gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Phase I/II-trial of a 5-aminofluorescein – albumin conjugate (AFLc-HSA) administered as an intravenous injection for intra-operative fluorescence detection in malignant brain tumors

Phase-I/II-Studie über die Anwendung von intravenös appliziertem 5-Aminofluorescein-Albumin (AFLcHSA) zur intraoperativen Fluoreszenzdarstellung von malignen Gehirntumoren

Meeting Abstract

  • corresponding author Paul Kremer - Neurochirurgische Universitätsklinik, Heidelberg
  • M. Fardanesh - Neurochirurgische Universitätsklinik, Heidelberg
  • R. Metzner - Neurochirurgische Universitätsklinik, Heidelberg
  • C. R. Wirtz - Neurochirurgische Universitätsklinik, Heidelberg
  • E. Frei - Deutsches Krebsforschungszentrum, Heidelberg
  • H. Schrenk - Deutsches Krebsforschungszentrum, Heidelberg
  • H. Sinn - Deutsches Krebsforschungszentrum, Heidelberg
  • A. Unterberg - Neurochirurgische Universitätsklinik, Heidelberg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.09.01

The electronic version of this article is the complete one and can be found online at:

Published: April 23, 2004

© 2004 Kremer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




A 5-aminofluorescein-albumin conjugate was intravenously injected for intraoperative fluorescence detection in maligant brain tumor surgery to study the intensity and the extent of fluorescence staining during surgery.


The dye was applied in a concentration of 0.5 or 1.0 mg/kg body weight 0.5 - 4 days before surgery in 16 patients (8 x glioblastomas, 4 x brain metastasis, 2 x oligo-dendrogliomas WHO III, 1 x desmopl. medulloblastoma, 1 x atyp. angioblastoma). Fluorescence was activated by an argonlaser at 488 nm (150 - 250 mWatt) and was observed using an long pass filter which was connected to the microscope. All surgical procedures were performded with neuronavigation. Tumor resection was controlled by an intraoperative and early postoperative MRI.


Fluorescence from tumor tissue could be observed when the dye was applied 2 - 3 days before surgery. Fluorescence from tumor tissue was brilliant in 4 patients ( 2 x glioblastomas, 1 x metastasis of lung carcinoma, 1 x atyp. angioblastoma), was sufficient in 8 patients (6 x glioblstomas, 1 x oligodendroglioma, 1 x brain metastasis of uncertain origin) and was not visible in 4 patients (2 x brain metastsis, 1 x desmopl. medullobl., 1 x oligodendroglioma). Fluorescence mainly was seen along the tumor borders. Samples of fluorescent stained tissue revealed tumor tissue in 52 of 56 cases. No penetration of the dye into the surrounding brain oedema, no bleaching or side effects caused by the dye were noted during or after surgery. Residual fluorescence was seen in one patient, which was confirmed by early postoperative MRI. In all other patients the tumors could be removed totally.


As presented in our study, 5-aminofluorescein-albumin seems to be highly suitable for intraoperative delineation of enhancing tumor margins in patients with malignant gliomas or metastasis.