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Fluorescence guided surgical resection is based on the basic principle that
photosensitizers are preferentially taken up and retained by cancer cells and the these
sensitizers absorb light in one band of the light spectrum and release the energy as
fluorescence that can be visualised in a different band of the spectrum. This study reports
fluorescence outcome of 110 consecutive intracranial tumors to identify its potential
benefits during fluorescence guided resection (FGR). The specificity of this technique
was very high with no false positive results. Its sensitivity varied from 83.7% in brain
lung metastasis to 85.7% in glioblastomas. A wide range of other intracranial tumors
were also studied but the numbers in each of these subgroups were small to deduct its
usefulness. However, grade III astrocytomas, primary cerebral lymphoma and
meningiomas fluoresced very well in all patients. FGR would be therefore very useful aid
during a wide range of intracranial tumor surgery with the advantages of specificity, high
sensitivity and would not be affected by brain shift and tumor removal. The limitations of
this technique were that the sensitivity was not 100% and it would be possible to miss 15% of tumors, blood can also obscure the fluorescence and it would be a problem in
vascular tumors, and photo bleaching can reduce the fluorescence.
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