1395 - Fluorescence guided resection of high grade (grade IV) glioma that are glioblastoma multiforme using Gliolan (aminolevulinic acid)

Page last updated: 14 February 2017

Application Detail



Description of Medical Service

GliolanŽ (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 Condition

Gliomas 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 Application

New MBS item

Medical Service Type


Previous Application Number

Not Applicable

Associated Documentation

Application Form


PICO Confirmation

Final Protocol (PDF 1748 KB)
Final Protocol (Word 723 KB)

Assessment Report


Public Summary Document

Public Summary Document (PDF 423 KB)
Public Summary Document (Word 411 KB)

Meetings for this Application


13 - 14 August 2015


6 - 7 October 2016


24 - 25 November 2016