Characterizing the heterogeneity in 5-aminolevulinic acid-induced fluorescence in glioblastoma.

Abstract:

OBJECTIVE:5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence is an effective surgical adjunct for the intraoperative identification of tumor tissue during resection of high-grade gliomas. The use of 5-ALA-induced PpIX fluorescence in glioblastoma (GBM) has been shown to double the extent of gross-total resection and 6-month progression-free survival. The heterogeneity of 5-ALA-induced PpIX fluorescence observed during surgery presents a technical and diagnostic challenge when utilizing this tool intraoperatively. While some regions show bright fluorescence after 5-ALA administration, other regions do not, despite that both regions of the tumor may be histopathologically indistinguishable. The authors examined the biological basis of this heterogeneity using computational methods. METHODS:The authors collected both fluorescent and nonfluorescent GBM specimens from a total of 14 patients undergoing surgery and examined their gene expression profiles. RESULTS:In this study, the authors found that the gene expression patterns characterizing fluorescent and nonfluorescent GBM surgical specimens were profoundly different and were associated with distinct cellular functions and different biological pathways. Nonfluorescent tumor tissue tended to resemble the neural subtype of GBM; meanwhile, fluorescent tumor tissue did not exhibit a prominent pattern corresponding to known subtypes of GBM. Consistent with this observation, neural GBM samples from The Cancer Genome Atlas database exhibited a significantly lower fluorescence score than nonneural GBM samples as determined by a fluorescence gene signature developed by the authors. CONCLUSIONS:These results provide a greater understanding regarding the biological basis of differential fluorescence observed intraoperatively and can provide a basis to identify novel strategies to maximize the effectiveness of fluorescence agents.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Almiron Bonnin DA,Havrda MC,Lee MC,Evans L,Ran C,Qian DC,Harrington LX,Valdes PA,Cheng C,Amos CI,Harris BT,Paulsen KD,Roberts DW,Israel MA

doi

10.3171/2019.2.JNS183128

subject

Has Abstract

pub_date

2019-05-24 00:00:00

pages

1706-1714

issue

6

eissn

0022-3085

issn

1933-0693

pii

2019.2.JNS183128

journal_volume

132

pub_type

杂志文章
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    doi:10.3171/jns.2002.96.5.0918

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    更新日期:2002-05-01 00:00:00

  • Local distribution and toxicity of prolonged hippocampal infusion of muscimol.

    abstract:OBJECT:The activity of gamma-aminobutyric acid (GABA), the principal inhibitory neurotransmitter, is reduced in the hippocampus in patients with complex partial seizures from mesial temporal sclerosis. To provide preliminary safety and distribution data on using convection-enhanced delivery of agents to treat complex p...

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    doi:10.3171/jns.2005.103.6.1035

    authors: Heiss JD,Walbridge S,Morrison P,Hampton RR,Sato S,Vortmeyer A,Butman JA,O'Malley J,Vidwan P,Dedrick RL,Oldfield EH

    更新日期:2005-12-01 00:00:00

  • Injury to the head and spinal cord. The epidemiological relevance of the medical literature published from 1960 to 1978.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Kraus JF

    更新日期:1980-11-01 00:00:00

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    doi:10.3171/jns.1986.64.1.0151

    authors: Nugent P,Hoshek S

    更新日期:1986-01-01 00:00:00

  • Polymorphism rs42524 of COL1A2 and sporadic intracranial aneurysms in the Chinese population.

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    doi:10.3171/JNS.2008.109.12.1060

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  • Barbiturate coma in focal cerebral ischemia. Relationship of protection to timing of therapy.

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    pub_type: 杂志文章

    doi:10.3171/jns.1982.56.5.0685

    authors: Selman WR,Spetzler RF,Roski RA,Roessmann U,Crumrine R,Macko R

    更新日期:1982-05-01 00:00:00

  • Induction of hypercontractility in human cerebral arteries by rewarming following hypothermia: a possible role for tyrosine kinase.

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    doi:10.3171/jns.1997.87.3.0431

    authors: Sagher O,Huang DL,Webb RC

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  • Aneurysmal bone cyst of the skull. Case report.

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    doi:10.3171/jns.1977.47.4.0633

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    更新日期:1977-10-01 00:00:00

  • A bacteriological study of craniocerebral missile wounds from Vietnam.

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    doi:10.3171/jns.1971.34.2part1.0145

    authors: Carey ME,Young H,Mathis JL,Forsythe J

    更新日期:1971-02-01 00:00:00

  • The Vanderbilt University neurosurgical heritage.

    abstract::The Vanderbilt University Hospital heritage was influenced by the excellence of the Johns Hopkins era--by Osler, Halsted, Cushing, Brooks, and many others. Upon this strong origin, the neurosurgery department was built by Cobb Pilcher and perpetuated by William F. Meacham. ...

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    doi:10.3171/jns.1993.79.3.0464

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    更新日期:1993-09-01 00:00:00

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    authors: Chalouhi N,Whiting A,Anderson EC,Witte S,Zanaty M,Tjoumakaris S,Gonzalez LF,Hasan D,Starke RM,Hann S,Ghobrial GM,Rosenwasser R,Jabbour P

    更新日期:2014-10-01 00:00:00

  • Risk of bleeding from unruptured aneurysm in cases with multiple intracranial aneurysms.

