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New Advances in Glioma Surgery

In This Video

  • Fluorescence-guided glioma surgery, recently approved by the FDA, allows surgeons to detect tumors as a fluorescent entity to distinguish them very clearly from normal brain
  • Intraoperative molecular diagnostics, pioneered at Massachusetts General Hospital, is a new technique that aids our pathologists in identifying specifically the molecular subtype of a tumor in the operating room
  • Personalizing the operating room with the appropriate therapies beyond surgery allows surgeons to achieve better outcomes for patients

Bob S. Carter, MD, PhD, chief of the Department of Neurosurgery at Massachusetts General Hospital, discusses fluorescence-guided glioma surgery, recently approved by the FDA. In this video, Dr. Carter elaborates on intraoperative molecular diagnostics, a technique pioneered at Mass General to molecularly subtype a tumor in the operating room.

Transcript

One of the new advances in glioma surgery pioneered here at Mass General is fluorescence-guided glioma surgery. In this particular treatment modality, only recently approved by the FDA, patients drink a solution prior to surgery which contains a fluorescent metabolite. At the time of surgery, under the microscope, our surgeons are able to detect the tumor as a fluorescent entity. The surgeon, using special filters on this microscope is allowed to see the tumor in a fluorescent fashion. This allows us to specifically highlight regions of tumor and distinguish them very clearly from normal brain. By doing this, we're able to preserve function, such as critical motor or speech function, which may be located near the tumor. We call this fluorescence-guided surgery a significant advance in our ability to separate the normal brain from tumor tissue, reserving function and maximizing tumor resection at the same time.

One of the other advances pioneered here at Mass General is intraoperative molecular diagnostics. This is a new technique which aids our pathologists in helping us to identify specifically the molecular subtype of a tumor in the operating room. In the intraoperative molecular diagnostic technique, a small sample of tumor tissue is taken at the time of surgery and immediately processed by QPCR, polymerase chain reaction. This allows us to determine which mutations are harbored by the tumor itself and direct specific therapies to these tumors. By personalizing in the operating room the appropriate adjunctive therapies beyond surgery we feel that we are able to achieve better outcomes for our patients.

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