Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam
Objective: The objective of this study was to assess the feasibility, safety, and efficacy of using fluorescein sodium (FS) with the YELLOW 560 nm filter as an adjunct in the resection of high-grade astrocytomas. Methods: Between October 2019 and October 2023, 62 patients diagnosed with high-grade a...
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Elsevier
2025-06-01
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| Series: | Interdisciplinary Neurosurgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751925000489 |
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| author | Anh Minh Nguyen Nguyen Thanh Lam Nguyen Duc Vu Hoa Viet Nguyen Nguyen Phan Thanh Tu Dang Cao Son |
| author_facet | Anh Minh Nguyen Nguyen Thanh Lam Nguyen Duc Vu Hoa Viet Nguyen Nguyen Phan Thanh Tu Dang Cao Son |
| author_sort | Anh Minh Nguyen |
| collection | DOAJ |
| description | Objective: The objective of this study was to assess the feasibility, safety, and efficacy of using fluorescein sodium (FS) with the YELLOW 560 nm filter as an adjunct in the resection of high-grade astrocytomas. Methods: Between October 2019 and October 2023, 62 patients diagnosed with high-grade astrocytoma were prospectively enrolled. Thirty-two patients underwent FS-guided microsurgical resection using a YELLOW 560 nm filter (Group I), and 30 patients underwent standard white-light microsurgical resection (Group II). FS was administered intravenously at a dose of 5–10 mg/kg prior to anesthesia induction. All patients underwent postoperative neurological evaluations and MRI at 72 h, and at 6 and 12 months. The primary endpoint was the accuracy of FS in delineating tumor margins via intraoperative biopsies. Secondary endpoints included extent of resection (EOR) and perioperative safety. Results: Group I was further stratified into Subgroup 1 (non-eloquent area tumors, n = 24) and Subgroup 2 (tumors adjacent to eloquent cortex, n = 8). Mean preoperative tumor volume was 40.97 cm3 in Subgroup 1 and 53.78 cm3 in Subgroup 2. GTR was achieved in 83.3 % of Subgroup 1 but not in Subgroup 2 (mean EOR: 87.47 %). In Group II, 43.3 % achieved GTR. Subgroup 1 showed significantly higher GTR rates than Group II (p = 0.0045). FS-guided margin delineation showed sensitivity of 80.95 %, specificity of 91.48 %, and positive predictive value of 92.72 % across 110 tissue samples. No serious adverse events were noted, except for transient yellow urine discoloration. Conclusions: FS with the YELLOW 560 nm filter is a safe and effective intraoperative tool that enhances tumor visualization and supports maximal safe resection in high-grade astrocytoma surgery, particularly in non-eloquent regions. |
| format | Article |
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| institution | OA Journals |
| issn | 2214-7519 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | Interdisciplinary Neurosurgery |
| spelling | doaj-art-4a32750e2d7f4c7d9d3b9f97809299c02025-08-20T02:15:16ZengElsevierInterdisciplinary Neurosurgery2214-75192025-06-014010203610.1016/j.inat.2025.102036Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in VietnamAnh Minh Nguyen0Nguyen Thanh Lam1Nguyen Duc Vu2Hoa Viet Nguyen3Nguyen Phan Thanh Tu4Dang Cao Son5Department of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet Nam; Department of Neurosurgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, UMP, Viet NamDepartment of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet NamDepartment of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet NamDepartment of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet Nam; Corresponding author at: 215 Hong Bang St., Ward 12, District 5, Ho Chi Minh City, Viet Nam.Department of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet NamDepartment of Neurosurgery, University Medical Center Ho Chi Minh City, UMC, Viet NamObjective: The objective of this study was to assess the feasibility, safety, and efficacy of using fluorescein sodium (FS) with the YELLOW 560 nm filter as an adjunct in the resection of high-grade astrocytomas. Methods: Between October 2019 and October 2023, 62 patients diagnosed with high-grade astrocytoma were prospectively enrolled. Thirty-two patients underwent FS-guided microsurgical resection using a YELLOW 560 nm filter (Group I), and 30 patients underwent standard white-light microsurgical resection (Group II). FS was administered intravenously at a dose of 5–10 mg/kg prior to anesthesia induction. All patients underwent postoperative neurological evaluations and MRI at 72 h, and at 6 and 12 months. The primary endpoint was the accuracy of FS in delineating tumor margins via intraoperative biopsies. Secondary endpoints included extent of resection (EOR) and perioperative safety. Results: Group I was further stratified into Subgroup 1 (non-eloquent area tumors, n = 24) and Subgroup 2 (tumors adjacent to eloquent cortex, n = 8). Mean preoperative tumor volume was 40.97 cm3 in Subgroup 1 and 53.78 cm3 in Subgroup 2. GTR was achieved in 83.3 % of Subgroup 1 but not in Subgroup 2 (mean EOR: 87.47 %). In Group II, 43.3 % achieved GTR. Subgroup 1 showed significantly higher GTR rates than Group II (p = 0.0045). FS-guided margin delineation showed sensitivity of 80.95 %, specificity of 91.48 %, and positive predictive value of 92.72 % across 110 tissue samples. No serious adverse events were noted, except for transient yellow urine discoloration. Conclusions: FS with the YELLOW 560 nm filter is a safe and effective intraoperative tool that enhances tumor visualization and supports maximal safe resection in high-grade astrocytoma surgery, particularly in non-eloquent regions.http://www.sciencedirect.com/science/article/pii/S2214751925000489Flurorescein sodiumAstrocytoma |
| spellingShingle | Anh Minh Nguyen Nguyen Thanh Lam Nguyen Duc Vu Hoa Viet Nguyen Nguyen Phan Thanh Tu Dang Cao Son Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam Interdisciplinary Neurosurgery Flurorescein sodium Astrocytoma |
| title | Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam |
| title_full | Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam |
| title_fullStr | Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam |
| title_full_unstemmed | Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam |
| title_short | Fluorescein sodium for resection of high-grade astrocytoma: A single-center prospective study in Vietnam |
| title_sort | fluorescein sodium for resection of high grade astrocytoma a single center prospective study in vietnam |
| topic | Flurorescein sodium Astrocytoma |
| url | http://www.sciencedirect.com/science/article/pii/S2214751925000489 |
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