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It remained unclear, however, to what extent inter\u2010 and intra\u2010tumoural differences of PpIX concentrations influence the efficacy of iPDT. In the current pilot study, we analysed PpIX concentrations quantitatively and assessed PpIX induced fluorescence and photobleaching intraoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Five patients harbouring non\u2010resectable glioblastomas were included. ALA (20 or 30\u2009mg\/kg body weight) was given 5\u20138\u2009hours before treatment. Stereotactic biopsies were taken throughout the tumour volume for both histological analysis and determination of PpIX concentrations, which were measured by chemical extraction. Cylindrical light diffusors were stereotactically implanted. Prior to and after irradiation, fluorescence measurements were performed. Outcome measurement was based on clinical and neuro\u2010radiological follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In three patients, a strong PpIX fluorescence was seen before treatment, which was completely photobleached after iPDT. High concentrations of PpIX could be detected in viable tumour parts of these patients (mean PpIX uptake per tumour: 1.4\u20133.0\u2009\u00b5M). In the other two patients, however, no or only low PpIX uptake (0\u20130.6\u2009\u00b5M) could be detected. The patients with strong PpIX uptake showed treatment response and long\u2010term clinical stabilisation (no progression in 29, 30 and 36 months), early treatment failure was seen in the remaining two patients (death after 3 and 9 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intra\u2010tumoural PpIX concentrations exhibited pronounced inter\u2010 and intra\u2010tumoural variations in glioblastoma, which are directly linked to variable degrees of fluorescence intensity. High intra\u2010tumoural PpIX concentrations with strong fluorescence intensity and complete photobleaching after iPDT seem to be associated with favourable outcome. Real\u2010time monitoring of PpIX fluorescence intensity and photobleaching turned out to be feasible and safe and might be employed for early treatment prognosis of iPDT. Lasers Surg. Med. 9999:XX\u2013XX, 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.22126","type":"journal-article","created":{"date-parts":[[2013,3,26]],"date-time":"2013-03-26T15:19:56Z","timestamp":1364311196000},"page":"225-234","source":"Crossref","is-referenced-by-count":114,"title":["Protoporphyrin <scp>IX<\/scp> Fluorescence and Photobleaching During Interstitial Photodynamic Therapy of Malignant Gliomas for Early Treatment Prognosis"],"prefix":"10.1002","volume":"45","author":[{"given":"Ann","family":"Johansson","sequence":"first","affiliation":[{"name":"Laser\u2010Forschungslabor University Hospital of Munich Marchioninistra\u00dfe 23 81377 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University Hospital of Munich Marchioninistra\u00dfe 15 81377 Munich 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