TY - CHAP
T1 - Fluorescein-guided surgery for spinal gliomas
T2 - Analysis of 220 consecutive cases
AU - Sun, Zhenxing
AU - Jing, Linkai
AU - Fan, Yingwei
AU - Zhang, Huifang
AU - Chen, Lin
AU - Wang, Guihuai
AU - Sharma, Hari Shanker
AU - Wang, James
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020
Y1 - 2020
N2 - Objective: Sodium fluorescein (FL) is widely used as a fluorescent tracer for brain tumor resection. However, FL-guided resection of spinal gliomas has been reported only occasionally. To evaluate the safety, characteristics, and usefulness of FL-guided surgery in the resection of spinal glioma. Methods: Between January 2015 and December 2018, 220 consecutive patients with 227 spinal gliomas underwent FL-guided resection using the Zeiss Pentero 900 surgical microscope with an integrated YELLOW 560 filter. FL evaluation and clinical outcomes were analyzed. Results: No FL-related complications occurred in this series. Entire tumor fluorescence was observed in 161 (70.93%) gliomas, nodular fluorescence in 46 (20.26%) tumors, and no fluorescence in 20 (8.81%) tumors. The intraoperative fluorescence of 217 (95.59%) gliomas was highly correlated with preoperative contrast-enhancing magnetic resonance imaging, except in eight ependymomas, one pilocytic astrocytoma, and one diffuse midline glioma. Gross-total resection was achieved in 78.85% (179/227) of spinal gliomas, including 94.30% (149/158) ependymal tumors and 43.48% (30/69) astrocytic and oligodendroglial tumors. At the final clinical follow-up, the spinal function of 75 (33.04%) patients showed significant improvement, 105 (46.26%) showed stabilization, and 47 (20.70%) showed deterioration. Conclusion: FL is a safe and useful real-time tool that could enhance tumor borders or residual tumors and hence increase the gross-total resection rate in cases with contrast-enhanced tumors.
AB - Objective: Sodium fluorescein (FL) is widely used as a fluorescent tracer for brain tumor resection. However, FL-guided resection of spinal gliomas has been reported only occasionally. To evaluate the safety, characteristics, and usefulness of FL-guided surgery in the resection of spinal glioma. Methods: Between January 2015 and December 2018, 220 consecutive patients with 227 spinal gliomas underwent FL-guided resection using the Zeiss Pentero 900 surgical microscope with an integrated YELLOW 560 filter. FL evaluation and clinical outcomes were analyzed. Results: No FL-related complications occurred in this series. Entire tumor fluorescence was observed in 161 (70.93%) gliomas, nodular fluorescence in 46 (20.26%) tumors, and no fluorescence in 20 (8.81%) tumors. The intraoperative fluorescence of 217 (95.59%) gliomas was highly correlated with preoperative contrast-enhancing magnetic resonance imaging, except in eight ependymomas, one pilocytic astrocytoma, and one diffuse midline glioma. Gross-total resection was achieved in 78.85% (179/227) of spinal gliomas, including 94.30% (149/158) ependymal tumors and 43.48% (30/69) astrocytic and oligodendroglial tumors. At the final clinical follow-up, the spinal function of 75 (33.04%) patients showed significant improvement, 105 (46.26%) showed stabilization, and 47 (20.70%) showed deterioration. Conclusion: FL is a safe and useful real-time tool that could enhance tumor borders or residual tumors and hence increase the gross-total resection rate in cases with contrast-enhanced tumors.
KW - Fluorescein
KW - Magnetic resonance imaging
KW - Microsurgery
KW - Spinal glioma
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85084683303&partnerID=8YFLogxK
U2 - 10.1016/bs.irn.2020.03.004
DO - 10.1016/bs.irn.2020.03.004
M3 - Chapter
C2 - 32448604
AN - SCOPUS:85084683303
SN - 9780128211144
T3 - International Review of Neurobiology
SP - 139
EP - 154
BT - Novel Therapeutic Advances in Glioblastoma
A2 - Bryukhovetskiy, Igor
A2 - Sharma, Aruna
A2 - Zhang, Zhiqiang
A2 - Sharma, Hari Shanker
PB - Academic Press Inc.
ER -
