Lighting the Way
November 08, 2019
A hospital in Tennessee has become the first to help treat brain tumors using fluorescence-guided surgery.
Last month, TriStar Centennial in Nashville performed a surgical procedure to remove a glioma, a type of tumor that develops in the glial cells of the brain or spine.
Glial cells are the most abundant cells in the central nervous system (CNS) and provide support and act as insulation for neurons. There are many different types of glial cells, including oligodendrocytes, astrocytes, ependymal cells and microglia.
Gliomas make up about 30 percent of all brain tumors and spinal cord tumors. They also account for 80 percent of malignant, or cancerous, brain tumors.
Treatment protocol for gliomas often includes chemotherapy and radiation, but in some cases, surgery is required to remove the tumor.
But, taking out tumors can be a daunting task.
"Brain tumors can be intricate masses with deep-reaching tentacles," said Dr. Faisal R. Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
That means removal can be difficult.
The Tennessee researchers sought to reduce glioma removal risk with Gleolan ™ [aminolevulinic acid hydrochloride (ALA HCl)], an oral solution patients drink before their brain procedure that fluoresces, or "lights up," when exposed to the blue light filters of a surgical microscope.
By lighting up the tumor, surgeons can see it better, allowing them to remove more of the mass.
Surgeons will use the fluorescent solution for patients with fast-growing, high-grade gliomas.
The researchers hope to increase survival rates for those living with these kinds of tumors.
AXIS Neuromonitoring is working to reduce the risks of brain surgery, too, but in a different way.
AXIS is helping to lower the risk of post-surgical complications after glioma removal and other brain surgery procedures by providing intraoperative neurophysiological monitoring (IONM) services in the operating room.
"IONM gives surgeons real-time information about how every move they make to remove the brain tumor can affect the neural structures of the patient they are working on," said Jahangiri.
To give surgeons this up-to-date information, AXIS places technologists in the operating room to work alongside the surgeon. Instead of operating on the patient, these technologists utilize diagnostic equipment watching for any changes.
"These technologists are looking for any change in nerves and neural structures that could leave the patient with lifelong negative effects," Jahangiri said.
For example, if a surgeon is working to remove a brain tumor, getting too close to some areas could leave a patient without the ability to speak. Getting too close to another area could mean changes in memory and cognition.
"Placing a rod in the spine a certain way could result in potential paralysis or change in gait," Jahanigri said.
By giving surgeons a more in-depth look while they're working, AXIS is helping patients live a life less complicated after their procedure.
"Reducing the risks of surgery can help patients enjoy a higher quality of life," Jahangiri said.
Source: Fox 17. TriStar Centennial is first TN hospital to use fluoresce-guided surgery on brain tumors. 3 October 2019.
