INTRAOPERATIVE FLUORESCENT CONTRASTING FOR PRIMARY AND SECONDARY BRAIN TUMORS: A LITERATURE REVIEW

Abstract

Relevance: Surgical resection of a brain tumor that is as radical and safe as possible remains an important step in the treatment of patients with primary and secondary brain tumors. It is difficult to distinguish tumor tissue from normal brain tissue during surgery using traditional white light microscopy. Intraoperative fluorescent contrast enhancement methods for brain tumors are used in real-time during the operation to overcome this limitation without disrupting the workflow. Several fluorescent drugs have been studied in recent decades, including 5-aminolevulinic acid (5-ALA), sodium fluorescein, and indocyanine green.
The study aimed to evaluate the experience of using intraoperative f luorescent contrast at the present and diagnostic capabilities,
significance, application, and development prospects for primary and secondary brain tumors based on an analysis of literature data.
Methods: A systematic search of publications in the MEDLINE/PubMed database was performed using keywords related to the results of fluorescence contrasting in brain tumors with potential clinical significance.
Results: According to the literature review, 5-ALA has been the most studied drug among the listed fluorescent drugs. It is approved for use in different countries for intraoperative fluorescent contrast of grade III and IV malignancy glial tumors. Package Inserts do not indicate using 5-ALA to treat primary and secondary brain tumors of other histological structures or using sodium fluorescein and indocyanine green to treat brain tumors. However, the literature analysis demonstrates a large experience of their successful use.
Conclusion: Fluorescent contrast of primary and secondary brain tumors is a new, promising, and insufficiently studied method of visualizing brain tumor tissue during surgery in real time. Studying the possibilities and features of fluorescent contrasting primary and secondary brain tumors is a relevant and promising area of study, and its implementation in practice will improve treatment results.