Fluorescence-Guided Resection of Malignant Glioma with 5-ALA

Figure 4

(a) An intraoperative photograph of the brain surface. (A) The tumor surface under xenon white light. Hypervascularity is observed; however, the tumor boundary is vague. (B) By irradiating excitation light of violet-blue, red fluorescence from the tumor tissues is observed and the tumor boundary is clearly recognized. (C) In the cavity after tumor removal under xenon white light, the residual tumor is not clearly recognized. (D) In the same operative field as (C) under excitation light of violet-blue, the residual tumor is clearly recognized. (b) The R/G ratio with fluorescence spectrum. We obtained the amplitude of the red (R) PpIX fluorescence from the glioma tissues and the green (G) autofluorescence from the glioma tissues in a spectrum.

(a)

(b)