Could Fluorescein Staining in Low-Grade Glial Tumors Guide for Peroperative Differentiation of Pathological Types?


Turkish Neurosurgery, vol.33, no.5, pp.847-854, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 5
  • Publication Date: 2023
  • Doi Number: 10.5137/1019-5149.jtn.42622-22.2
  • Journal Name: Turkish Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Page Numbers: pp.847-854
  • Keywords: Fluorescein, Glioma, Isocitrate dehydrogenase
  • Istanbul Gelisim University Affiliated: No


AIM: To define whether characteristics of fluorescein staining help to distinguish low grade gliomas intraoperatively. MATERIAL and METHODS: We studied 46 patients with supratentorial newly diagnosed noncontrast-enhancing LGGs removed by fluorescence guidance under the YELLOW 560 nm filter. Patients who were treated between July 2019 and 2022 were retrospectively analyzed. Clinical data were collected from patient records. Patients’ intraoperative video recordings, pathological examination, and preoperative magnetic resonance imaging (MRI) were analyzed and compared for each patient after the operation. Histopathologically, patients were divided into WHO Grade 2 oligodendrogliomas, diffuse astrocytomas (IDH mutant, 1p19q negative tumors), and pre-glioblastomas (IDH wild type, 1p19q negative tumors). Resection margins were checked using controls contrast-enhanced cranial MRI at the postoperative 24 and72 hours. RESULTS: Our observations indicate that fluorescein primarily stains diffuse astrocytomas (IDH mutant, 1p19q negative tumors) and pre-glioblastomas (IDH wild type, 1p19q negative tumors) rather than WHO Grade 2 oligodendrogliomas. CONCLUSION: Fluorescein staining might be an option to determine tumor borders in WHO Grade 2 glial tumors, particularly for those with a higher malignancy potential.