Protoporphyrin Imaging in Multispectral Evaluation of Resections

Inclusion criteria:

* Age Requirement: Patients must be 18 years of age or older.
* Diagnosis: Patients with a preoperative diagnosis of a suspected high-grade glioma based demographics and MRI imaging.
* MRI Findings: Patients must meet one of the following criteria:

  * Group 1: Suspected high-grade glioma with contrast enhancement on MRI (GBM-like).
  * Group 2: Suspected high-grade glioma without contrast enhancement on MRI (LGG-like).
* Surgical Resection: Patients scheduled to undergo surgical resection of the tumor as part of standard treatment.
* 5-ALA Administration: Patients who will receive 5-aminolevulinic acid (5-ALA) for fluorescence guidance during surgery.
* Post-op MRI: Patients who are able to undergo pre- and postoperative MRI (standard of care at the center).
* Informed Consent: Patients who are able to understand and provide written informed consent prior to enrollment in the study.
* Eligibility for Multispectral Imaging: Patients whose surgical procedures allow for the use of multispectral imaging technology for tumor visualization.
* Performance Status: Patients with a Karnofsky Performance Status (KPS) of 60 or greater, indicating that they are capable of at least limited self-care.
* No Prior Treatment: Patients who have not received prior treatment for the current brain tumor, including surgery, radiotherapy, or chemotherapy.

Exclusion criteria:

* Patients with a known allergy or contraindication to 5-aminolevulinic acid (5-ALA) or its components.
* Use of all other fluorescent markers.
* Patients with a history of porphyria or other disorders related to 5-ALA metabolism.
* Patients with recurrent gliomas or those who have received prior treatment for their current brain tumor, including surgery, radiotherapy, or chemotherapy.
* Pregnant or breastfeeding patients, due to potential risks associated with 5-ALA administration.
* Patients with severe comorbidities or other medical conditions that, in the investigator's opinion, would pose an unacceptable risk or compromise the safety of participation in the study.
* Patients with a Karnofsky Performance Status (KPS) below 60, indicating an inability to perform minimal self-care.
* Patients with a history of severe hepatic or renal impairment that may impact the metabolism of 5-ALA.
* Patients unable to undergo MRI imaging for any reason (e.g., presence of non-MRI-compatible implants).
* Patients unable to provide written informed consent due to cognitive, language, or other barriers.
* Patients with tumors located in regions where fluorescence imaging is not technically feasible or where the use of multispectral imaging could interfere with the standard surgical approach.
* Pregnancy