NIMG-49. INTRAOPERATIVE 5-ALA INTENSITY ANALYSIS OF GLIOMA USING IMAGE J

Abstract PURPOSE: The 5 aminolevulinic acid (5-ALA) is used for intraoperative tumor visualization in neurosurgery. We hypothesized that glioma may vary in malignancy according to the brightness of 5-ALA. We quantified the brightness of 5-ALA and compared it with the pathological results of glioma. MATERIALS AND METHODS: From 2019 to 2023, we investigated 35 glioma patients who underwent surgery with 5-ALA. Twenty-three cases of glioblastoma (GBM), four cases of anaplastic astrocytoma (AA), three cases of oligodendroglioma (OL), one case of anaplastic oligodendroglioma (AO), and four cases of low grade glioma (LGG) were examined. The pathological diagnosis was based on classification of WHO 2016. The 5-ALA was administered before surgery, and the 5-ALA brightness were quantified. RESULTS: In GBM, the mean brightness was 134.5 ± 65.4, except for one negative case. AA showed the mean brightness with 180.5 ± 51.6. Three cases of OL showed the mean brightness with 78.6 ± 32.7. AO showed the brightness with 153. All LGGs showed negative in the brightness. CONCLUSION: The 5-ALA showed higher brightness in GBM , AA, AO and negative in LGG. In the future, we will accumulate cases and add further studies.