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Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images.

Authors
 JU HYUNG MOON  ;  SE HOON KIM  ;  JIN‑KYOUNG SHIM  ;  TAE-HOON ROH  ;  KYOUNG SU SUNG  ;  JI‑HYUN LEE  ;  JUNSEONG PARK  ;  JUNJEONG CHOI  ;  EUI‑HYUN KIM  ;  SUN HO KIM  ;  SEOK-GU KANG  ;  JONG HEE CHANG 
Citation
 ONCOLOGY REPORTS, Vol.36(2) : 837-844, 2016 
Journal Title
 ONCOLOGY REPORTS 
ISSN
 1021-335X 
Issue Date
2016
MeSH
Aged ; Aminolevulinic Acid/administration & dosage* ; Brain Neoplasms/pathology* ; Brain Neoplasms/surgery ; Female ; Fluorescence ; Glioblastoma/pathology* ; Glioblastoma/surgery ; Glioma/pathology* ; Glioma/surgery ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Surgery, Computer-Assisted/methods
Keywords
5-aminolevulinic acid ; fluorescence ; glioblastoma ; pathology ; ventricular wall
Abstract
During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic invasion of tumor cells. However, the meaning of ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5‑ALA fluorescence‑guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5‑ALA fluorescence of the ventricular wall. Twenty‑five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9%) exhibited 5‑ALA‑induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5‑ALA‑induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5%), but the remaining 6 (54.5%) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5‑ALA‑induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5‑ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non‑tumor cells from tissues with 5‑ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.
Full Text
https://www.spandidos-publications.com/or/36/2/837
DOI
10.3892/or.2016.4881
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Roh, Tae Hoon(노태훈)
Lee, Ji Hyun(이지현) ORCID logo https://orcid.org/0000-0002-9223-9478
Chang, Jong Hee(장종희)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147049
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