ReviewCancers2023
How Reliable Is Fluorescence-Guided Surgery in Low-Grade Gliomas? A Systematic Review Concerning Different Fluorophores.
Review in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis 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, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- A systematic review of the effectiveness and the diagnostic accuracy of intraoperative ultrasound in the resection of low-grade gliomas.Journal of ultrasound · 2025Pooled it
- High-Throughput Discovery of Near-Infrared Oxazine Probes for Fluorescence-Guided Glioblastoma Surgery.Cancers · 2026Article
- Comparative Analysis of Frameless Robotic Stereotactic Biopsy with Intraoperative Sodium Fluorescein Versus Frame-Based Stereotactic Technique.Diagnostics (Basel, Switzerland) · 2026Article
- A novel near-infrared II viscosity-responsive probe for surgical fluorescence guidance: laboratory investigation in a murine subcutaneous glioma model.Frontiers in oncology · 2026Article
- Advances in Preoperative and Intraoperative Technologies for Safe Resection of Gliomas in Cognitive Regions.Cancers · 2025Review
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- Review
- Review
- Article
- A preclinical study of a novel dual-modality contrast agent in rodent models.Frontiers in bioengineering and biotechnology · 2025Article
- Double fluorescence-guided surgery with 5-ALA and fluorescein sodium in grade 2 and grade 3 adult-type diffuse gliomas: retrospective analysis of 112 cases.Brain & spine · 2025Article
- Review of Clinically Assessed Molecular Fluorophores for Intraoperative Image Guided Surgery.Molecules (Basel, Switzerland) · 2024Review
- "Beyond the Knife"-Applying Theranostic Technologies to Enhance Outcomes in Neurosurgical Oncology.Brain sciences · 2024Review
- Deep Learning for MRI Segmentation and Molecular Subtyping in Glioblastoma: Critical Aspects from an Emerging Field.Biomedicines · 2024Review
- Article
- Review
- The Impact of Lateral Ventricular Opening in the Resection of Newly Diagnosed High-Grade Gliomas: A Single Center Experience.Cancers · 2024Article
- Understanding and Managing Pineal Parenchymal Tumors of Intermediate Differentiation: An In-Depth Exploration from Pathology to Adjuvant Therapies.Journal of clinical medicine · 2024Review
- Enlightening the invisible: Applications, limits and perspectives of intraoperative fluorescence in neurosurgery.Brain & spine · 2024Review
- The optimization and application of photodynamic diagnosis and autofluorescence imaging in tumor diagnosis and guided surgery: current status and future prospects.Frontiers in oncology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFluorescence-guided surgery has been increasingly used to support glioma surgery with the purpose of obtaining a maximal safe resection, in particular in high-grade gliomas, while its role is less definitely assessed in low-grade gliomas.
methodsA systematic review was conducted. 5-aminolevulinic acid, sodium fluorescein, indocyanine green and tozuleristide were taken into account. The main considered outcome was the fluorescence rate, defined as the number of patients in whom positive fluorescence was detected out of the total number of patients. Only low-grade gliomas were considered, and data were grouped according to single fluorophores.
results16 papers about 5-aminolevulinic acid, 4 about sodium fluorescein, 2 about indocyanine green and 1 about tozuleristide were included in the systematic review. Regarding 5-aminolevulinic acid, a total of 467 low-grade glioma patients were included, and fluorescence positivity was detected in 34 out of 451 Grade II tumors (7.3%); while in Grade I tumors, fluorescence positivity was detected in 9 out of 16 cases. In 16 sodium fluorescein patients, seven positive fluorescent cases were detected. As far as indocyanine is concerned, two studies accounting for six patients (three positive) were included, while for tozuleristide, a single clinical trial with eight patients (two positive) was retrieved.
conclusionsThe current evidence does not support the routine use of 5-aminolevulinic acid or sodium fluorescein with a standard operating microscope because of the low fluorescence rates. New molecules, including tozuleristide, and new techniques for fluorescence detection have shown promising results; however, their use still needs to be clinically validated on a large scale.
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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.