Abstract

The current neuronavigation techniques increase safety and surgeon confidence during neurosurgical procedure performance. However, its real usefulness remains in integrating multimodal information from advanced magnetic resonance imaging, as tractography (DTI), functional studies that evaluate motor and sensitive language, motor function (BOLD techniques with different paradigms), and nuclear medicine. At the operating room, the fusion of sonographic information acquired in real-time with the predefined plan increase the chance to achieve gross-total resection of primary brain tumors. Combining these different image modalities with brain mapping and motor stimulation information in selected cases is possible, increasing surgery safety. In this review, we present our experience with multimodal neuronavigation to treat brain tumors in pediatric patients.

Highlights

  • Gliomas are primary tumors of the central nervous system

  • For all central nervous system (CNS) tumors, of which brain tumors account for approximately 88%, the average annual incidence rate adjusted for age (2006 to 2010) for women (22.8 per 100,000) is higher than for men (19.1 per 100,000) [1, 2]

  • According to the World Health Organization (WHO) classification of brain tumors, they are divided into gliomas of the low and high degree of malignancy

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Summary

Introduction

Gliomas are primary tumors of the central nervous system 70,000 new cases of malignant primary and benign brain tumors of the central nervous system (CNS) are diagnosed in the United States each year. Gliomas represent 80% of the primary malignant brain tumors. According to the World Health Organization (WHO) classification of brain tumors, they are divided into gliomas of the low and high degree of malignancy. The magnetic resonance imaging technique renders the integration of different structural images (FLAIR, diffusion, perfusion, SPGR, TRUFFI), functional aspects (DTI, BOLD), and metabolic profile (spectroscopy). They evaluated peritumoral edema by diffusion and perfusion sequences [8, 9]. One of the technological resources that have changed the treatment of patients with CNS neoplasms is neuronavigation

Characteristics of Magnetic Resonance Imaging Studies for Neuronavigation
Perfusion
Functional MRI Images
The utility of fMRI and DTI in presurgical planning
Nuclear medicine for imaging brain tumors
Neuronavigation principles
DTI and fMRI in functional neuronavigation
Neuronavigation and intraoperative electrical stimulation
Findings
Conclusions
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