Numerous shades of red-a systematic evaluation of qualitative estimation of ALA-derived fluorescence in neurosurgery.
Neurosurg Rev. 2018 Jan;41(1):Three-18
Authors: Kamp MA, Krause Molle Z, Munoz-Bendix C, Rapp M, Sabel M, Steiger HJ, Cornelius JF
5-Aminolevulinic acid (5-ALA)-fluorescence-guided resection is effectively established in lots of neuro-oncologic facilities. Totally different classifications of 5-ALA-induced fluorescence have been reported. The purpose of the systematic evaluation was to guage the frequency of graduations, definitions, and designations of 5-ALA-induced fluorescence qualities. A scientific database search of PubMed was carried out to determine research reporting (1) on 5-ALA fluorescence-guided both spinal or cranial surgical procedure, (2) on qualitative estimation and/or categorization of 5-ALA-induced fluorescence, (Three) in English, and (four) had been printed as peer-reviewed unique research. Completely, 93 research had been recognized. Totally different classification methods of 5-ALA-induced fluorescence had been discovered. Over 60 % of the included research used a dichotomized categorization of 5-ALA-induced fluorescence and 27.5 % of research distinguished two totally different intensities of 5-ALA fluorescent tissue along with non-fluorescing tissue. Greater than 50 % of research explicitly outlined standards for categorization of 5-ALA-induced fluorescence. The main limitation of the current evaluation may be that it primarily includes information from retrospective, uncontrolled, non-randomized trials. Nonetheless, a exact definition of every 5-ALA-induced fluorescence high quality is important. Though dichotomized classification is the most typical and easy commencement system, it might not be appropriate for each medical or scientific activity. A 3-level 5-ALA-induced fluorescence classification with exact definition of every fluorescence high quality and their correlation with histological options could be extra helpful and reproducible in these circumstances.
PMID: 27225452 [PubMed – indexed for MEDLINE]