Intra-operative Imaging Techniques During Surgical Management of Gliomas

Abstract

The goal of glioma surgery is to maximise tumour removal while preserving existing function. Intra-operative imaging techniques play an important part in achieving this goal. This article surveys those techniques and discusses the indications, advantages and drawbacks of each. Structural techniques such as intra-operative magnetic resonance imaging (MRI), ultrasound, diffusion tensor imaging and 5-aminolevulinic acid staining offer anatomical information. Functional techniques such as functional MRI, magnetoencephalography and transcranial magnetic stimulation provide information about the functionality of brain regions. When incorporated into a frameless stereotactical neuronavigation system, these modalities increase both the efficacy and safety of glioma surgery by allowing the surgeon to achieve the most extensive and safe resection possible.