Marymol Koshy
University Technology Mara, Malaysia
Title: USEFULNESS OF FLUORESCENCE-GUIDED-SURGERY IN ACHIEVING GROSS TOTAL RESECTION OF MALIGNANT GLIOMA: EVALUATION USING MR VOLUMETRIC STUDY
Biography
Biography: Marymol Koshy
Abstract
Malignant gliomas are highly infiltrative and aggressive primary brain tumors. Intraoperatively the extent of resection of the tumor is believed to be key prognostic factor, however there is no distinct margin between the tumor mass and surrounding oedematous brain. Achieving gross total resection (GTR) using conventional white light microsurgical technique is a challenge. 5-aminolevulinic acid (5-ALA) can be used as an adjunct for the surgery of adult malignant glioma and improves the rate of gross total resection and patient survival. The department of neurosurgery, Sungai Buloh Hospital is the first public hospital in Malaysia to adopt fluorescence guided surgery using 5-ALA. Application of early pre and post operative MR is also done to assess the volumetric extent of resection. The findings in this study demonstrates the enormous potential of 5-ALA for visualization of tumor tissue intraoperatively. Fluorescence-guided surgery enabled a GTR in 100% patients. Performing early postoperative MR imaging yielded reliable and accurate information in detecting residual tumor. However due to small sample, the study was underpowered, and thus, did not reach statistical significance. We advocate to increase the sample size, which in turn will increase the power of the statistical analysis. The application of 5-ALA has a great potential as a novel standard in neurosurgery in Malaysia to maximize tumor resections for malignant gliomas.