Fluorescence-Guided Resection of Malignant Glioma with 5-ALA

Malignant gliomas are extremely difficult to treat with no specific curative treatment. On the other hand, photodynamic medicine represents a promising technique for neurosurgeons in the treatment of malignant glioma. The resection rate of malignant glioma has increased from 40% to 80% owing to 5-am...

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Bibliographic Details
Published inInternational journal of biomedical imaging Vol. 2016; no. 2016; pp. 1 - 11
Main Authors Kaneko, Sadahiro, Kaneko, Sadao
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 01.01.2016
John Wiley & Sons, Inc
Hindawi Limited
Subjects
Abnormalities
Anticancer properties
Brain cancer
Brain research
Cancer
Care and treatment
Chemotherapy
Diagnosis
Enzymes
Eyes
Fluorescence
Gliomas
Medical imaging
Medical prognosis
Metabolism
Methods
Neurosurgery
NMR
Nuclear magnetic resonance
Patient outcomes
Photochemotherapy
Radiation therapy
Real time
Surgery
Tumors
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Summary:Malignant gliomas are extremely difficult to treat with no specific curative treatment. On the other hand, photodynamic medicine represents a promising technique for neurosurgeons in the treatment of malignant glioma. The resection rate of malignant glioma has increased from 40% to 80% owing to 5-aminolevulinic acid-photodynamic diagnosis (ALA-PDD). Furthermore, ALA is very useful because it has no serious complications. Based on previous research, it is apparent that protoporphyrin IX (PpIX) accumulates abundantly in malignant glioma tissues after ALA administration. Moreover, it is evident that the mechanism underlying PpIX accumulation in malignant glioma tissues involves an abnormality in porphyrin-heme metabolism, specifically decreased ferrochelatase enzyme activity. During resection surgery, the macroscopic fluorescence of PpIX to the naked eye is more sensitive than magnetic resonance imaging, and the alert real time spectrum of PpIX is the most sensitive method. In the future, chemotherapy with new anticancer agents, immunotherapy, and new methods of radiotherapy and gene therapy will be developed; however, ALA will play a key role in malignant glioma treatment before the development of these new treatments. In this paper, we provide an overview and present the results of our clinical research on ALA-PDD.
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Academic Editor: Yantian Zhang
ISSN:1687-4188
1687-4196
DOI:10.1155/2016/6135293