Objective: Metabolic navigation in the surgery of malignant gliomas is the most effective way to distinguish the border of the tumor during surgery and achieve a more radical resection, and as a result, to increase the recurrence interval and increase the life expectancy. 

Purpose of the study. The purpose of this study was to carry out a comparative analysis of the specificity and sensitivity of the fluorescence navigation method in surgery for malignant gliomas using two different fluorescence inducers. 

Material and methods: A comparative analysis of fluorescent navigation was carried out in 50 patients (group 2) with glioma of a high degree of anaplasia, who were treated at the Department of neurooncology of the RNSI name after prof. A.L. Polenov. In 25 patients (group 1), chlorin E6 1 mg/kg intravenously (Photoditazin) was used as a fluorescence inducer, the other 25 patients (group 2) received 5ALA 20 mg/kg orally (Alasens). Each group included 10 patients with Grade III anaplasia and 15 patients with Grade IV anaplasia. Both groups were statistically representative (p> 0.05). 

Results: For surgery of Grade III gliomas, the sensitivity of the method was – 83.8% (chlorin E6), 82.5% (5ALA); specificity – 66.7% (chlorin E6), 64.1% (5ALA). For Grade IV glioma surgery, the sensitivity of the method is – 87.7% (chlorin E6), 88.3% (5ALA); specificity – 85.2% (chlorin E6), 88.1% (5ALA). 

Conclusion: Statistical analysis showed comparable high efficacy of the drugs in the surgery of malignant gliomas. The sensitivity and specificity of the method for fluorescent preparations of chlorin E6 and 5ALA did not show a statistically significant difference in the achievement of the result (p>0.05).

Artemii Rynda defended his Ph.D. thesis at the age of 35 at the Russian Neurosurgical Institute named after Professor A.L. Polenov, Russian Federation. I work as a neurosurgeon at the Russian Neurosurgical Institute named after Professor A.L. Polenov. I have more than 100 publications that have been cited more than 30 times, and the h-index of publications is 3. I am the winner of the Brainlab Neurosurgery Award (American Association of Neurological Surgeons, USA) 2021.