Letter: Intraoperative Near-Infrared Optical Imaging Can Localize Gadolinium-Enhancing Gliomas During Surgery

摘要

Copyright © 2017 by the Congress of Neurological SurgeonsTo the Editor:We enjoyed reading the recent paper by Lee et al.1 The authors are to be congratulated for this impressive study, which confirms that intraoperative optical imaging is the potential to overcome previous intraoperative tool limitations....Indocyanine green has been used here as a near-infrared dye—the authors pointing out that 5-aminolevulinic acid (5-ALA) does not have Food and Drug Administration approval—because indocyanine green is cheap, does not present major contraindications, and is already used for several years in vascular neurosurgery. These practical advantages have important drawbacks: the near-infrared imaging failed to detect tumor in 20% of the series (3 patients out of 15 patients, 2 WHO grade II, 1 WHO grade III) and its specificity was almost half of white light alone. The authors reported that 5-ALA also exhibited limitations as a diagnostic test.2 It is obviously...