SynthesisJournal of neuro-oncology2019
Fluorescence guided surgery by 5-ALA and intraoperative MRI in high grade glioma: a systematic review.
Synthesis in Journal of neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled 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.
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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Intraoperative imaging technology to maximise extent of resection for glioma: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled 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
- Human-in-the-Loop Enhances Machine Learning Inference in Intraoperative Optical Coherence Tomography Glioma Imaging.Medical sciences (Basel, Switzerland) · 2026Article
- Localized treatment of glioblastoma: a review of clinical strategies and advances in drug delivery systems.Nanomedicine (London, England) · 2025Review
- Comparing Utility of Intraoperative Magnetic Resonance Imaging and 5-Aminolevulinic Acid in High-Grade Glioma Resection Surgery: A Systematic Review and Meta-Analysis.Neurosurgery practice · 2025Review
- Article
- Integration of 5-ALA fluorescence and intraoperative MRI in awake craniotomy for glioma resection: a six-year retrospective analysis.Neurosurgical review · 2025Article
- Towards Optical Biopsy in Glioma Surgery.International journal of molecular sciences · 2025Review
- Review
- Utility and Safety of 5-ALA Guided Surgery in Pediatric Brain Tumors: A Systematic Review.Cancers · 2024Review
- Intraoperative magnetic resonance imaging in glioma surgery: a single-center experience.Journal of neuro-oncology · 2024Article
- Epigenetic profiling reveals a strong association between lack of 5-ALA fluorescence andNeuro-oncology practice · 2023Article
- Highlighted Advances in Therapies for Difficult-To-Treat Brain Tumours Such as Glioblastoma.Pharmaceutics · 2023Review
- Advances in Intraoperative Flow Cytometry.International journal of molecular sciences · 2022Review
- Novel intraoperative strategies for enhancing tumor control: Future directions.Neuro-oncology · 2022Review
- Intraoperative MR Imaging during Glioma Resection.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2022Review
- Challenges and Perspectives of Standard Therapy and Drug Development in High-Grade Gliomas.Molecules (Basel, Switzerland) · 2021Review
- Technical limitations and pitfalls of diffusion-weighted imaging in intraoperative high-field MRI.Neurosurgical review · 2021Article
- Intraoperative MRI for Brain Tumors.Journal of neuro-oncology · 2021Review
- Near-Infrared Imaging with Second-Window Indocyanine Green in Newly Diagnosed High-Grade Gliomas Predicts Gadolinium Enhancement on Postoperative Magnetic Resonance Imaging.Molecular imaging and biology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFluorescence guided surgery by 5-aminolevulinic acid (5-ALA) and intraoperative MRI (iMRI) are currently the most important intraoperative imaging techniques in high grade glioma (HGG) surgery. Few comparative studies exist for these techniques. This review aims to systematically compare 5-ALA and iMRI assisted surgery based on the current literature and discuss the potential impact of a combined use of both techniques.
methodsA systematic literature search based on preferred reporting items for systematic reviews and meta-analysis was performed concerning accuracy of tumor detection; extent of resection; neurological deficits (ND); Quality of life (QoL); usability and combined use of both techniques. Original clinical articles on HGG published until March 31st were screened.
results169 publications were screened, 81 were eligible and 22 were finally included in the review using. Overall, there is evidence that both imaging techniques improve gross total resection rate in non-eloquent lesions. Imaging results do not correlate at the border zone of a HGG. 5-ALA and contrast-enhanced iMRI seem to have a supplementary effect in tumor detection. Overall, both imaging techniques alone or combined do not seem to increase rate of permanent ND or decrease QoL in HGG surgery when used with intraoperative monitoring/mapping.
conclusionBased on the currently available literature no superiority of one technique over the other can be found in the most important outcome parameters. Based on the available information a combined use of 5-ALA and iMRI seems very promising to achieve a resection beyond gadolinium-enhancement. However, only low quality of evidence exists for this approach.
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Registered trials
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