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Functional Mapping for Glioma Surgery, Part 1: Preoperative Mapping Tools.
Sebastian Ille1, Sandro M Krieg1
1Department of Neurosurgery, Technical University of Munich, Germany, School of Medicine, Klinikum rechts der Isar, Ismaninger Strasse 22, Munich 81675, Germany.
Neurosurgery Clinics of North America
|November 23, 2020
Summary
Noninvasive brain mapping techniques like fMRI and MEG improve surgical planning for resective surgery. These methods help identify eloquent areas, increasing resection extent and reducing functional deficits.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neurophysiology
Background:
- Intraoperative mapping enhances resection extent and reduces functional deficits.
- Reliable noninvasive techniques are crucial for surgical planning, indication, and patient consultation.
- Recent advancements show promise for noninvasive methods in intraoperative mapping.
Purpose of the Study:
- To provide an overview of noninvasive techniques for identifying eloquent brain areas.
- To discuss the strengths and limitations of each modality for pre-resective surgery planning.
- To highlight the importance of these techniques in tailoring surgical approaches.
Main Methods:
- Review of functional magnetic resonance imaging (fMRI).
- Review of tractography.
- Review of neurophysiologic methods: navigated transcranial magnetic stimulation (nTMS) and magnetoencephalography (MEG).
Main Results:
- Each modality (fMRI, tractography, nTMS, MEG) offers unique advantages for identifying eloquent areas.
- Limitations exist for each noninvasive technique.
- These methods enable pre-operative identification and surgical approach tailoring.
Conclusions:
- Noninvasive brain mapping techniques are essential for optimizing resective surgery.
- Understanding the strengths and limitations of fMRI, tractography, nTMS, and MEG is key.
- These tools facilitate better surgical planning, potentially improving patient outcomes.
