Journal of Neuro-Oncology

, Volume 141, Issue 3, pp 487–494 | Cite as

Established and emerging uses of 5-ALA in the brain: an overview

  • Ricardo Díez ValleEmail author
  • Constantinos G. Hadjipanayis
  • Walter Stummer
Topic Review



5-aminolevulinic acid (5-ALA) was approved by the FDA in June 2017 as an intra-operative optical imaging agent for patients with gliomas (suspected World Health Organization Grades III or IV on preoperative imaging) as an adjunct for the visualization of malignant tissue during surgery. 5-ALA fluorescence-guided surgery (FGS) has been in widespread use in Europe and other continents since 2007.


We reviewed the data available and summarize the most important known uses of 5-ALA FGS and its potential future applications.


The technique has been extensively studied, and more than 300 papers have been published on this topic. Visualization of high-grade glioma tissue is robust and reproducible, and can impact the extent of tumor resection and patient outcomes. 5-ALA FGS for other kind of tumors needs further development.

Graphical abstract


5-Aminolevulinic acid Glioma Glioblastoma Fluorescence-guided surgery 



This study did not receive any funding.

Compliance with ethical standards

Conflict of interest

Walter Stummer has received speaker and consultant fees by Carl Zeiss, Leica, Medac, NXDC. Constantinos Hadjipanayis is a consultant for NXDC and Synaptive Medical Inc. He will receive potential royalties from NXDC. He has also received speaker fees by Carl Zeiss and Leica. Ricardo Díez Valle has received speaker fees by Medac.

Research involving human participants or animals

This article does not contain any studies with human participants or animals performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity ClinicNavarraSpain
  2. 2.Department of NeurosurgeryIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Department of NeurosurgeryUniversitätsklinikum MünsterMünsterGermany

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