부산대학교 도서관

The usefulness of photodynamic diagnosis (PDD) with 5-aminolevulinic acid (5-ALA) for brain tumors has already been recognized, and in Japan, the preoperative administration of 5-ALA formulation for malignant gliomas was approved by insurance in 2013 with the intent to improve the removal rate. We have performed 5-ALA-PDD for various brain tumors for many years and have used quantitative evaluation of fluorescence intensity by spectral analysis (measurement with a fluorometer) in addition to the conventional subjective evaluation of fluorescence strength by the surgeon (three-step evaluation by the naked eye). In this paper, we first describe the fluorescence intensity of 5-ALA exposure in brain tumors other than gliomas. Second, we identify the characteristics and usefulness of 5-ALA-PDD in metastatic brain tumors, which are increasing among brain tumors. Finally, we introduce navigation-guided needle biopsy, which has been previously performed, including the use of auxiliary light sources. Although the mechanism of 5-ALA-induced fluorescence in brain tumors is still unclear, we will review our data to further develop 5-ALA-PDD in clinical practice.