5-Aminolevulinic Acid Fluorescence in High Grade Glioma Surgery: Surgical Outcome, Intraoperative Findings, and Fluorescence Patterns

Figure 4

F 47/Y, preoperative MRI scan with gadolinium showing a left frontal high grade glioma (a). Intraoperative view: (b) identification by MRI-navigation of tumor boundaries on the cortical surface (markers A, B, C, D) and identification by mapping in awake surgery of surrounding language areas (1–5). (c) Final inspection of the surgical cavity under blue-light (d) showing no fluorescent residual tumor. The tumor at blue-light inspection showed a fluorescent inner part corresponding to enhancing component at preoperative MRI (a). The postoperative MRI scan (f) confirms the complete resection of tumor (f). Histological report: anaplastic astrocytoma (astrocytoma grade III sec WHO).