22 February 2006 Fluorescence guided resection for malignant glioma using 5-aminolevulinic acid
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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, Herbert Stepp, Tobias Beck, Tobias Beck, Thomas Pongratz, Thomas Pongratz, Thomas Meinel, Thomas Meinel, Jörg Ch. Tonn, Jörg Ch. Tonn, Walter Stummer, 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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