gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Laserspectroscopy in 5-ALA treated gliomas: spectroscopical evaluation of 5-ALA fluorescence uptake and kinetics in human glioma cells

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  • J. Schroeteler - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland
  • Y. Klosterkemper - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland
  • M. Schwake - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland
  • T. Fortmann - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland
  • W. Stummer - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland
  • C. Ewelt - Klinik für Neurochirurgie, Westfälische Wilhelms-Universität, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.09.03

doi: 10.3205/12dgnc081, urn:nbn:de:0183-12dgnc0815

Published: June 4, 2012

© 2012 Schroeteler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: 5-aminolaevulinic acid (5-ALA) has improved surgical therapy of malignant gliomas. However, there is a lack of knowledge concerning 5-ALA uptake and fluorescence kinetic in different histologies. Aim of this study was to detect differences in malignant gliomas concerning uptake kinetic and fluorescence of 5-ALA loaded glioma cells by spectroscopy.

Methods: Sample examination took place 4 hours after 5-ALA application. Before surgery, 20 mg /Kg bodyweight 5-ALA was given. Tumor slices which showed a maximum of fluorescence using the surgical microscope at the beginning and during resection, were cut into 1 cm3 blocks, incubated in 5% glucose solution and used for spectroscopical evaluation by an un-pulsed diode laser with a wavelength of 405 nm and with an energy of 30 mW combined with a spectroscope. The distance between laser and example was 1 mm. Measurements were performed every hour for 1 second in order to reduce a photo bleaching effect starting at baseline 4 hours after 5-ALA application and ending 14 hours after 5-ALA application.

Results: The tumors of 8 patients were evaluated of which 5 were glioblastomas (GBM) and 3 anaplastic astrocytomas (AA). We observed a reduction in fluorescence accumulation in the cells in a negative exponential way. A photo bleaching effect was detected in slices, analyzed for more than 1 second. AA showed significantly lower 5-ALA-uptake as well as a significantly lower curve in total fluorescence compared to GBM.

Conclusions: In gliomas, 5-ALA fluorescence decreases in a negative exponential curve helping to interpret the kinetics and intraoperative findings. This observation may be useful for intraoperative predictions of histology.