Trial reportJournal of neurosurgery2011
Quantitative fluorescence in intracranial tumor: implications for ALA-induced PpIX as an intraoperative biomarker.
Trial report in Journal of neurosurgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 162 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
162 citing papers in PubMed, 5 syntheses or guidelines pooled it, 310 citations in OpenAlex.
- Efficacy and safety of 5-aminolevulinic acid-guided surgery versus white-light resection in newly diagnosed glioblastoma: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Survival Outcomes Among Patients With High-Grade Glioma Treated With 5-Aminolevulinic Acid-Guided Surgery: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2019Pooled it
- Various shades of red-a systematic analysis of qualitative estimation of ALA-derived fluorescence in neurosurgery.Neurosurgical review · 2018Pooled it
- Agents for fluorescence-guided glioma surgery: a systematic review of preclinical and clinical results.Acta neurochirurgica · 2017Pooled it
- 5-ALA Fluorescence Image Guided Resection of Glioblastoma Multiforme: A Meta-Analysis of the Literature.International journal of molecular sciences · 2015Pooled it
- Intraoperative fluorescence imaging with aminolevulinic acid detects grossly occult breast cancer: a phase II randomized controlled trial.Breast cancer research : BCR · 2021Trial
- Red-light excitation of protoporphyrin IX fluorescence for subsurface tumor detection.Journal of neurosurgery · 2018Trial
- Intraoperative Near-Infrared Optical Contrast Can Localize Brain Metastases.World neurosurgery · 2017Trial
- Randomized, Prospective Double-Blinded Study Comparing 3 Different Doses of 5-Aminolevulinic Acid for Fluorescence-Guided Resections of Malignant Gliomas.Neurosurgery · 2017Trial
- Shining a light on brain tumors: a review of Raman spectroscopy in the operating room.Journal of biomedical optics · 2026Review
- Article
- 5-ALA Photodynamic Therapy Induces Competing Death and Survival Pathways in Glioblastoma Cells.Current issues in molecular biology · 2026Article
- Fluorescence lifetime imaging of 5-ALA-induced PpIX and autofluorescence for detecting infiltrating glioblastoma margins in patients.Biomedical optics express · 2026Article
- 5-ALA vs. fluorescein guided resection for high-grade gliomas: A systematic review and meta-analysis.Molecular and clinical oncology · 2026Article
- Image-Guided Brain Tumor Surgery.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2026Review
- NeuroDepth: an ultra long whole brain reachable multi-channel probe for real-time precise functional localization of deep human brain tumor margins.Microsystems & nanoengineering · 2025Article
- Emerging uses of 5-aminolevulinic-acid-induced protoporphyrin IX in medicine: a review of multifaceted, ubiquitous, molecular diagnostic, therapeutic, and theranostic opportunities.Journal of biomedical optics · 2025Review
- Pioneer of Biomedical Optics: Brian C. Wilson.Journal of biomedical optics · 2025Article
- Integrating mass spectrometry and hyperspectral imaging for protoporphyrin IX detection in malignant glioma tissue.Scientific reports · 2025Article
- Clinical translation of photoacoustic imaging using exogenous molecular contrast agents [Invited].Biomedical optics express · 2025Review
102 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
objectAccurate discrimination between tumor and normal tissue is crucial for optimal tumor resection. Qualitative fluorescence of protoporphyrin IX (PpIX), synthesized endogenously following δ-aminolevulinic acid (ALA) administration, has been used for this purpose in high-grade glioma (HGG). The authors show that diagnostically significant but visually imperceptible concentrations of PpIX can be quantitatively measured in vivo and used to discriminate normal from neoplastic brain tissue across a range of tumor histologies.
methodsThe authors studied 14 patients with diagnoses of low-grade glioma (LGG), HGG, meningioma, and metastasis under an institutional review board-approved protocol for fluorescence-guided resection. The primary aim of the study was to compare the diagnostic capabilities of a highly sensitive, spectrally resolved quantitative fluorescence approach to conventional fluorescence imaging for detection of neoplastic tissue in vivo.
resultsA significant difference in the quantitative measurements of PpIX concentration occurred in all tumor groups compared with normal brain tissue. Receiver operating characteristic (ROC) curve analysis of PpIX concentration as a diagnostic variable for detection of neoplastic tissue yielded a classification efficiency of 87% (AUC = 0.95, specificity = 92%, sensitivity = 84%) compared with 66% (AUC = 0.73, specificity = 100%, sensitivity = 47%) for conventional fluorescence imaging (p < 0.0001). More than 81% (57 of 70) of the quantitative fluorescence measurements that were below the threshold of the surgeon's visual perception were classified correctly in an analysis of all tumors.
conclusionsThese findings are clinically profound because they demonstrate that ALA-induced PpIX is a targeting biomarker for a variety of intracranial tumors beyond HGGs. This study is the first to measure quantitative ALA-induced PpIX concentrations in vivo, and the results have broad implications for guidance during resection of intracranial tumors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.