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Laser biospectroscopy and 5-ALA fluorescence navigation as a helpful tool in the meningioma resection

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Abstract

5-aminolevulinic acid (5-ALA) is a natural precursor of protoporphyrin IX (PP IX), which possesses fluorescent properties and is more intensively accumulated in tumor cells than in normal tissue. Therefore, the use of 5-ALA in the surgical treatment of intracranial tumors, particularly gliomas, has gained popularity in the last years, whereas its use in other intracranial pathological entities including meningiomas has been reported occasionally. This study describes a series of 28 patients with intracranial meningiomas, who were administered 5-ALA for a better visualization of tumor boundaries. Twelve patients underwent also laser spectroscopic analysis in order to confirm the visual impression of tumor tissue visualization. Bone infiltration was readily demonstrated. In one case, the tumor recurrence could have been prevented by removal of a tumor remnant, which would possibly have been better recognized if spectroscopic analysis had been used. Fluorescent navigation (FN) is a useful method for maximizing the radicality of meningioma surgery, particularly if the tumor infiltrates the bone, the skull base, and/or the surrounding structures.

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Acknowledgments

We acknowledge and thank Dr. Luca Marsili, MD, Neurologist, NCL-Institute of Neurosciences, Rome, Italy, for his invaluable help in editing this manuscript.

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Authors and Affiliations

  1. Burdenko Neurosurgical Institute, Moscow, Russia

    A. A. Potapov, S. A. Goryaynov, V. A. Okhlopkov, L. V. Shishkina & D. A. Golbin

  2. A. M. Prokhorov General Physics Institute, Moscow, Russia

    V. B. Loschenov & T. A. Savelieva

  3. Faculty of Basic Medicine, Lomonosov Moscow State University, Moscow, Russia

    A. P. Chumakova

  4. I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    M. F. Goldberg

  5. The Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

    M. D. Varyukhina

  6. Department of Biomedicine, University or Rome “Tor Vergata” and NCL-Institute of Neurological Sciences, Rome, Italy

    A. Spallone

  7. Neurological Centre of Latium, Via Patrica 15, 00178, Rome, Italy

    A. Spallone

Authors
  1. A. A. Potapov
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  2. S. A. Goryaynov
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  3. V. A. Okhlopkov
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  4. L. V. Shishkina
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  5. V. B. Loschenov
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  6. T. A. Savelieva
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  7. D. A. Golbin
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  8. A. P. Chumakova
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  9. M. F. Goldberg
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  10. M. D. Varyukhina
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  11. A. Spallone
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Corresponding author

Correspondence to A. Spallone.

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Potapov, A.A., Goryaynov, S.A., Okhlopkov, V.A. et al. Laser biospectroscopy and 5-ALA fluorescence navigation as a helpful tool in the meningioma resection. Neurosurg Rev 39, 437–447 (2016). https://doi.org/10.1007/s10143-015-0697-0

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  • DOI: https://doi.org/10.1007/s10143-015-0697-0

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