Compendium

Publications on the use of 5-aminolevulinic acid (5-ALA) in fluorescence-guided surgery

Focusing on neurosurgical indications

7 November 2025 · 10 min read

Compiled by ZEISS Medical Technology

SUMMARY

List of articles about 5-ALA in fluorescence-guided surgery

This literature compendium presents an overview of peer-reviewed publications discussing the use of 5-ALA in fluorescence-guided neurosurgical procedures across various oncological indications. The objective is to compile and share evidence-based medical insights into the application of 5-ALA to support knowledge exchange within the neurosurgical community.

Each publication is based on the author´s own professional opinion or on their study results. It does not necessarily reflect the opinion of Carl Zeiss Meditec AG and may not be in line with the clinical evaluation or intended purpose of our medical devices. Therefore, suitability of clinical application for each publication should be carefully assessed by the concerned physician.

Year	Title	Publication type (study design)	Journal	Authors
2025 Jun	Comparative analysis of clinical outcomes in high-grade glioma patients: 5-ALA fluorescence-guided surgery vs. conventional white-light resection Link to Publication	Original article (retrospective, single-center, n=141)	Cancers	Ryskeldiyev N, Moldabekov A, Berdibayeva D, Maidan A, Tursynbekov T, Davletov D, Tleubergenov M, Kabykenova A, Kerimbayeva D, Doskaliyev A, Akshulakov S
2025 May	Comparative analysis of 5-ALA and fluorescent techniques in high-grade glioma treatment Link to Publication	Systematic review	Biomedicines	Valerio JE, de Jesús Aguirre Vera G, Zumaeta J, Rea NS, Fernandez Gomez MP, Mantilla-Farfan P, Valente L, Alvarez-Pinzon AM
2025 Feb	Predicting intraoperative 5‑ALA‑induced tumor fluorescence via MRI and deep learning in gliomas with radiographic lower‑grade characteristics Link to Publication	Original article (retrospective, single-center, n=163)	Journal of Neuro-Oncology	Suero Molina E, Azemi G, Özdemir Z, Russo C, Krähling H, Valls Chavarria A, Liu S, Stummer W, Di Ieva A
2023 Dec	Intraoperative MRI-guided resection is not superior to 5-aminolevulinic acid guidance in newly diagnosed glioblastoma: a prospective controlled multicenter clinical trial Link to Publication	Original article (prospective, multicenter, n=314)	Journal of Clinical Oncology	Roder C, Stummer W, Coburger J, Scherer M, Haas P, von der Brelie C, Kamp MA, Löhr M, Hamisch CA, Skardelly M, Scholz T, Schipmann S, Rathert J, Brand CM, Pala A, Ernemann U, Stockhammer F, Gerlach R, Kremer P, Goldbrunner R, Ernestus RI, Sabel M, Rohde V, Tabatabai G, Martus P, Bisdas S, Ganslandt O, Unterberg A, Wirtz CR, Tatagiba M
2023 Oct	Second-generation wide-field visualization devices for 5-ALA-induced fluorescence and concepts for validation in neurosurgery - a systematic review Link to Publication	Systematic review	Neurosurgery Practice	Özdemir Z, Suero Molina E, Hellwig SJ, Stepp H, Stummer W
2023 Oct	Use of 5-ALA fluorescence-guided surgery versus white-light conventional microsurgery for the resection of newly diagnosed glioblastomas (RESECT study): a french multicenter randomized phase III study Link to Publication	Original article (prospective, multicenter, n=171)	Journal of Neurosurgery	Picart T, Pallud J, Berthiller J, Dumot C, Berhouma M, Ducray F, Armoiry X, Margier J, Guerre P, Varlet P, Meyronet D, Metellus P, Guyotat J
2023 Aug	How reliable is fluorescence-guided surgery in low-grade gliomas? A systematic review concerning different fluorophores Link to Publication	Systematic review	Cancers	Bianconi A, Bonada M, Zeppa P, Colonna S, Tartara F, Melcarne A, Garbossa D, Cofano F
2022 Nov	Turning on the light for brain tumor surgery: a 5-aminolevulinic acid story Link to Publication	Review	Neuro-Oncology	McCracken DJ, Schupper AJ, Lakomkin N, Malcolm J, Painton Bray D, Hadjipanayis CG
2022 Sep	5-ALA-guided tumor resection during awake speech mapping in gliomas located in eloquent speech areas: single-center experience Link to Publication	Original article (prospective, single-center, n=28)	Frontiers in Oncology	Goryaynov SA, Buklina SB, Khapov IV, Batalov AI, Potapov AA, Pronin IN, Belyaev AU, Aristov AA, Zhukov VU, Pavlova GV, Belykh E
