• World Neurosurg · Nov 2019

    Is the intensity of the 5-ALA-derived fluorescence related to the light source?

    • Marcel A Kamp, Johannes Knipps, Lisa Margarete Neumann, Hendrik-Jan Mijderwijk, Maxine Dibué-Adjei, Hans-Jakob Steiger, Philipp J Slotty, Marion Rapp, Jan-Frederick Cornelius, and Michael Sabel.
    • Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany. Electronic address: MarcelAlexander.Kamp@med.uni-duesseldorf.de.
    • World Neurosurg. 2019 Nov 1; 131: e271-e276.

    ObjectiveWith the introduction of the 5-aminolevulinic acid (5-ALA) technique, surgical neuro-oncology has made a major advance. 5-ALA fluorescence-guided resection of malignant glioma results in more complete surgical resections and subsequently prolonged survival. However, it remains uncertain how light intensities of the blue light source and 5-ALA-derived fluorescence intensities of the illuminated tissue are connected. The aim of the present study was to compare light intensities of different blue light sources and protoporphyrin (PpIX) fluorescence intensities of PpIX solutions with defined concentrations after illumination with different light sources.Material And MethodsThe light spectrum of 7 different blue light sources and the fluorescence intensity of 2 PpIX solutions (0.15 μg/mL and 5 μg/mL) were quantified after illumination. We compared the Zeiss OPMI Pentero microscope, the Zeiss OPMI Pentero 900 microscope, the Leica M530 OH6 microscope, an endoscope equipped with the 5-ALA technique, a mini-spectrometer equipped with a multi-channel light-emitting diode (LED) source emitting monochromatic light, a modified commercially available LED head lamp, and a commercially available unmodified UV-LED lamp. PpIX fluorescence was quantified in a standardized setup using a mini-spectrometer.ResultsMaximum light intensities of the evaluated light sources were reached at different wavelengths. All tested devices were able to detect PpIX-induced fluorescence. However, the intensity of PpIX fluorescence of the differently concentrated PpIX solutions (0.15 μg/mL and 5 μg/mL) was significantly dependent on the light source used.ConclusionsIntensity of the 5-ALA-derived fluorescence is related to the light source used.Copyright © 2019 Elsevier Inc. All rights reserved.

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