Predicting brain tumor regrowth in relation to motor areas by functional brain mapping

Area of Science:

• Neuro-oncology
• Neurosurgery
• Radiology

Background:

• High-grade gliomas frequently recur, leading to poor patient prognosis.
• Existing regrowth prediction models lack direct clinical applicability.
• Novel methods are needed to predict tumor recurrence patterns.

Purpose of the Study:

• To evaluate navigated transcranial magnetic stimulation (nTMS) and functional magnetic resonance imaging (fMRI) for predicting high-grade glioma regrowth direction.
• To assess the clinical utility of nTMS and fMRI in guiding treatment decisions.

Main Methods:

• Prospective enrollment of 60 high-grade glioma patients with tumor recurrence.
• Serial MRI analysis and measurement of tumor regrowth speed and direction relative to eloquent motor areas.
• Utilized nTMS, nTMS-based tractography, and fMRI to define motor areas.

Main Results:

• Tumor recurrence towards motor areas was observed in 69% (group 1), 64.3% (group 2), and 66.7% (group 3) of patients.
• Average monthly growth towards motor areas was significantly higher in patients with residual tumors facing motor areas (2.3 ± 5.5 mm/month, P = .0492).

Conclusions:

• nTMS and fMRI provide a novel, clinically applicable strategy for predicting high-grade glioma regrowth.
• This predictive approach can significantly impact surgical treatment and radiotherapy planning.
• The findings support the integration of nTMS and fMRI into routine clinical practice for glioma management.