Evidence map›Paper›PMID 29920583›Full record

ArticleOperative neurosurgery (Hagerstown, Md.)2019

5-Aminolevulinic Acid-Induced Fluorescence in Focal Cortical Dysplasia: Report of 3 Cases.

David W Roberts, Jaime J Bravo, Jonathan D Olson, William F Hickey, Brent T Harris, Lananh N Nguyen, Jennifer Hong, Linton T Evans, Xiaoyao Fan, Dennis Wirth and 2 more

Abstract readCase Reports
In one paragraph

Article in Operative neurosurgery (Hagerstown, Md.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 2 countries.

David W RobertsSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Jaime J BravoThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Jonathan D OlsonThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
William F HickeyDepartment of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Brent T HarrisDepartments of Pathology and Neurology, Georgetown University Medical Center, Washington, District of Columbia.
Lananh N NguyenDepartment of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Jennifer HongSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Linton T EvansSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Xiaoyao FanSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Dennis WirthThayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Brian C WilsonPrincess Margaret Cancer Centre, University Health Network, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
Keith D PaulsenSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Dartmouth College · US

Funding

Coregistered Fluorescence-Enhanced Resection of Malignant GliomaR01NS052274 · NINDS · DARTMOUTH-HITCHCOCK CLINIC · PI ROBERTS, DAVID W · 2007 to 2018
$4.6M
NINDS NIH HHS R01 NS052274
6 · The paper itself

Abstract

backgroundThree patients enrolled in a clinical trial of 5-aminolevulinic-acid (5-ALA)-induced fluorescence-guidance, which has been demonstrated to facilitate intracranial tumor resection, were found on neuropathological examination to have focal cortical dysplasia (FCD).

objectiveTo evaluate in this case series visible fluorescence and quantitative levels of protoporphyrin IX (PpIX) during surgery and correlate these findings with preoperative magnetic resonance imaging (MRI) and histopathology.

methodsPatients were administered 5-ALA (20 mg/kg) approximately 3 h prior to surgery and underwent image-guided, microsurgical resection of their MRI- and electrophysiologically identified lesions. Intraoperative visible fluorescence was evaluated using an operating microscope adapted with a commercially available blue light module. Quantitative PpIX levels were assessed using a handheld fiber-optic probe and a wide-field imaging spectrometer. Sites of fluorescence measurements were co-registered with both preoperative MRI and histopathological analysis.

resultsThree patients with a pathologically confirmed diagnosis of FCD (Types 1b, 2a, and 2b) underwent surgery. All patients demonstrated some degree of visible fluorescence (faint or moderate), and all patients had quantitatively elevated concentrations of PpIX. No evidence of neoplasia was identified on histopathology, and in 1 patient, the highest concentrations of PpIX were found at a tissue site with marked gliosis but no typical histological features of FCD.

conclusionFCD has been found to be associated with intraoperative 5-ALA-induced visible fluorescence and quantitatively confirmed elevated concentrations of the fluorophore PpIX in 3 patients. This finding suggests that there may be a role for fluorescence-guidance during surgical intervention for epilepsy-associated FCD.

Indexed as

Aminolevulinic AcidDrug Resistant EpilepsyFemaleFluorescenceHumansIntraoperative Neurophysiological MonitoringMagnetic Resonance ImagingMaleMalformations of Cortical DevelopmentMicrosurgeryMiddle AgedPhotosensitizing AgentsProspective StudiesYoung AdultAminolevulinic AcidPhotosensitizing Agents5-Aminolevulinic acidEpilepsyFluorescence guided surgeryFocal cortical dysplasiaOptical spectroscopyProtoporphyrin IX

Identifiers

PMID29920583
PMCPMC7056820
OpenAlexW2809399569

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.