5-ALA induced PpIX fluorescence spectroscopy in neurosurgery: a review

A Gautheron; J D Bernstock; T Picart; J Guyotat; P A Valdés; B Montcel

doi:10.3389/fnins.2024.1310282

5-ALA induced PpIX fluorescence spectroscopy in neurosurgery: a review

Front Neurosci. 2024 Jan 29:18:1310282. doi: 10.3389/fnins.2024.1310282. eCollection 2024.

Authors

A Gautheron^{1

2}, J D Bernstock^{3

4}, T Picart^{5

6}, J Guyotat⁵, P A Valdés^{7

8

9}, B Montcel²

Affiliations

¹ Université Jean Monnet Saint-Etienne, CNRS, Institut d Optique Graduate School, Laboratoire Hubert Curien UMR 5516, Saint-Étienne, France.
² Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France.
³ Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
⁴ David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States.
⁵ Department of Neurosurgical Oncology and Vascular Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France.
⁶ Université Lyon 1, INSERM 1052, CNRS 5286, Lyon, France.
⁷ Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, United States.
⁸ Department of Neurobiology, University of Texas Medical Branch, Galveston, TX, United States.
⁹ Department of Electrical and Computer Engineering, Rice University, Houston, TX, United States.

Abstract

The review begins with an overview of the fundamental principles/physics underlying light, fluorescence, and other light-matter interactions in biological tissues. It then focuses on 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence spectroscopy methods used in neurosurgery (e.g., intensity, time-resolved) and in so doing, describe their specific features (e.g., hardware requirements, main processing methods) as well as their strengths and limitations. Finally, we review current clinical applications and future directions of 5-ALA-induced protoporphyrin IX (PpIX) fluorescence spectroscopy in neurosurgery.

Keywords: 5-aminolevulinic acid (5-ALA); brain tumors; fluorescence guided surgery; fluorescence spectroscopy; image guidance; neurooncology; neurosurgery; protoporphyrin IX (PpIX).

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work has been funded in part by a public grant from the French National Research Agency (ANR) under the “France 2030” investment plan, which has the reference EUR MANUTECH SLEIGHT—ANR-17-EURE-0026 (BM); in part by the Université de Lyon through program LABEX PRIMES under Grant ANR-11-LABX-0063 within the program Investissements d’Avenir under Grant ANR-11-IDEX-0007, operated by the French National Research Agency (BM); in part by France Life Imaging under Grant ANR-11-INBS-0006 within the program Infrastructures d’Avenir en Biologie Santé, operated by the French National Research Agency (BM); and in part by a Cancer Prevention Research Institute of Texas Early Clinical Investigator grant # RP220581 (PV) and National Institutes of Health Trailblazer grant # 5R21EB034033 (PV).