Advanced imaging in brain tumor surgery

Robert J. Young, Nicole Brennan, Justin F. Fraser, Cameron Brennan

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


The advanced imaging techniques outlined in this article are only slowly establishing their place in surgical practice. Even a low risk of false information is unacceptable in neurosurgery, thus decision-making is necessarily conservative. As more validation studies and greater experience accrue, surgeons are becoming more comfortable weighing the quality of information from functional imaging studies. Advanced imaging information is highly complementary to established surgical " good practice" such as anatomic planning, awake craniotomy, and electrocortical stimulation; its greatest impact is perhaps on how neurosurgery is planned and discussed before the patient is ever brought to the operating room. Access to functional magnetic resonance (MR) imaging, diffusion tractography, and intraoperative MR imaging can influence neurosurgical decisions before, during, and after surgery. However, the widespread adoption of these techniques in neurosurgical practice remains limited by the lack of standardized methods, the need for validation across institutions, and the unclear cost-effectiveness particularly for intraoperative MR imaging. Before advanced imaging results can be used therapeutically, it is incumbent on the neurosurgeon and neuroradiologist to develop a working understanding of each technique's strengths and weaknesses, positive and negative predictive values, and modes of failure. This content presents several imaging methods that are increasingly used in neurosurgical planning. As these techniques are progressively applied to surgery, radiologists, medical physicists, neuroscientists, and engineers will be necessary partners with the treating neurosurgeon to bridge the gap between the experimental and the therapeutic.

Original languageEnglish
Pages (from-to)311-335
Number of pages25
JournalNeuroimaging Clinics of North America
Issue number3
StatePublished - Aug 2010


  • Awake mapping
  • Brain tumor surgery
  • Diffusion tensor imaging
  • Electrocortical stimulation
  • Functional MR imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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