Influence of dexamethasone on visible 5-ALA fluorescence and quantitative protoporphyrin IX accumulation measured by fluorescence lifetime imaging in glioblastomas: is pretreatment obligatory before fluorescence-guided surgery?
Lisa I. Wadiura,David Reichert,Veronika Sperl,Alexandra Lang,Barbara Kiesel,Mikael T. Erkkilae,Adelheid Wöhrer,Julia Furtner,Thomas Roetzer,Rainer A. Leitgeb,Mario Mischkulnig,Georg Widhalm +11 more
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In this paper, the influence of dexamethasone on visible fluorescence and quantitative PpIX accumulation was investigated and no significant influence was found on either visible 5-aminolevulinic acid (5-ALA) fluorescence during GBM surgery or Ppix accumulation based on FLIM.Abstract:
Objective Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is nowadays widely applied for improved resection of glioblastomas (GBMs). Initially, pretreatment with dexamethasone was considered to be essential for optimal fluorescence effect. However, recent studies reported comparably high rates of visible fluorescence in GBMs despite absence of dexamethasone pretreatment. Recently, the authors proposed fluorescence lifetime imaging (FLIM) for the quantitative analysis of 5-ALA-induced protoporphyrin IX (PpIX) accumulation. The aim of this study was thus to investigate the influence of dexamethasone on visible fluorescence and quantitative PpIX accumulation. Methods The authors prospectively analyzed the presence of visible fluorescence during surgery in a cohort of patients with GBMs. In this study, patients received dexamethasone preoperatively only if clinically indicated. One representative tumor sample was collected from each GBM, and PpIX accumulation was analyzed ex vivo by FLIM. The visible fluorescence status and mean FLIM values were correlated with preoperative intake of dexamethasone. Results In total, two subgroups with (n = 27) and without (n = 20) pretreatment with dexamethasone were analyzed. All patients showed visible fluorescence independent from preoperative dexamethasone intake. Furthermore, the authors did not find a statistically significant difference in the mean FLIM values between patients with and without dexamethasone pretreatment (p = 0.097). Conclusions In this first study to date, the authors found no significant influence of dexamethasone pretreatment on either visible 5-ALA fluorescence during GBM surgery or PpIX accumulation based on FLIM. According to these preliminary data, the authors recommend administering dexamethasone prior to fluorescence-guided surgery of GBMs only when clinically indicated.read more
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Raman Imaging and Fluorescence Lifetime Imaging Microscopy for Diagnosis of Cancer State and Metabolic Monitoring.
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Analysis of corticosteroid and antiepileptic drug treatment effects on heme biosynthesis mRNA expression in lower-grade gliomas: potential implications for 5-ALA metabolization.
Mario Mischkulnig,Veronika Sperl,Friedrich Erhart,Barbara Kiesel,Alexandra Lang,Arthur Hosmann,Thomas Roetzer,Jessica Makolli,Denise Traxler,Martin Borkovec,Karl Rössler,Georg Widhalm,Lisa I. Wadiura +12 more
TL;DR: In this article , the effect of preoperative corticosteroid/AED treatment on heme biosynthesis mRNA expression in a clinically relevant patient population was investigated and no significant differences in expression of any of the 11 investigated heme enzymes/transporters were found.
References
More filters
Journal ArticleDOI
The 2007 WHO Classification of Tumours of the Central Nervous System
David N. Louis,Hiroko Ohgaki,Otmar D. Wiestler,Webster K. Cavenee,Peter C. Burger,Anne Jouvet,Bernd W. Scheithauer,Paul Kleihues +7 more
TL;DR: The fourth edition of the World Health Organization (WHO) classification of tumours of the central nervous system, published in 2007, lists several new entities, including angiocentric glioma, papillary glioneuronal tumour, rosette-forming glioneurs tumour of the fourth ventricle, Papillary tumourof the pineal region, pituicytoma and spindle cell oncocytoma of the adenohypophysis.
Journal ArticleDOI
Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial.
Walter Stummer,Uwe Pichlmeier,Thomas Meinel,Otmar D. Wiestler,Friedhelm E. Zanella,Hans-Jürgen Reulen +5 more
TL;DR: Tumour fluorescence derived from 5-aminolevulinic acid enables more complete resections of contrast-enhancing tumour, leading to improved progression-free survival in patients with malignant glioma.
Journal ArticleDOI
Fluorescence Lifetime Measurements and Biological Imaging
TL;DR: The lifetime of a photophysical process is the time required by a population of N electronically excited molecules to be reduced by a factor of e via the loss of energy through fluorescence and other non-radiative processes and the average length of time τ is called the mean lifetime, or simply lifetime.
Journal ArticleDOI
Glioma extent of resection and its impact on patient outcome.
Nader Sanai,Mitchel S. Berger +1 more
TL;DR: Despite persistent limitations in the quality of data, mounting evidence suggests that more extensive surgical resection is associated with longer life expectancy for both low- and high-grade gliomas.
Journal ArticleDOI
Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias.
Walter Stummer,Hanns-Jürgen Reulen,Thomas Meinel,Uwe Pichlmeier,Wiebke Schumacher,Jörg-Christian Tonn,Veit Rohde,Falk Oppel,Bernd Turowski,Christian Woiciechowsky,Kea Franz,Torsten Pietsch +11 more
TL;DR: The present data provide Level 2b evidence (Oxford Centre for Evidence-based Medicine) that survival depends on complete resection of enhancing tumor in glioblastoma multiforme and treatment bias was demonstrated regarding resection and second-line therapies.