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13 March 2024 δ-Aminolevulinic Acid (ALA) in fluorescence guided surgery
Brian W. Pogue
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Proceedings Volume PC12825, Molecular-Guided Surgery: Molecules, Devices, and Applications X; PC1282501 (2024) https://doi.org/10.1117/12.3012664
Event: SPIE BiOS, 2024, San Francisco, California, United States
Abstract
Aminolevulinic acid is a naturally occurring small protein that is widely utilized in most cells of the body as a building block for heme synthesis. While is has many uses in medicine, the most seminal change in its use came in the 1990s with the adoption of it as a topical agent that led to production of the photosensitizer protoporphyrin IX, within dermatology lesions such as actinic keratoses. The PpIX allows for effective photodynamic therapy treatment of many lesions, not just in the skin but in many squamous tissues, bacteria, and even some solid tumors. The administration routes approved for human use now include topical, intravesical, and oral, with it being used as a fluorescent guide to surgical resection. The use in bladder cancer resection has been adopted for decades, although its acceptance in the urology surgery community remains controversial. The use in glioma resection has been approved for nearly a decade and its adoption within the neurosurgery community is steadily growing. Recent data has shown that PpIX also has a delayed fluorescence which originates in the absence of oxygen to quench the triplet state, and so it provides a unique way to visualize hypoxia.
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Brian W. Pogue "δ-Aminolevulinic Acid (ALA) in fluorescence guided surgery", Proc. SPIE PC12825, Molecular-Guided Surgery: Molecules, Devices, and Applications X, PC1282501 (13 March 2024); https://doi.org/10.1117/12.3012664
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KEYWORDS
Medical imaging
Resection
Proteins
Quenching
Skin
Solids
Surgery
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