{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:20:56Z","timestamp":1783776056271,"version":"3.55.0"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Complete resection of skull base meningiomas provides patients with the best chance for a cure; however, surgery is frequently difficult given the proximity of lesions to vital structures, such as cranial nerves, major vessels, and venous sinuses. Accurate discrimination between tumor and normal tissue is crucial for optimal tumor resection. Qualitative assessment of protoporphyrin IX (PpIX) fluorescence following the exogenous administration of 5-aminolevulinic acid (ALA) has demonstrated utility in malignant glioma resection but limited use in meningiomas. Here the authors demonstrate the use of ALA-induced PpIX fluorescence guidance in resecting a skull base meningioma and elaborate on the advantages and disadvantages provided by both quantitative and qualitative fluorescence methodologies in skull base meningioma resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 52-year-old patient with a sphenoid wing WHO Grade I meningioma underwent tumor resection as part of an institutional review board\u2013approved prospective study of fluorescence-guided resection. A surgical microscope modified for fluorescence imaging was used for the qualitative assessment of visible fluorescence, and an intraoperative probe for in situ fluorescence detection was utilized for quantitative measurements of PpIX. The authors assessed the detection capabilities of both the qualitative and quantitative fluorescence approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient harboring a sphenoid wing meningioma with intraorbital extension underwent radical resection of the tumor with both visibly and nonvisibly fluorescent regions. The patient underwent a complete resection without any complications. Some areas of the tumor demonstrated visible fluorescence. The quantitative probe detected neoplastic tissue better than the qualitative modified surgical microscope. The intraoperative probe was particularly useful in areas that did not reveal visible fluorescence, and tissue from these areas was confirmed as tumor following histopathological analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fluorescence-guided resection may be a useful adjunct in the resection of skull base meningiomas. The use of a quantitative intraoperative probe to detect PpIX concentration allows more accurate determination of neoplastic tissue in meningiomas than visible fluorescence and is readily applicable in areas, such as the skull base, where complete resection is critical but difficult because of the vital structures surrounding the pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2011.2.focus1112","type":"journal-article","created":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T10:40:44Z","timestamp":1482835244000},"page":"E8","source":"Crossref","is-referenced-by-count":56,"title":["Quantitative and qualitative 5-aminolevulinic acid\u2013induced protoporphyrin IX fluorescence in skull base meningiomas"],"prefix":"10.3171","volume":"30","author":[{"given":"Kimon","family":"Bekelis","sequence":"first","affiliation":[{"name":"Section of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo A.","family":"Vald\u00e9s","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering, Hanover;"},{"name":"Dartmouth Medical School, Hanover, New Hampshire;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadir","family":"Erkmen","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Leblond","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering, Hanover;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Kim","sequence":"additional","affiliation":[{"name":"Ontario Cancer Institute, University of Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Ontario Cancer Institute, University of Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent T.","family":"Harris","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Neurology, Georgetown University Medical Center, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith D.","family":"Paulsen","sequence":"additional","affiliation":[{"name":"Thayer School of Engineering, Hanover;"},{"name":"Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery and"},{"name":"Dartmouth Medical School, Hanover, New Hampshire;"},{"name":"Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0300008","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/jns.2004.101.2.0210","article-title":"Malignant progression in meningioma: documentation of a series and analysis of cytogenetic findings","volume":"101","author":"Al-Mefty","year":"2004"},{"key":"b2-0300008","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s007010050398","article-title":"Risk factors predicting recurrence in patients operated on for intracranial meningioma. 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