Efficacy of fluorescence-guided techniques compared to conventional methods: a comprehensive review

Abstract

Background: Glioblastoma (GBM) is a highly aggressive brain tumour with a poor prognosis. Surgical resection, aimed at achieving maximal safe resection, is crucial for improving patient outcomes. Conventional surgical techniques often fall short in accurately delineating tumour margins, necessitating advancements such as fluorescence-guided surgery (FGS). Objectives: This review aims to compare the effectiveness of advanced fluorescence-guided surgery with conventional surgical techniques in newly diagnosed glioblastoma patients, focusing on complete resection rates and postoperative complications. Methods: A systematic literature search was conducted to identify peer-reviewed articles, clinical trials, meta-analyses, and systematic reviews published in English within the last 15 years. Studies involving newly diagnosed glioblastoma patients and comparing FGS with conventional techniques were included. Data on complete resection rates and postoperative complications were extracted and analyzed. Discussions: The review findings indicate that FGS, particularly with 5-aminolevulinic acid (5-ALA) and fluorescein sodium, significantly improves complete resection rates and may reduce postoperative complications compared to conventional methods. The enhanced visualization of tumor margins facilitates more precise resection, potentially leading to better patient outcomes. However, challenges such as the variability in fluorophore efficacy and the cost of FGS technology remain. Further research is needed to optimize FGS and validate its long-term benefits.