ArticleBrain sciences2023
Technical Pearls to Effectively Use 5-ALA in Fluorescence-Guided Tumor Resection-5 Lessons from the Operating Room.
Article in Brain sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Exploit the γ-Glutamyl hydroxymethyl rhodamine green fluorescence in surgical resection: A systematic literature review on clinical indications, fields of application and outcomes.Neurosurgical review · 2025Pooled it
- Review
- Advances in Preoperative and Intraoperative Technologies for Safe Resection of Gliomas in Cognitive Regions.Cancers · 2025Review
- Comparative Analysis of 5-ALA and Fluorescent Techniques in High-Grade Glioma Treatment.Biomedicines · 2025Review
- Surgical efficacy and survival outcomes of fluorescein sodium-guided surgery in glioblastoma: a single-center experience.Brain & spine · 2025Article
- Article
- Identification of Molecular Targets and Anti-Cancer Agents in GBM: New Perspectives for Cancer Therapy.Brain sciences · 2023Article
- Current Strategies in Photodynamic Therapy (PDT) and Photodynamic Diagnostics (PDD) and the Future Potential of Nanotechnology in Cancer Treatment.Pharmaceutics · 2023Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince its introduction in 2007 in Europe and in 2017 in the United States, 5-ALA has demonstrated an undisputed advantage in providing real-time tumor visualization. The aim of the present paper is to summarize our institutional experience over a decade of routine 5-ALA-guided procedures in order to provide five surgical tricks to ease surgical workflow.
methodsData were collected from 822 patients diagnosed with histopathologically confirmed high-grade gliomas (HGG)-according to the WHO 2021 criteria-who underwent surgery at the Fondazione Policlinico Universitario Agostino Gemelli between January 2012 and January 2022.
resultsFrom our large institutional experience, the learned technical pearls were grouped in five distinct domains: 1. Analysis of visualization, overall workflow, and technical recommendations to improve intraoperative set-up; 2. Techniques to reduce the risk of inadvertent residuals and failure to evocate fluorescence; 3. Analysis of specific surgical conditions favoring remnants; 4. Assessment of different degrees of fluorescence and their surgical meaning; 5. Analysis of false positive cases.
conclusionsWith all the limitations of a qualitative and retrospective analysis, this paper was specifically conceived as a vademecum for educational purposes to promote and maximize 5-ALA employment.
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Registered trials
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