• Arjen Bogaards, Abhay Varma, Sean P Collens, Aihua Lin, Anoja Giles, Victor X D Yang, Juan M Bilbao, Lothar D Lilge, Paul J Muller, and Brian C Wilson.
• Department of Medical Biophysics, Ontario Cancer Institute/University Health Network and University of Toronto, Toronto, Ontario, Canada M5G 2M9.
• Lasers Surg Med. 2004 Jan 1; 35 (3): 181-90.

Background And ObjectivesFluorescence image-guided brain tumor resection is thought to assist neurosurgeons by visualizing those tumor margins that merge imperceptibly into normal brain tissue and, hence, are difficult to identify. We compared resection completeness and residual tumor, determined by histopathology, after white light resection (WLR) using an operating microscope versus additional fluorescence guided resection (FGR).Study Design/Materials And MethodsWe employed an intracranial VX2 tumor in a preclinical rabbit model and a fluorescence imaging/spectroscopy system, exciting and detecting the fluorescence of protoporphyrin IX (PpIX) induced endogenously by administering 5-aminolevulinic acid (ALA) at 4 hours before surgery.ResultsUsing FGR in addition to WLR significantly increased resection completeness by a factor 1.4 from 68+/-38 to 98+/-3.5%, and decreased the amount of residual tumor post-resection by a factor 16 from 32+/-38 to 2.0+/-3.5% of the initial tumor volume.ConclusionsAdditional FGR increased completeness of resection and enabled more consistent resections between cases.Copyright 2004 Wiley-Liss, Inc.

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