Intra-axial Supratentorial Tumours Resection under Fluorescein Guidance with 560 nm Yellow Filter: A Cross-sectional Study

Introduction: Excision of intra-axial tumours with maximal resection and minimal deficits is one of the intricate procedures in neurosurgery. Fluorescence-guided Surgery (FGS) helps in better identification of tumour tissue and allows Maximal Safe Resection (MSR) of high-grade brain tumours. Sodium fluorescein dye, when injected intravenously, gets concentrated in High-grade Glioma (HGG) tissue due to a disrupted Blood-Brain Barrier (BBB), thus aiding in MSR, Extent Of Resection (EOR), and Gross Total Resection (GTR). Aim: To assess the effectiveness of intraoperative use of sodium fluorescein in achieving MSR and GTR. Materials and Methods: This was a cross-sectional study conducted on 30 patients with HGG who underwent surgery between January 2021 and May 2023 at SDM College of Medical Sciences, Dharwad, Karnataka, India. Two groups of 15 patients each were divided into those operated with the use of Fluorescein Sodium (FS) and those without FS. FS was administered at a dose of 5 mg/kg at the time of craniotomy. The primary endpoint was the number of patients with Histopathological Examination (HPE)-confirmed HGGs showing no contrast-enhancing tumour in the immediate postoperative Magnetic Resonance Imaging (MRI). Secondary endpoints included residual tumours on postoperative MRI, Focal Neurological Deficits (FND), and FS-related toxicity. The association between FS status and recurrence at different treatment time points was assessed using the Pearson Chi-square test. Recurrence rates were compared in each FS group using the Cochran Q test. Statistical significance was set at a 5% level (p-value