Journal of Surgery
Volume 6, Issue 5, October 2018, Pages: 116-122
Received: Jul. 24, 2018;
Accepted: Aug. 15, 2018;
Published: Sep. 12, 2018
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Artemii Yurievich Rynda, Department Neurooncology, Polenov Russian Research Institute of Neurosurgery, Div. Almazov National Medical Research Centre, St. Petersburg, Russia
Dmitrii Michailovich Rostovtsev, Department Neurooncology, Polenov Russian Research Institute of Neurosurgery, Div. Almazov National Medical Research Centre, St. Petersburg, Russia
Victor Emelijanovich Olyushin, Department Neurooncology, Polenov Russian Research Institute of Neurosurgery, Div. Almazov National Medical Research Centre, St. Petersburg, Russia
Yliay Michaiylovna Zabrodskaya, Department Neurooncology, Polenov Russian Research Institute of Neurosurgery, Div. Almazov National Medical Research Centre, St. Petersburg, Russia
Objective: the purpose of this study was to assess the usefulness and accuracy of visualization of glial brain tumors of varying degrees of malignancy when surgically removed with fluorescent control of fotoditazine. Evaluation of the edges of tumor tissue was also carried out in order to increase the degree gross total resection (GTR), and to evaluate the specificity and sensitivity of the fluorescence method. Design and methods: thirty one glial tumor patients, with varying degrees of malignancy, underwent controlled fluorescence-guided resection in the presence of the indicator molecule fotoditazine. To detect fluorescence, a OHS-1 operating microscope Leica with a special fluorescence module was used. Evaluation of the efficacy, sensitivity and specificity of the method was assessed using various histo-morphological studies. GTR was assessed using postoperative MRI. Results: for grade I and II gliomas, the sensitivity of the surgical tumor removal method was 68.3%, and the specificity was 60.1%. For grade III and IV gliomas, the sensitivity of the surgical tumor removal method was 85.4%, and the specificity was 76.2%. The extent to which total surgical resection was achieved was 79.3% in grade I-II and 95.6% in grade III-IV. Conclusions: intraoperative fluorescent imaging with fotoditazine is a highly effective, sensitive, and specific method which permits glial tumors of various histologic types to be resected more completely and effectively.
Artemii Yurievich Rynda,
Dmitrii Michailovich Rostovtsev,
Victor Emelijanovich Olyushin,
Yliay Michaiylovna Zabrodskaya,
Fluorescence-Guided Resection of Glial Brain Tumors with Fotoditazin, Journal of Surgery.
Vol. 6, No. 5,
2018, pp. 116-122.
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