Brain Tumor (Glioma)

What is Awake Craniotomy with 5-ALA?

The patient remains awake during brain tumor resection so the surgeon can map eloquent cortex in real-time. 5-ALA fluorescence makes tumor tissue glow pink under blue light, enabling maximal safe resection while preserving speech, motor, and cognitive function.

Why China?

• Tiantan Hospital: Asia's largest neurosurgery center — 15,000+ craniotomies/year
• 7T iMRI: Intraoperative MRI available for real-time resection control
• Cost: $15,000-$25,000 vs. $60,000-$120,000 in the US

Who is a candidate?

• Glioma in or near eloquent cortex (Broca, Wernicke, motor strip)
• Cooperative patient able to perform intraoperative tasks
• No severe claustrophobia or anxiety disorder

Outcomes

Gross total resection rate with 5-ALA: 65-70% (vs 35% without). Median OS for GBM with GTR: 18-20 months. New permanent deficit rate: <5% with mapping.