Solid stress estimations via intraoperative 3D navigation in patients with brain tumors

Area of Science:

• Biomedical Engineering
• Neurosurgery
• Oncology

Background:

• Physical forces from brain tumors, specifically solid stress, impact brain function but haven't been directly measured in patients.
• Previous estimations of solid stress correlate negatively with patient neurological performance.
• Measuring solid stress may inform clinical management strategies for brain tumors.

Purpose of the Study:

• To develop and validate an intraoperative technique for quantitatively measuring solid stress and brain tissue replacement in patients with brain tumors.
• To explore the potential of solid stress and tissue loss as clinical biomarkers for brain tumors.
• To investigate the correlation between solid stress, tissue loss, and tumor type.

Main Methods:

• Developed an intraoperative technique combining neuro-navigation and finite element modeling to estimate solid stress and brain tissue replacement.
• Measured brain deformation in 30 patients during surgical procedures immediately prior to tumor resection.
• Calculated solid stress and quantified the volume of brain tissue lost due to tumor growth.

Main Results:

• Mean solid stresses ranged from 10 to 600 Pa, with tissue replacement up to 10% of brain volume.
• Quantified solid stress and tissue loss in 30 patients, distinguishing glioblastoma from brain metastatic tumors.
• Demonstrated that solid stress serves as a sensitive biomarker for chemotherapy response in mice.

Conclusions:

• Presented a novel, quantitative intraoperative approach to measure solid stress in brain tumor patients, adaptable to clinical workflows.
• Established brain tissue loss as a novel mechanical biomarker, alongside solid stress, for personalized brain cancer management.
• Highlighted the potential of these physical biomarkers to predict patient outcomes and guide clinical decision-making.