Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
The Utilization of Fluorescein in Central Nervous System Tumor Surgery
share announcement

The Utilization of Fluorescein in Central Nervous System Tumor Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 9120

Special Issue Editor

Dr. Morgan Broggi

E-Mail Website
Guest Editor
Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
Interests: brain tumors; fluorescence techniques in neurosurgery; minimally invasive neurosurgery; neuroendoscopy; adult hydrocephalus; complication assessment in neurosurgery

Special Issue Information

Dear Colleagues,

It is well established that the extent of surgical resection has a positive impact upon the clinical course of many brain tumors, including gliomas. As a consequence, many tools have been introduced to pursue this aim. In particular, sodium fluorescein has emerged as a safe, cheap, and effective dye for highlighting the tumor tissue, especially at its margins where surgical resection is more challenging.

The aim of this Special Issue is to gather, in one collection, reviews and original research articles to illustrate the current applications, advantages and disadvantages, and future potential of sodium fluorescein in the field of neuro-oncological brain surgery. Specifically, the combination of fluorescein-guided surgery and intraoperative imaging tools, such as neuronavigation, ultrasound (US), and MRI, is a stimulating and underdeveloped field of research. Moreover, comparison of sodium fluorescein and other fluorescent drugs would be an interesting topic for discussion. Finally, contributions on the use of fluorescein-aided confocal laser endomicroscopy will also be welcome.

Dr. Morgan Broggi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sodium fluorescein
  • brain tumors
  • neuro-oncological surgery
  • fluorescent guided surgery
  • high-grade gliomas
  • astrocytomas
  • intraoperative ultrasound (US)
  • intraoperative MRI
  • neuronavigation/image guided neurosurgery

Published Papers (2 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

14 pages, 3384 KiB  
Article
Confocal Laser Endomicroscopy Assessment of Pituitary Tumor Microstructure: A Feasibility Study
by Evgenii Belykh, Brandon Ngo, Dara S. Farhadi, Xiaochun Zhao, Michael A. Mooney, William L. White, Jessica K. Daniels, Andrew S. Little, Jennifer M. Eschbacher and Mark C. Preul
J. Clin. Med. 2020, 9(10), 3146; https://doi.org/10.3390/jcm9103146 - 29 Sep 2020
Cited by 14 | Viewed by 6038
Abstract
This is the first study to assess confocal laser endomicroscopy (CLE) use within the transsphenoidal approach and show the feasibility of obtaining digital diagnostic biopsies of pituitary tumor tissue after intravenous fluorescein injection. We confirmed that the CLE probe reaches the tuberculum sellae [...] Read more.
This is the first study to assess confocal laser endomicroscopy (CLE) use within the transsphenoidal approach and show the feasibility of obtaining digital diagnostic biopsies of pituitary tumor tissue after intravenous fluorescein injection. We confirmed that the CLE probe reaches the tuberculum sellae through the transnasal transsphenoidal corridor in cadaveric heads. Next, we confirmed that CLE provides images with identifiable histological features of pituitary adenoma. Biopsies from nine patients who underwent pituitary adenoma surgery were imaged ex vivo at various times after fluorescein injection and were assessed by a blinded board-certified neuropathologist. With frozen sections used as the standard, pituitary adenoma was diagnosed as “definitively” for 13 and as “favoring” in 3 of 16 specimens. CLE digital biopsies were diagnostic for pituitary adenoma in 10 of 16 specimens. The reasons for nondiagnostic CLE images were biopsy acquisition <1 min or >10 min after fluorescein injection (n = 5) and blood artifacts (n = 1). In conclusion, fluorescein provided sufficient contrast for CLE at a dose of 2 mg/kg, optimally 1–10 min after injection. These results provide a basis for further in vivo studies using CLE in transsphenoidal surgery. Full article
(This article belongs to the Special Issue The Utilization of Fluorescein in Central Nervous System Tumor Surgery)
►▼ Show Figures

Figure 1

10 pages, 467 KiB  
Article
Lighting Up the Tumor—Fluorescein-Guided Resection of Gangliogliomas
by Julius Höhne, Francesco Acerbi, Jacopo Falco, Mehmet Osman Akçakaya, Nils Ole Schmidt, Talat Kiris, Camilla de Laurentis, Paolo Ferroli, Morgan Broggi and Karl-Michael Schebesch
J. Clin. Med. 2020, 9(8), 2405; https://doi.org/10.3390/jcm9082405 - 28 Jul 2020
Cited by 18 | Viewed by 2596
Abstract
(1) Background: Gangliogliomas comprise a small number of brain tumors. They usually present as World Health Organization (WHO) grade I, and they delineate on gadolinium-enhanced MRI; the surgical goal is wide radical resection, and the course thereafter is usually benign. Fluorescein sodium (FL) [...] Read more.
(1) Background: Gangliogliomas comprise a small number of brain tumors. They usually present as World Health Organization (WHO) grade I, and they delineate on gadolinium-enhanced MRI; the surgical goal is wide radical resection, and the course thereafter is usually benign. Fluorescein sodium (FL) tends to accumulate in areas with altered blood–brain barrier (BBB). Thus far, the results provided by prospective and retrospective studies show that the utilization of this fluorophore may be associated with better visualization and improvement of resection for several tumors of the central nervous system. In this study, we retrospectively studied the effect of fluorescein sodium on visualization and resection of gangliogliomas. (2) Methods: Surgical databases in three neurosurgical departments (Regensburg University Hospital; Besta Institute, Milano, Italy; and Liv Hospital, Istanbul, Turkey), with approval by the local ethics committee, were retrospectively reviewed to find gangliogliomas surgically removed by a fluorescein-guided technique by the aid of a dedicated filter on the surgical microscope from April 2014 to February 2020. Eighteen patients (13 women, 5 men; mean age 22.9 years, range 3 to 78 years) underwent surgical treatment for gangliogliomas during 19 operations. Fluorescein was intravenously injected (5 mg/kg) after general anesthesia induction. Tumors were removed using a microsurgical technique with the YELLOW 560 Filter (YE560) (KINEVO/PENTERO 900, Carl Zeiss Meditec, Oberkochen, Germany). (3) Results: No side effects related to fluorescein occurred. In all tumors, contrast enhancement on preoperative MRI correlated with bright yellow fluorescence during the surgical procedure (17 gangliogliomas WHO grade I, 1 ganglioglioma WHO grade II). Fluorescein was considered helpful by the operating surgeon in distinguishing tumors from viable tissue in all cases (100%). Biopsy was intended in two operations, and subtotal resection was intended in one operation. In all other operations considered preoperatively eligible, gross total resection (GTR) was achieved in 12 out of 16 (75%) instances. (4) Conclusions: The use of FL and YE560 is a readily available method for safe fluorescence-guided tumor resection, possibly visualizing tumor margins intraoperatively similar to contrast enhancement in T1-weighted MRI. Our data suggested a positive effect of fluorescein-guided surgery on intraoperative visualization and extent of resection during resection of gangliogliomas. Full article
(This article belongs to the Special Issue The Utilization of Fluorescein in Central Nervous System Tumor Surgery)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-2
Back to TopTop