Optimizing glioblastoma resection: intraoperative mapping and beyond

The management of glioblastomas starts with surgical resection if possible, along with subsequent chemotherapy and radiation therapy. Several retrospective studies have suggested that extent of resection plays a role in the prognosis of glioblastoma patients. The importance of extent of resection must be balanced with preserving patient's functional status for tumors in eloquent areas. Here we review the preoperative imaging modalities such as functional MRI and magnetoencephalography (MEG), and the intraoperative techniques such as motor and language mapping, intraoperative MRI, and intraoperative techniques such as 5-aminolevulinic acid administration, that allow maximal safe operative resection of glioblastomas.