Glioblastoma multiforme (GBM) has a history of invasive growth, often extending into neural tissue well beyond MRI contrast-enhancement margins. During a presentation during the 82nd Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), Jan Coburger, MD, highlighted the results of research that explores whether 5 aminolevulinic-acid fluorescence (5-ALA) offers additional detection benefits compared to intraoperative MRI (iMRI) when dealing with invasive tumors.
For the study 5-Aminoleyulinic acid fluorescence exceeds Gd-DTPA enhanced intraoperative MRI in tumor detection at the border of glioblastoma multiforme: A prospective study based on histopathological assessment, researchers enrolled 34 patients harboring a GBM with intended gross total resection. All patients had surgery using iMRI and 5-ALA guided resection following a specific protocol. A white-light tumor resection was performed first, then spatial location of residual fluorescence was subsequently marked. After that, an iMRI was performed and residual uptake of contrast was marked and navigated biopsies were taken from these areas and from additional areas. Correlations of histopathological findings with imaging results were tested using Spearman's rho.
The researchers found that imaging results of 5-ALA and iMRI were significantly different at the border zone of GBMs, and that 5-ALA has a higher sensitivity and a lower specificity for tumor detection than Gd-DTPAenhanced iMRI. They concluded that for detection of infiltrating tumors, 5-ALA is superior to Gd-DTPA-enhanced iMRI concerning both sensitivity and specificity.
The above story is based on materials provided by American Association of Neurological Surgeons (AANS). Note: Materials may be edited for content and length.
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