Abstract
The introduction of fluorescence-based techniques has revolutionized the microsurgical resection of brain tumors, especially gliomas. In this review, we summarize the results of application of 5-ALA to glioma surgery, highlighting results and opportunities for innovation.
Highlights
BackgroundMalignant glioma, the most common type of brain cancer, is a highly aggressive glial cell cancer that is subdivided into anaplastic glioma and glioblastoma, which is the more common of the two types [1]
Treatment for malignant glioma consists of resection surgery followed by adjuvant radiation and chemotherapy-usually in the form of temozolomide [1]
Preoperative images are taken by CT and MRI to guide the surgery; these images are obscured by brain shift-a phenomena that shifts regions of the brain slightly due to intraoperative events, such as tissue removal, brain swelling, and cerebrospinal fluid drainage
Summary
The most common type of brain cancer, is a highly aggressive glial cell cancer that is subdivided into anaplastic glioma and glioblastoma, which is the more common of the two types [1]. It is apparent that indocyanine green could potentially have a major impact on fluorescence-guided surgery, but more research must be conducted on the procedure before it can be integrated into standard glioma resection protocol Besides their use in a myriad of imaging techniques and drug therapy, nanoparticles can be utilized as exogenous contrast agents for enhancing tumor tissue during neurosurgery. Polyamidoamine dendrimer use for fluorescence-guided surgery is appealing because this method can reduce the toxicity of some of the molecules, such as indocyanine green, that it is attached to This technology has mainly been utilized for other usesimaging, targeted delivery, and therapeutic agents-and has yet to be studied extensively for its ability to label tumor tissue during brain surgery. ACPPs could potentially have a major impact on resection surgery procedures for numerous types of cancer due to their dynamic nature and versatility
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