Brain tumor resection guided by fluorescence imaging and MRI image guidance

Recent evidence suggests a correlation between extent of tumor resection and patient prognosis, making maximal tumor resection a clinical ideal for neurosurgeons. Our group is currently undertaking a clinical study using fluorescence-based detection of tumor coupled with a standard 3-D image guidance system to study the effectiveness of fluorescence-based detection in the neurosurgical operating room. For fluorescence-based detection, we used 5-aminolevulinic acid to induce accumulation of protoporphyrin IX in malignant tissues. In this paper, we chose one prototypical, highly fluorescent case of glioblastoma multiforme, a high-grade glioma, to highlight some of the key findings and methodology used in our study of fluorescence-based detection and resection of brain tumors.