{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:40:29Z","timestamp":1791690029731,"version":"4.3.4"},"reference-count":49,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>(1) Background: Despite many surgical and technological advances, pituitary adenoma surgery is still burdened by non-negligible rates of incomplete tumor resection, mainly due to difficulties in differentiating pathology from normal pituitary tissue. Some fluorescent agents have been recently investigated as intraoperative contrast agents in pituitary surgery. The aim of this study is to evaluate the actual knowledge about the usefulness of such fluorophores with a particular focus on both the pharmacokinetics and pharmacodynamics issues of the pituitary gland. (2) Methods: We reviewed the current literature about fluorophores use in pituitary surgery and reported the first fully endoscopic experience with fluorescein. (3) Results: The studies investigating 5-ALA use reported contrasting results. ICG showed encouraging results, although with some specificity issues in identifying pathological tissue. Low-dose fluorescein showed promising results in differentiating pathology from normal pituitary tissue. Apart from the dose and timing of administration, both the fluorophores\u2019 volume of distribution and the histological variability of the interstitial space and vascular density played a crucial role in optimizing intraoperative contrast enhancement. (4) Conclusions: Both pharmacokinetics and pharmacodynamics issues determine the potential usefulness of fluorophores in pituitary surgery. ICG and fluorescein showed the most promising results, although further studies are needed.<\/jats:p>","DOI":"10.3390\/brainsci11050565","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T22:29:07Z","timestamp":1619648947000},"page":"565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Fluorophores Use in Pituitary Surgery: A Pharmacokinetics and Pharmacodynamics Appraisal"],"prefix":"10.3390","volume":"11","author":[{"given":"Daniele","family":"Bongetta","sequence":"first","affiliation":[{"name":"Neurosurgery Unit, Ospedale Fatebenefratelli-Sacco, 20131 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Tartara","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Istituto Clinico Citt\u00e0 Studi, 20131 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pagella","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Somma","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Universit\u00e0 degli Studi di Napoli Federico II, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilou","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Ospedale Fatebenefratelli-Sacco, 20131 Milano, Italy"},{"name":"Neurosurgery Department, University degli Studi Milano Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-9194","authenticated-orcid":false,"given":"Giuseppe","family":"Di Perna","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, AOC Citt\u00e0 della Scienza e della Salute, 10127 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5440-3276","authenticated-orcid":false,"given":"Francesco","family":"Zenga","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, AOC Citt\u00e0 della Scienza e della Salute, 10127 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cofano","sequence":"additional","affiliation":[{"name":"Department of Neuroscience \u201cRita Levi Montalcini\u201d, University of Turin, 10127 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Garbossa","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, AOC Citt\u00e0 della Scienza e della Salute, 10127 Turin, Italy"},{"name":"Department of Neuroscience \u201cRita Levi Montalcini\u201d, University of Turin, 10127 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-6120","authenticated-orcid":false,"given":"Cesare","family":"Zoia","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/cncr.20412","article-title":"The prevalence of pituitary adenomas: A systematic review","volume":"101","author":"Ezzat","year":"2004","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.3171\/2007.12.17635","article-title":"Endoscopic pituitary surgery: A systematic review and meta-analysis","volume":"111","author":"Tabaee","year":"2009","journal-title":"J. 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