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Implementation of Minimally Invasive Brain Tumor Resection in Rodents for High Viability Tissue Collection
Published on: May 9, 2022
Advances in Intraoperative Glioma Tissue Sampling and Infiltration Assessment
Nadeem N Al-Adli1,2, Jacob S Young1, Katie Scotford1
1Department of Neurosurgery, University of California San Francisco, San Francisco, CA 94131, USA.
Abstract:
Gliomas are infiltrative brain tumors that often involve functional tissue. While maximal safe resection is critical for maximizing survival, this is challenged by the difficult intraoperative discrimination between tumor-infiltrated and normal structures. Surgical expertise is essential for identifying safe margins, and while the intraoperative pathological review of frozen tissue is possible, this is a time-consuming task. Advances in intraoperative stimulation mapping have aided surgeons in identifying functional structures and, as such, has become the gold standard for this purpose. However, intraoperative margin assessment lacks a similar consensus. Nonetheless, recent advances in intraoperative imaging techniques and tissue examination methods have demonstrated promise for the accurate and efficient assessment of tumor infiltration and margin delineation within the operating room, respectively. In this review, we describe these innovative technologies that neurosurgeons should be aware of.
Insights
Identifying safe margins during glioma resection is challenging. Innovative intraoperative imaging and tissue examination technologies offer promising solutions for accurate tumor infiltration assessment and margin delineation in neurosurgery.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- Gliomas are infiltrative brain tumors requiring maximal safe resection for improved survival.
- Distinguishing tumor-infiltrated tissue from normal brain during surgery is a significant challenge.
- Current intraoperative methods for margin assessment lack a definitive consensus.
Purpose of the Study:
- To review innovative intraoperative technologies for glioma surgery.
- To highlight advancements in tumor infiltration assessment and margin delineation.
- To inform neurosurgeons about emerging tools for optimizing glioma resection.
Main Methods:
- Review of recent advancements in intraoperative imaging techniques.
- Examination of novel tissue examination methods for intraoperative use.
- Discussion of technologies aiding in tumor margin delineation.
Main Results:
- Intraoperative stimulation mapping is the gold standard for identifying functional brain structures.
- New imaging and tissue analysis methods show potential for accurate intraoperative margin assessment.
- These technologies promise efficient and precise tumor infiltration evaluation.
Conclusions:
- Accurate intraoperative margin assessment remains a critical unmet need in glioma surgery.
- Emerging technologies in imaging and tissue analysis offer solutions for precise tumor delineation.
- Neurosurgeons should be aware of these innovations to enhance glioma resection outcomes.
