22 February 2006 Fluorescence guided resection for malignant glioma using 5-aminolevulinic acid
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Abstract
Background: Oral application of 20 mg/kg body weight of 5-aminolevulinic acid (ALA) results in a highly specific accumulation of fluorescent Protoporphyrin IX (PpIX) in malignant glioma tissue. In a clinical phase II study, Photodynamic Therapy (PDT) to postsurgical tumor-remnants was monitored by fluorescence spectroscopy and photobleaching of PpIX was detected. Methods: Fluorescence spectra were measured from the tumor remnant pre and at intervals during PDT with 100, 150 and 200 J/cm2 and from adjacent normal cortex. The spectra obtained were fitted with spectra from pure PpIX, autofluorescence and photoproducts, the fit-parameters quantifying the contributions of these components to the measured spectrum. Results: The PpIX-fluorescence bleached to 8%, 16% and 1% of the initial intensity for the 100, 150 and 200 J/cm2-groups (median values). Photoproduct formation was minimal. PpIX-fluorescence of normal cortex was 6% of tumor remnant fluorescence (median, range: 0% to 49%).
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Herbert Stepp, Tobias Beck, Thomas Pongratz, Thomas Meinel, Jörg Ch. Tonn, Walter Stummer, "Fluorescence guided resection for malignant glioma using 5-aminolevulinic acid", Proc. SPIE 6078, Photonic Therapeutics and Diagnostics II, 60782W (22 February 2006); doi: 10.1117/12.652069; https://doi.org/10.1117/12.652069
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