2022 Aug	5-Aminolevulinic acid and sodium fluorescein in IV ventricle ependymoma surgery: preliminary experience comparing the two techniques Link to Publication	Original article (retrospective, single-center, n=6)	Neurological Sciences	"Boschi A, Lastrucci G, Pisano A, Becattini E, Buccoliero A, Della Puppa A."
2022 Jan	Effect of 5-aminolevulinic acid and sodium fluorescein on the extent of resection in high-grade gliomas and brain metastasis Link to Publication	Review	Cancers	Ahrens LC, Krabbenhøft MG, Hansen RW, Mikic N, Pedersen CB, Poulsen FR, Korshoej AR
2022 Jan	Intraoperative 5-ALA fluorescence-guided resection of high-grade glioma leads to greater extent of resection with better outcomes: a systematic review Link to Publication	Systematic review	Journal of Neuro-Oncology	Eatz TA, Eichberg DG, Lu VM, Di L, Komotar RJ, Ivan ME
2021 Oct	5-Aminolevulinic acid for enhanced surgical visualization of high-grade gliomas: a prospective, multicenter study Link to Publication	Original article (prospective, multicenter, n=69)	Journal of Neurosurgery	Schupper AJ, Baron RB, Cheung W, Rodriguez J, Kalkanis SN, Chohan MO, Andersen BJ, Chamoun R, Nahed BV, Zacharia BE, Kennedy J, Moulding HD, Zucker L, Chicoine MR, Olson JJ, Jensen RL, Sherman JH, Zhang X, Price G, Fowkes M, Germano IM, Carter BS, Hadjipanayis CG, Yong RL
2021 Jul	5-ALA in suspected low-grade gliomas: current role, limitations, and new approaches Link to Publication	Review	Frontiers in Oncology	Kiesel B, Freund J, Reichert D, Wadiura L, Erkkilae MT, Woehrer A, Hervey-Jumper S, Berger MS, Widhalm G
2020 Dec	5-ALA fluorescence for intraoperative visualization of spinal ependymal tumors and identification of unexpected residual tumor tissue: experience in 31 patients Link to Publication	Original article (single-center, n=31)	Journal of Neurosurgery: Spine	Millesi M, Kiesel B, Mazanec V, Wadiura LI, Wöhrer A, Herta J, Wolfsberger S, Novak K, Furtner J, Rössler K, Knosp E, Widhalm G
2020 Apr	Validating a new generation filter system for visualizing 5-ALA-induced PpIX fluorescence in malignant glioma surgery: a proof of principle study Link to Publication	Original article (prospective, single-center, n=32)	Acta Neurochirurgica	Suero Molina E, Stögbauer L, Jeibmann A, Warneke N, Stummer W
2019 Oct	Comparison of 5-aminolevulinic acid and sodium fluorescein for intraoperative tumor visualization in patients with high-grade gliomas: a single-center retrospective study Link to Publication	Original article (retrospective, single-center, n=209)	Journal of Neurosurgery	Hansen RW, Pedersen CB, Halle B, Korshoej AR, Schulz MK, Kristensen BW, Poulsen FR
2019 Sep	Fluorescence diagnosis in neurooncology: retrospective analysis of 653 cases Link to Publication	Original article (retrospectiv, multicenter, n=641)	Frontiers in Oncology	Goryaynov SA, Okhlopkov VA, Golbin DA, Chernyshov KA, Svistov DV, Martynov BV, Kim AV, Byvaltsev VA, Pavlova GV, Batalov A, Konovalov NA, Zelenkov PV, Loschenov VB, Potapov AA
2014 Feb	5-ALA complete resections go beyond MR contrast enhancement: shift corrected volumetric analysis of the extent of resection in surgery for glioblastoma Link to Publication	Original article (retrospective, single-center, n=13)	Acta Neurochirurgica	Schucht P, Knittel S, Slotboom J, Seidel K, Murek M, Jilch A, Raabe A, Beck J
2006 May	Fluorescence-guided surgery for resection of malignant glioma: a randomized controlled multicentre phase III trial Link to Publication	Original article (multicenter, n=270)	The Lancet Oncology	Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ

2024 Nov	Fluorescence-guided surgery using 5-aminolevulinic acid/protoporphyrin IX in brain metastases Link to Publication	Systematic review and meta-analysis	Neurosurgery Practice	Price A, Bernstock JD, Truong N, Wu K, Lee JYK, Tucker IJ, Gessler F, DeSena S, Friedman G, Valdes PA
2024 Jun	Does 5-ALA fluorescence microscopy improve complete resectability in cerebral/cerebellar metastatic surgery? A retrospective data analysis from a cranial center Link to Publication	Original article (retrospective, single-center, n=73)	Cancers (Basel)	Sarkis HM, Zawy Alsofy S, Stroop R, Lewitz M, Schipmann S, Unnewehr M, Paulus W, Nakamura M, Ewelt C
2022 Dec	Utility of 5-ALA for fluorescence-guided resection of brain metastases: a systematic review Link to Publication	Systematic review	Journal of Neuro-Oncology	Shah HA, Leskinen S, Khilji H, Narayan V, Ben-Shalom N, D'Amico RS

