Interest of Fluorescein in Fluorescence-guided Resection of Gliomas (FLEGME) (FLEGME)

Fluorescence guidance is a safe and efficient tool for glioblastomas resection. The most widely used technique is based on 5-aminolevulinic acid (5ala), which stains glioblastoma cells through a metabolic abnormality and thus helps in defining tumoral edges through a modified microscope. A multicentric, randomized study comparing 5ala guided surgery with conventional procedures showed that this technique doubles the rate of complete removal on post-operative magnetic resonance imaging (MRI), and increases the 6 months progression-free survival. More recently, fluorescein appeared as an interesting alternative fluorophore for glioblastomas, with a highly reduced cost (2.5 euros versus 1000 euros per dose). However its use remains scarcely studied and its clinical benefit unsure. In that context, the investigators propose a randomized trial comparing conventional " white light " surgery with fluorescein-guided resection of glioblastomas, in order to assess the relevance of this technique in glioblastomas removal.

Fluorescein (Fluorescéine sodique FAURE) will be given intravenously during the induction of the anesthesia

In the control arm, the surgery will be performed under classical conditions (so-called " white-light " surgery).

Fluorescéine Sodique Faure given intravenously during the induction of the anesthesia, at the dose of 3mg/kg, diluted in 50mL of physiological serum, in 10 minutes.

Inclusion Criteria: Age between 18 and 79 Karnofsky index > 70 % Brain MRI showing a parenchymal lesion with typical features of glioblastoma, < 1week Achievable gross total removal, as assessed by the neurosurgical staff Written consent Exclusion Criteria: Contraindication to fluorescein Contraindication to MRI History of brain surgery <6 months Guardianship, tutelage or deprivation of liberty Pregnancy or breastfeeding Participation to other interventional clinical studies