Fluorescence-guided resection of cerebral tumours

Traditionally, cerebral tumours were operated through a microscope under white light. In recent years, MRI used for peroperative navigation and techniques of colour-visualising the malignant tissue have made resection more precise, radical and safe. However, 5-aminolevulinic acid has been shown to increase neurological deficit due to supramarginal resection. Two widely used substances for tumour-visualisation are 5-aminolevulinic and sodium fluorescein. Both have shown an increased rate of resection compared with white light, but the evidence towards 5-aminolevulinic acid is strongest.