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Table of Contents    
CORRESPONDENCES
Year : 2018  |  Volume : 66  |  Issue : 4  |  Page : 1212

Enhanced resection of primary high grade gliomas using a combination of intraoperative magnetic resonance imaging and intraoperative fluorescence (5-aminolevulinic acid): Detecting the presence of glioma cells in ventricular ependymal walls


Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1Tomioka, Urayasu, 279-0021 Chiba, Japan

Date of Web Publication18-Jul-2018

Correspondence Address:
Dr. Satoshi Tsutsumi
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1Tomioka, Urayasu, 279-0021 Chiba
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.237024

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How to cite this article:
Tsutsumi S. Enhanced resection of primary high grade gliomas using a combination of intraoperative magnetic resonance imaging and intraoperative fluorescence (5-aminolevulinic acid): Detecting the presence of glioma cells in ventricular ependymal walls. Neurol India 2018;66:1212

How to cite this URL:
Tsutsumi S. Enhanced resection of primary high grade gliomas using a combination of intraoperative magnetic resonance imaging and intraoperative fluorescence (5-aminolevulinic acid): Detecting the presence of glioma cells in ventricular ependymal walls. Neurol India [serial online] 2018 [cited 2018 Aug 17];66:1212. Available from: http://www.neurologyindia.com/text.asp?2018/66/4/1212/237024




Sir,

The authors documented enhanced resection of high-grade gliomas using a combination of intraoperative MRI (iMRI) and 5-aminolevulinic acid (5-ALA) fluorescence in a relatively large number of patients. In this well-written article, results are properly analyzed with statistical measures. Although 62% of the lesions were located in the left cerebral hemisphere, a total resection of the enhancing tumor followed by a satisfactory outcome was achieved in 97.29% of 37 patients. Though patient selection and criteria allotted for surgeries with iMRI and 5-ALA were not mentioned, the authors successfully demonstrated the usefulness of these combinations at resecting high-grade gliomas. Intraoperative use of 5-ALA fluorescence may complement contrast MR images more than the direct visualization of tumor extension and the tumor tissue left behind.[1] Moyadi et al., had demonstrated that the intraoperative fluorescence reveals diffuse subpial spread in glioblastomas.[2] Recently, Moon et al., demonstrated an interesting possibility that glioma cells exhibiting 5-ALA fluorescence may be present in the ventricular walls, despite no signs of tumor involvement found on MRI.[3] The combined use of intraoperative MRI and 5-ALA is undoubtedly valuable for increasing the resectability, especially in non-eloquent areas.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sharma V, Kedia R, Narang KS, Jha AN. Enhanced resection of primary high-grade gliomas using a combination of intraoperative magnetic resonance imaging and intraoperative fluorescence (5-aminolevulinic acid): A single-centre experience. Neurol India 2018;66:747-52  Back to cited text no. 1
    
2.
Moiyadi A, Sridhar E. Intraoperative fluorescence reveals diffuse subpial spread in glioblastoma. Neurol India 2015;63:960-3.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Moon JH, Kim SH, Shim JK, Roh TH, Sung KS, Lee JH,et al. Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. Oncol Rep 2016;36:837-44.  Back to cited text no. 3
    




 

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