10054-STMO-1 5-ALA INTENSITY ANALYSIS OF NON-NEOPLASTIC LESIONS BY IMAGE J

Abstract PURPOSE We used 5-ALA during surgery for malignant brain tumors, and analyzed the brightness using Image J for positive findings during surgery. We report on three cases that were positive for intraoperative 5-ALA and had high brightness but were diagnosed as non-tumor, including the results of brightness analysis by Image J. METHODS 5-ALA was administered according to the protocol, and intraoperative 5-ALA-positive findings were analyzed with Image J (Wayne Rasband: NIH), brightness was measured with histograms, and maximum brightness was compared. RESULTS Case 1 was suspected malignant tumor before surgery, but the diagnosis was inflammation, different from lymphoma. The intraoperative maximum brightness was as high as 239, but there was no finding of' blazing fire' characteristic of malignant tumors, and the lesion and its surroundings were uniformly red. Case 2 required differentiation between metastatic brain tumor and radiation necrosis, and case 3 required differentiation between recurrent anaplastic astrocytoma and radiation necrosis, both of which had high intraoperative brightness (113,166). CONCLUSION Measuring the brightness of 5-ALA-positive findings during surgery can help in the rapid pathological diagnosis of tumors and the determination of peripheral edema.