Current Neurology and Neuroscience Reports

, Volume 11, Issue 3, pp 313–319

Neurosurgery for Brain Tumors: Update on Recent Technical Advances

  • Jonathan H. Sherman
  • Kathryn Hoes
  • Joshua Marcus
  • Ricardo J. Komotar
  • Cameron W. Brennan
  • Philip H. Gutin
Article

DOI: 10.1007/s11910-011-0188-9

Cite this article as:
Sherman, J.H., Hoes, K., Marcus, J. et al. Curr Neurol Neurosci Rep (2011) 11: 313. doi:10.1007/s11910-011-0188-9
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Abstract

Advances in diagnostic imaging modalities and improved access to specialty care have led directly to an increased diagnosis of both metastatic and primary brain tumors. As technology has improved, so has the ability to treat this larger patient population. Diffusion tensor imaging (DTI) has recently shown the potential to aid in histologic diagnosis as well as to identify local brain invasion outside of that readily identifiable by conventional MRI. Similar to DTI, functional MRI provides a noninvasive means of delineating tumor margin from eloquent cortex and aids in preoperative surgical planning. As the literature shows increasing support for the advantages of extensive resection in glioma patients, modalities that aid in this regard are displaying increased importance. Surgeons have recently demonstrated the utility of intraoperative MRI in increasing extent of resection in both low- and high-grade glioma patients. Intraoperative tumor fluorescence provided by the chemical compound 5-aminolevulinic acid assists surgeons in identifying the true tumor margin during resection of glial neoplasms consequently increasing extent of resection. Finally, laser interstitial thermal therapy is an emerging treatment modality allowing surgeons to treat small intracranial lesions with potentially decreased morbidity via this minimally invasive approach. The following review analyzes the recent literature in an effort to describe how these modalities can and should be used in the treatment of patients with intracranial pathology.

Keywords

Intraoperative MRIDiffusion tensor imagingFunctional MRI5-Aminolevulinic acidLaser interstitial thermal therapy

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jonathan H. Sherman
    • 1
  • Kathryn Hoes
    • 2
  • Joshua Marcus
    • 3
  • Ricardo J. Komotar
    • 1
  • Cameron W. Brennan
    • 1
    • 3
  • Philip H. Gutin
    • 1
    • 3
  1. 1.Department of NeurosurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Robert Wood Johnson Medical SchoolUniversity of Medicine & Dentistry of New JerseyPiscatawayUSA
  3. 3.Department of Neurological SurgeryWeill Cornell Medical CollegeNew YorkUSA