Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images

Ju Hyung Moon, Se Hoon Kim, Jin Kyoung Shim, Tae Hoon Roh, Kyoung Su Sung, Ji Hyun Lee, Junseong Park, Junjeong Choi, Eui Hyun Kim, Sun Ho Kim, Seok Gu Kang, Jong Hee Chang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic i nvasion o f t umor c ells. H owever, t he m eaning o f ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5-ALA fluorescence-guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5-ALA fluorescence of the ventricular wall. Twenty-five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9%) exhibited 5-ALA-induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5-ALA-induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5%), but the remaining 6 (54.5%) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5-ALA-induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5-ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non-tumor cells from tissues with 5-ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.

Original languageEnglish
Pages (from-to)837-844
Number of pages8
JournalOncology Reports
Volume36
Issue number2
DOIs
Publication statusPublished - 2016 Aug

Fingerprint

Aminolevulinic Acid
Magnetic Resonance Spectroscopy
Fluorescence
Neoplasms
Glioblastoma
Lateral Ventricles
Glioma
Magnetic Resonance Imaging
Observation

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Moon, Ju Hyung ; Kim, Se Hoon ; Shim, Jin Kyoung ; Roh, Tae Hoon ; Sung, Kyoung Su ; Lee, Ji Hyun ; Park, Junseong ; Choi, Junjeong ; Kim, Eui Hyun ; Kim, Sun Ho ; Kang, Seok Gu ; Chang, Jong Hee. / Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. In: Oncology Reports. 2016 ; Vol. 36, No. 2. pp. 837-844.
@article{edddc814d4624d169c8c39b99bb31cbb,
title = "Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images",
abstract = "During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic i nvasion o f t umor c ells. H owever, t he m eaning o f ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5-ALA fluorescence-guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5-ALA fluorescence of the ventricular wall. Twenty-five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9{\%}) exhibited 5-ALA-induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5-ALA-induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5{\%}), but the remaining 6 (54.5{\%}) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5-ALA-induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5-ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non-tumor cells from tissues with 5-ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.",
author = "Moon, {Ju Hyung} and Kim, {Se Hoon} and Shim, {Jin Kyoung} and Roh, {Tae Hoon} and Sung, {Kyoung Su} and Lee, {Ji Hyun} and Junseong Park and Junjeong Choi and Kim, {Eui Hyun} and Kim, {Sun Ho} and Kang, {Seok Gu} and Chang, {Jong Hee}",
year = "2016",
month = "8",
doi = "10.3892/or.2016.4881",
language = "English",
volume = "36",
pages = "837--844",
journal = "Oncology Reports",
issn = "1021-335X",
publisher = "Spandidos Publications",
number = "2",

}

Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. / Moon, Ju Hyung; Kim, Se Hoon; Shim, Jin Kyoung; Roh, Tae Hoon; Sung, Kyoung Su; Lee, Ji Hyun; Park, Junseong; Choi, Junjeong; Kim, Eui Hyun; Kim, Sun Ho; Kang, Seok Gu; Chang, Jong Hee.

In: Oncology Reports, Vol. 36, No. 2, 08.2016, p. 837-844.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images

AU - Moon, Ju Hyung

AU - Kim, Se Hoon

AU - Shim, Jin Kyoung

AU - Roh, Tae Hoon

AU - Sung, Kyoung Su

AU - Lee, Ji Hyun

AU - Park, Junseong

AU - Choi, Junjeong

AU - Kim, Eui Hyun

AU - Kim, Sun Ho

AU - Kang, Seok Gu

AU - Chang, Jong Hee

PY - 2016/8

Y1 - 2016/8

N2 - During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic i nvasion o f t umor c ells. H owever, t he m eaning o f ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5-ALA fluorescence-guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5-ALA fluorescence of the ventricular wall. Twenty-five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9%) exhibited 5-ALA-induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5-ALA-induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5%), but the remaining 6 (54.5%) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5-ALA-induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5-ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non-tumor cells from tissues with 5-ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.

AB - During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic i nvasion o f t umor c ells. H owever, t he m eaning o f ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5-ALA fluorescence-guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5-ALA fluorescence of the ventricular wall. Twenty-five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9%) exhibited 5-ALA-induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5-ALA-induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5%), but the remaining 6 (54.5%) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5-ALA-induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5-ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non-tumor cells from tissues with 5-ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.

UR - http://www.scopus.com/inward/record.url?scp=84976478875&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976478875&partnerID=8YFLogxK

U2 - 10.3892/or.2016.4881

DO - 10.3892/or.2016.4881

M3 - Article

C2 - 27374931

AN - SCOPUS:84976478875

VL - 36

SP - 837

EP - 844

JO - Oncology Reports

JF - Oncology Reports

SN - 1021-335X

IS - 2

ER -