Surgical removal of
tumor mass is a common approach in the management of
brain tumors. However, the precise delineation of normal tissue from
tumor tissue for a complete resection of
tumor mass in
brain tumor surgery remains a difficult task for neurosurgeons.
Aminolevulinic acid (ALA)-mediated exgogenous fluorescence of
protoporphyrin IX (
PpIX) is a sensitive approach for
tumor imaging. Recent studies suggest that the use of ALA/
PpIX-mediated fluorescence-guided resection (FGR) or fluorescence-guided surgery can enable more accurate and complete resection of
brain tumors, especially when used in quantitative fashion. This review will highlight the current progress in
PpIX-mediated FGR and discuss technical challenges in intraoperative quantification of intracellular
PpIX fluorescence during FGR of
brain tumor.