Evidence map›Paper›PMID 39767656›Full record

ArticleBiomedicines2024

In Situ Light-Source Delivery During 5-Aminulevulinic Acid-Guided High-Grade Glioma Resection: Spatial, Functional and Oncological Informed Surgery.

José Pedro Lavrador, Francesco Marchi, Ali Elhag, Nida Kalyal, Engelbert Mthunzi, Mariam Awan, Oliver Wroe-Wright, Alba Díaz-Baamonde, Ana Mirallave-Pescador, Zita Reisz and 4 more

Abstract read
In one paragraph

Article in Biomedicines, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Review
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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

14 authors.

José Pedro LavradorDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.ORCID 0000-0002-9518-111X
Francesco MarchiDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.ORCID 0000-0001-6532-7168
Ali ElhagDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Nida KalyalDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.ORCID 0000-0002-1408-1396
Engelbert MthunziDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Mariam AwanDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Oliver Wroe-WrightDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Alba Díaz-BaamondeDepartment of Neurophysiology, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.ORCID 0000-0002-1256-516X
Ana Mirallave-PescadorDepartment of Neurophysiology, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Zita ReiszDepartment of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Richard GullanDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Francesco VerganiDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Keyoumars AshkanDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Ranjeev BhangooDepartment of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectives5-aminulevulinic acid (5-ALA)-guided surgery for high-grade gliomas remains a challenge in neuro-oncological surgery. Inconsistent fluorescence visualisation, subjective quantification and false negatives due to blood, haemostatic agents or optical impediments from the external light source are some of the limitations of the present technology.

methodsThe preliminary results from this single-centre retrospective study are presented from the first 35 patients operated upon with the novel Nico Myriad Spectra System©. The microdebrider (Myriad) with an additional in situ light system (Spectra) can alternately provide white and blue light (405 nm) to within 15 mm of the tissue surface to enhance the morphology of the anatomical structures and the fluorescence of the pathological tissues.

resultsA total of 35 patients were operated upon with this new technology. Eight patients (22.85%) underwent tubular retractor-assisted minimally invasive parafascicular surgery (tr-MIPS). The majority had high-grade gliomas (68.57%). Fluorescence was identified in 30 cases (85.71%), with residual fluorescence in 11 (36.66%). The main applications were better white-blue light alternation and visualisation during tr-MIPS, increase in the extent of resection at the border of the cavity, identification of satellite lesions in multifocal pathology, the differentiation between radionecrosis and tumour recurrence in redo surgery and the demarcation between normal ependyma versus pathological ependyma in tumours infiltrating the subventricular zone.

conclusionsThis proof-of-concept study confirms that the novel in situ light-source delivery technology integrated with the usual intraoperative armamentarium provides a spatially, functionally and oncologically informed framework for glioblastoma surgery. It allows for the enhancement of the morphology of anatomical structures and the fluorescence of pathological tissues, increasing the extent of resection and, possibly, the prognosis for patients with high-grade gliomas.

Indexed as

5-ALAblue-light sourceglioblastomaGliolanMIPSNico MyriadSpectrasurgery

Identifiers

PMID39767656
PMCPMC11673840

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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.