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Advanced Imaging Modalities and Treatment of Gliomas: Neurosurgery

  • Johannes Wölfer
  • Walter Stummer
Part of the Medical Radiology book series (MEDRAD)

Abstract

Current data warrant cytoreductive surgical approaches in low as well as high grade gliomas. Surgical aims vary depending on histology – speed of growth and impending malignant transformation being major aspects in low grades, while surgical improvement of preconditions for adjuvant therapy gains prognostic relevance in malignant glioma. A delicate balance between the extent of resection and functional integrity has to be kept in all of these procedures. Their planning and realization thus require reliable conceptions of tumor extension with reference to functional anatomy. Radiology and nuclear medicine provide preoperative and, to a certain extent also intraoperative insights. Additional intraoperative assistance is provided by electrophysiology and – in malignant glioma – by direct tumor visualization, which uses pharmacologic agents together with specialized optics. Emerging surgical concepts like functionally guided tissue removal or so-called supramarginal resection are still waiting for their clinical validation and for new techniques which might be able to morphologically substantiate the respective rationale.

Keywords

Malignant Glioma Cytoreductive Surgery Brain Shift Glioma Surgery Amino Acid Positron Emission Tomography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We thankfully acknowledge the provision of images by the Institute of Clinical Radiology (W.-L. Heindel, T. Niederstadt, W. Schwindt) and the Clinic of Nuclear Medicine (M. Schäfers).

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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Neurochirurgische KlinikUniversitätsklinikum MünsterMünsterGermany

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