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    pub_type: 杂志文章

    doi:10.3171/jns.1981.55.4.0524

    authors: Heiskanen O

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  • Surgical management of camptocormia in Parkinson's disease: systematic review and meta-analysis.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,meta分析

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    更新日期:1994-08-01 00:00:00

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    doi:10.3171/jns.1999.91.1.0051

    authors: Muizelaar JP,Zwienenberg M,Rudisill NA,Hecht ST

    更新日期:1999-07-01 00:00:00

  • Neuronal heterotopia with capillary penetration of neurons and cortical dysplasia in a patient with complex partial seizures. Case report.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1993.78.4.0654

    authors: Jay V,Becker LE,Otsubo H,Hwang P,Hoffman HJ,Armstrong DC

    更新日期:1993-04-01 00:00:00

  • Neuroepithelial (colloid) cysts of the septum pellucidum.

    abstract::The authors present two cases of neuroepithelial (colloid) cysts found above the diencephalic roof, occupying the space between the two fornices and the two leaves of the septum pellucidum, and describe the clinical history, neurological, and neuroradiological findings. Both lesions were removed through a right transv...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1975.43.1.0069

    authors: Ciric I,Zivin I

    更新日期:1975-07-01 00:00:00

  • Meningiomas causing spontaneous intracranial hematomas.

    abstract::Four cases of spontaneous intracranial hematomas caused by unsuspected meningiomas are reported. Nine previous cases were found in the literature and the entire series of 13 cases is reviewed. Because of their unusual clinical presentation, these cases were not diagnosed correctly prior to radiological studies. Hypert...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1976.45.4.0437

    authors: Modesti LM,Binet EF,Collins GH

    更新日期:1976-10-01 00:00:00

  • Anomalies of the posterior communicating artery and their potential clinical significance.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1984.60.3.0572

    authors: Bisaria KK

    更新日期:1984-03-01 00:00:00

  • Results of gamma knife surgery for Cushing's disease.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

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    authors: Sheehan JP,Xu Z,Salvetti DJ,Schmitt PJ,Vance ML

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  • Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

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    authors: Komatsu F,Imai M,Shigematsu H,Aoki R,Oda S,Shimoda M,Matsumae M

    更新日期:2018-06-01 00:00:00

  • Computed tomography angiography, perfusion computed tomography, and a drug-eluting stent for the treatment of in-stent restenosis of the middle cerebral artery.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

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    更新日期:2010-04-01 00:00:00

  • Primary visual cortical thickness in correlation with visual field defects in patients with pituitary macroadenomas: a structural 7-Tesla retinotopic analysis.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

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    更新日期:2019-10-18 00:00:00

  • Prediction of survival in glioma patients by means of positron emission tomography.

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    pub_type: 杂志文章

    doi:10.3171/jns.1985.62.6.0816

    authors: Patronas NJ,Di Chiro G,Kufta C,Bairamian D,Kornblith PL,Simon R,Larson SM

    更新日期:1985-06-01 00:00:00

  • Ganglioglioma presenting as a vascular lesion in a 10-year-old boy. Case report.

    abstract::The authors present the case of a 10-year-old boy admitted for evaluation of a generalized seizure and a history of headaches. Computerized tomography (CT) and gadolinium-enhanced magnetic resonance (MR) imaging demonstrated a large nonhomogeneous contrast-enhancing mass of the left frontal lobe, with a large cystic c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1993.79.6.0920

    authors: Baltuch GH,Farmer JP,Meagher-Villemure K,O'Gorman AM,Montes JL

    更新日期:1993-12-01 00:00:00

  • A historical case of beaten-copper cranium.

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    journal_title:Journal of neurosurgery

    pub_type: 历史文章,杂志文章

    doi:10.3171/ped.2007.106.1.71

    authors: Rühli FJ,Nicklisch N,Alt KW

    更新日期:2007-01-01 00:00:00

  • Atorvastatin reduction of intravascular thrombosis, increase in cerebral microvascular patency and integrity, and enhancement of spatial learning in rats subjected to traumatic brain injury.

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    doi:10.3171/jns.2004.101.5.0813

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    更新日期:2004-11-01 00:00:00

  • CSF dynamics and pressure-volume relationships in communicating hydrocephalus.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.1.0045

    authors: Kosteljanetz M

    更新日期:1986-01-01 00:00:00

  • Endovascular treatment of ruptured dissecting aneurysms aimed at occlusion of the dissected site by using Guglielmi detachable coils.

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    doi:10.3171/jns.1999.90.5.0853

    authors: Yamaura I,Tani E,Yokota M,Nakano A,Fukami M,Kaba K,Matsumoto T

    更新日期:1999-05-01 00:00:00

  • Resection and brain brachytherapy with permanent iodine-125 sources for brain metastasis.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.4.JNS152530

    authors: Raleigh DR,Seymour ZA,Tomlin B,Theodosopoulos PV,Berger MS,Aghi MK,Geneser SE,Krishnamurthy D,Fogh SE,Sneed PK,McDermott MW

    更新日期:2017-06-01 00:00:00