malignant Glioma Tissue

Cited by 231 publications

References 13 publications

Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery

Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery

Differentiation-dependent photodynamic therapy regulated by porphobilinogen deaminase in B16 melanoma

Review of Neurosurgical Fluorescence Imaging Systems for Clinical Application

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