This photo shows the advantages of fluorescence-guided neurosurgery in the procedure performed by Dr. Tarek El Ahmadieh. The photo above shows the removal of a high-grade glioma in the brain without blue light. The bottom photo shows the fluorescent features of gliomas under blue light.
Brain surgery and the surrounding environment can make patients nervous and curious on the day of surgery. But knowing about technological advances may take some of the stress off. Whether you or a loved one has been or will be treated for high-grade glioma, fluorescence-guided surgery can ensure your surgeon removes more tumor cells.
Research shows that gliomas account for more than a quarter of all primary brain tumors. Surgical removal of them remains the first line of treatment. Fluorescence-guided surgery allows neurosurgeons, such as Tarek El Ahmadieh, MD, of Loma Linda University Health, to improve the visualization of tumor cells in the operating room.
How does it work?
On the morning of surgery, the patient drank a 5-aminolevulinic acid (5-ALA) solution. 5-ALA is a naturally occurring amino acid in the body that accumulates in glioma cells. The progressive conversion of 5-ALA present in tumor cells to have a fluorescent signature created a clear visual difference for El Ahmadieh between tumor and normal brain tissue. The glow is only visible with blue light. The blue light highlights tumor tissue as bright pink and makes surrounding normal tissue appear shaded and purple.
El Ahmadieh says he removes as much of the glioma as possible, then turns on a blue light to reveal any remaining tumor tissue. This practice allows surgeons to remove tumor cells that are invisible to the naked eye. Some gliomas are invasive, spreading far beyond the area detected by MRI, El Ahmadieh said.
“For us surgeons, surgical resection is an everyday practice that has been shown to be positively associated with progression-free survival and quality of life,” El Ahmadieh said. “I think showing patients and their families how effective and advanced our technology is can give them peace of mind.”
LLUH neurosurgeons offer the latest innovative surgical options for disorders of the brain, spine, and peripheral nerves. Learn more about brain tumor services and the conditions we treat.
