Pre-operative cellularity mapping and intra-MRI surgery: potential for improving neurosurgical biopsies

Stereotactic biopsies are frequently performed to secure definitive diagnosis for brain tumor patients. Fundamentally, there are two major difficulties in these endeavors. First, because of intra-tumoral heterogeneity inherent in many forms of brain cancer, biopsies taken from one region may yield a different diagnosis than if another area is biopsied. Second, stereotactic needle biopsies inherently rely on mathematical algorithms for targeting, without real-time visualization of the actual biopsy site. This article describes the novel MRI-based technologies that can potentially afford neurosurgeons the opportunity to address these challenges.