2025 Mar	Significance of 5-ALA-guided fluorescence in resection of invasive intracranial meningiomas: findings from a prospective clinical study Link to Publication	Original article (prospective, single-center, n=13)	Cancers (Basel)	Matsuda M, Sugii N, Sakamoto N, Yamano A, Ishikawa E
2024 Aug	Fluorescence guidance in skull base surgery: applications and limitations - a systematic review Link to Publication	Systematic review	Brain and Spine	Suero Molina E, Bruneau M, Reuter G, Shahein M, Cavallo LM, Daniel RT, Kasper EM, Froelich S, Jouanneau E, Manet R, Messerer M, Mazzatenta D, Meling TR, Roche PH, Schroeder HW, Tatagiba M, Visocchi M, Prevedello DM, Stummer W, Cornelius JF
2023 Jan	Protoporphyrin IX (PpIX) fluorescence during meningioma surgery: correlations with histological findings and expression of heme pathway molecules Link to Publication	Original article (single-center, n=44)	Cancers (Basel)	Spille DC, Bunk EC, Thomas C, Özdemir Z, Wagner A, Akkurt BH, Mannil M, Paulus W, Grauer OM, Stummer W, Senner V, Brokinkel B

2025 Apr	5-Aminolevulinic acid (5-ALA) in paediatric brain tumour surgery - a systematic review and exploration of fluorophore alternatives Link to Publication	Systematic review	Child's Nervous System	Collins VG, Kanodia C, Yahya QB, Liistro M, Kaliaperumal C
2014 Feb	Analysis of 5-aminolevulinic acid-induced fluorescence in 55 different spinal tumors Link to Publication	Original article (prospective, single-center, n=52)	Neurosurgical Focus	Millesi M, Kiesel B, Woehrer A, Hainfellner JA, Novak K, Martínez-Moreno M, Wolfsberger S, Knosp E, Widhalm G

2024 Oct	Sodium fluorescein and 5-aminolevulinic acid fluorescence-guided biopsy in brain lesions: a systematic review and meta-analysis Link to Publication	Systematic review and meta-analysis	Journal of Neuro-Oncology	Gomes FC, Ferreira MY, Larcipretti ALL, Freitas BCB, Andreão FF, Turpin J, Bertani R, Singha S, Polverini AD, Ferreira C, Dellaretti M, D'Amico RS
2018 Jun	5-ALA-induced fluorescence as a marker for diagnostic tissue in stereotactic biopsies of intracranial lymphomas: experience in 41 patients Link to Publication	Original article (prospective, single-center, n=41)	Neurosurgical Focus	Kiesel B, Millesi M, Woehrer A, Furtner J, Bavand A, Roetzer T, Mischkulnig M, Wolfsberger S, Preusser M, Knosp E, Widhalm G

2025 Apr	Current and future applications of 5-aminolevulinic acid in neurosurgical oncology Link to Publication	Review	Cancers	Chen JS, Young JS, Berger MS
2024 Oct	Enlightening the invisible: applications, limits and perspectives of intraoperative fluorescence in neurosurgery Link to Publication	Review	Brain and Spine	Cossu G, Le Van T, Kerherve L, Houidi SA, Morlaix E, Bonneville F, Chapon R, Baland O, Cao C, Lleu M, Farah W, El Cadhi A, Beaurain J, Picart T, Xu B, Berhouma M
2024 Jul	Fluorescence-guided surgical techniques in adult diffuse low-grade gliomas: state-of-the-art and emerging techniques: a systematic review Link to Publication	Systematic review	Cancers (Basel)	Picart T, Gautheron A, Caredda C, Ray C, Mahieu-Williame L, Montcel B, Guyotat J
2022 Jan	Effect of 5-aminolevulinic acid and sodium fluorescein on the extent of resection in high-grade gliomas and brain metastasis Link to Publication	Review	Cancers (Basel)	Ahrens LC, Krabbenhøft MG, Hansen RW, Mikic N, Pedersen CB, Poulsen FR, Korshoej AR
2021 Jun	Fluorescence-guided surgery: a review on timing and use in brain tumor surgery Link to Publication	Review	Frontiers in Neurology	Schupper AJ, Rao M, Mohammadi N, Baron R, Lee JYK, Acerbi F, Hadjipanayis CG