Table 3.
Main characteristics and results of studies assessing the predictors and modulators of fluorescence positivity in TDLGGs.
| Study | Design | Effectives | Predictors of Intraoperative Fluorescence |
|---|---|---|---|
| Arita, 2012 [62] |
Prospective, monocentric 11C Methionine PET (WHO 2007) |
11 gliomas, including 2 (18.2%) grade 2 (peripheric samples) |
Fluorescence and 11C-methionine uptake are independently associated with cell density. Fluorescence is associated with proliferation index and cell density. |
| Jaber, 2016 [70] |
Retrospective analysis of a prospectively collected database, monocentric (WHO 2007) |
166 gliomas lacking the typical presentation of glioblastoma 82 (49.4%) grade 2 76 (45.8%) grade 3 8 (4.8%) grade 4 |
Age, tumor grade, tumor volume, contrast enhancement and 18F-FET uptake. |
| Saito, 2017 [63] |
Retrospective, Monocentric (WHO 2007) |
60 gliomas 8 (13.3%) grade 2 17 (28.3%) grade 3 35 (58.3%) grade 4 |
In univariate analysis: IDH1wt, no 1p19 codeletion, proliferation index, tumor margin heterogeneity, contrast enhancement. In multivariate analysis: IDH1wt. |
| Jaber, 2018 [71] |
Retrospective analysis of a prospectively collected database, monocentric (WHO 2016) |
74 DLGGs 12 (16.2%) oligodendrogliomas 62 (13.8%) astrocytomas |
In univariate and multivariate analysis: FET uptake and preoperative contrast enhancement. |
| Goryaynov, 2019bis [64] |
Retrospective, Monocentric (WHO 2016) |
27 gliomas including 22 (81.5%) grade 2 |
Cell density, proliferation index, anti-epileptic drug intake. |
| Widhalm, 2019 [66] |
Prospective, monocentric (WHO 2016) |
22 suspected DLGGs 8 (36%) grade 2 11 (50%) grade 3 3 (14%) grade 4 |
Contrast enhancement, increased cell density. |
| Wadiura, 2020 [65] |
Retrospective, Bicentric (WHO 2016) |
110 suspected DLGGs 65 (59%) grade 2 38 (35%) grade 3 7 (6%) grade 4 |
Dexamethasone/anti-epileptic drugs intake were not independent predictors. |
| Batalov, 2021 [67] |
Retrospective, Monocentric (WHO 2016) |
75 gliomas with CE in 57 (76%) cases: 16 (21.3%) grade 2 13 (17.3%) grade 3 46 (61.4%) grade 4 |
Increased Tumor Blood Flow (assessed by Arterial Spin Labelling) is a predictor of positive fluorescence, both in gliomas with and without contrast enhancement. |
| Kaneko, 2021 [68] |
Retrospective, Monocentric (WHO 2016) |
25 DLGGs initially suspected to be high-grade (24% CE) 8 (32%) oligodendrogliomas 15 (60%) IDHmut and 2 (8%) IDHwt astrocytomas |
In univariate analysis: gadolinium enhancement, proliferation index, 18F-FET PET uptake ratio and ADC-based tumor cellularity In multivariate analysis: proliferation index and 18F FET PET uptake ratio. |
| Hosmann, 2021 [72] | Retrospective, bicentric (WHO 2016) |
59 DLGGs 29 (49%) IDH1mut and 3 (5%) IDH1wt astrocytomas 23 (39%) Oligodendrogliomas 4 (7%) Not otherwise specified |
IDH1wt status significantly more frequent in fluorescent tumors than in non-fluorescent tumors. |
| Müther, 2022 [69] |
Retrospective, Monocentric (WHO 2016) |
179 gliomas 113 (63.1%) grade 2 66 (36.9%) grade 3 |
Contrast enhancement on the MRI, proliferation index. |
| Hosmann, 2023 [73] |
Retrospective, 3 centers (WHO 2016) |
86 DLGGs with CE for 23 (26.7%) cases 56 (65.1%) astocytomas 30 (34.9%) oligodendroliomas |
Contrast enhancement and CD34 expression correlated with fluorescence positivity. |
| TOTAL | Total: Table 1, Table 2 and Table 3 | Positive 5-ALA fluorescence | |
| 659 DLGGs | 19.4% (128/659) DLGGs | ||
| 231 grade 3 (all) | 74.5% (172/231) grade 3 (all) and | ||
| and grade 4 (without CE) gliomas | Grade 4 (without CE) gliomas | ||
CE = Contrast Enhancement, FET = Fluoro-Ethyl-Tyrosine, IDHmut = IDH1 mutated, IDH1wt = IDH1 wild-type, PET = Positron Emission Topography.