ArticleNature biomedical engineering2024
Localization of protoporphyrin IX during glioma-resection surgery via paired stimulated Raman histology and fluorescence microscopy.
Article in Nature biomedical engineering, 2024. 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
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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.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 5-Aminolevulinic acid (5-ALA) in paediatric brain tumour surgery-a systematic review and exploration of fluorophore alternatives.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Pooled it
- Shining a light on brain tumors: a review of Raman spectroscopy in the operating room.Journal of biomedical optics · 2026Review
- Review
- Clinical fluorescent probes: mechanisms, advantages and inspirations.Chemical science · 2026Review
- Contemporary surgical strategies for resection of intracranial gliomas.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Review
- Review
- High-fidelity intravital imaging of biological dynamics with latent-space-enhanced digital adaptive optics.Nature biotechnology · 2026Article
- Quantification of dual-state 5-ALA-induced PpIX fluorescence: methodology and validation in tissue-mimicking phantoms.Physics in medicine and biology · 2026Article
- Fluorescence lifetime imaging of 5-ALA-induced PpIX and autofluorescence for detecting infiltrating glioblastoma margins in patients.Biomedical optics express · 2026Article
- Imaging lymphatic function and inflammation response through hypoxia via endogenous biomarker.Journal of biomedical optics · 2026Article
- 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
- Review
- Combining quantitative susceptibility mapping, arterial spin labeling and diffusion weighted imaging for distinguishing true progression from pseudoprogression in high-grade gliomas.Neuroradiology · 2025Article
- Near-infrared fatty acid molecular probe for image-guided surgery of glioblastoma.Npj imaging · 2025Article
- Review
- Review
- The abscopal effects of sonodynamic therapy in cancer.British journal of cancer · 2025Review
- Comparison of 5-aminolevulinic acid and MMP-14 targeted peptide probes in preclinical models of GBM.Theranostics · 2025Article
- Analysis of the Porphyrin Peak Shift and Fluorescence Lifetime in Gliomas with Different Tumor Grades, Intratumoral Regions, and Visible Fluorescence Status.Diagnostics (Basel, Switzerland) · 2024Article
- Spatially resolved transcriptomic profiles reveal unique defining molecular features of infiltrative 5ALA-metabolizing cells associated with glioblastoma recurrence.Genome medicine · 2023Article
Corrections and comments
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Authors and funding
38 authors.
Funding
Abstract
The most widely used fluorophore in glioma-resection surgery, 5-aminolevulinic acid (5-ALA), is thought to cause the selective accumulation of fluorescent protoporphyrin IX (PpIX) in tumour cells. Here we show that the clinical detection of PpIX can be improved via a microscope that performs paired stimulated Raman histology and two-photon excitation fluorescence microscopy (TPEF). We validated the technique in fresh tumour specimens from 115 patients with high-grade gliomas across four medical institutions. We found a weak negative correlation between tissue cellularity and the fluorescence intensity of PpIX across all imaged specimens. Semi-supervised clustering of the TPEF images revealed five distinct patterns of PpIX fluorescence, and spatial transcriptomic analyses of the imaged tissue showed that myeloid cells predominate in areas where PpIX accumulates in the intracellular space. Further analysis of external spatially resolved metabolomics, transcriptomics and RNA-sequencing datasets from glioblastoma specimens confirmed that myeloid cells preferentially accumulate and metabolize PpIX. Our findings question 5-ALA-induced fluorescence in glioma cells and show how 5-ALA and TPEF imaging can provide a window into the immune microenvironment of gliomas.
Indexed as
Identifiers
38987630What OpenQuestion holds
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.