Description of Medical ServiceGliolanŽ (aminolevulinic acid HCl; ALA) is a prodrug that is metabolised intracellularly to form the fluorescent molecule protoporphyrin (PPIX). The exogenous application of Gliolan leads to a highly selective accumulation of PPIX in tumour cells and epithelial tissues. Following excitation with blue light (λ = 400 - 410 nm) using a specially equipped operating microscope, PPIX, which accumulates selectively in the malignant tissue, emits a fluorescent red-violet light, whilst healthy brain tissue appears blue. This phenomenon is exploitable to guide tumour resection (both to visualise difficult to see tumour and to avoid resection of normal brain), and gives rise to the new surgical method of fluorescence guided resection. Achieving a complete tumour resection is a key precursor to the patients’ subsequent adjuvant radiochemotherapy and ultimately influences survival.
Description of Medical ConditionGliomas comprise of a heterogeneous group of neoplasms that differ in location within the central nervous system, age and sex distribution, growth potential, extent of invasiveness, morphological features, tendency for progression, and response to treatments. In adults, the most frequently encountered of these are high-grade or malignant neoplasms of astrocytic and oligodendrocytic lineage, such as anaplastic astrocytoma, anaplastic oligodendroglioma, and glioblastoma multiforme, respectively. High grade gliomas are locally invasive tumours of the brain with a very poor prognosis for which there is no cure. Left untreated, survival is about 3-6 months.
Reason for ApplicationNew MBS item
Medical Service TypeTherapeutic
Previous Application NumberNot Applicable
PICO ConfirmationFinal Protocol (PDF 1748 KB)
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Public Summary DocumentPublic Summary Document (PDF 423 KB)
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