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Cancers
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Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors
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Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 6056

Special Issue Editors

Dr. Andrea Bianconi

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Guest Editor
Neurosurgery Unit, Department of Neuroscience, University of Turin, Via Giuseppe Verdi, 8, 10124 Turin, Italy
Interests: neuroncology; glioma; brain mapping; intraoperative ultrasound; intraoperative fluorescence; neuromonitoring; fiber tracking
Special Issues, Collections and Topics in MDPI journals
Dr. Pietro Fiaschi

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Guest Editor
Section of Neurosurgery, Department of Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, IRCCS Policlinico San Martino, University of Genoa, Genova, Italy
Interests: Cancer Stem Cells; Neurosurgery; Cancer Biology
Prof. Dr. Diego Garbossa

E-Mail Website
Guest Editor
Neurosurgery Unit, Department of Neuroscience, University of Turin, Via Giuseppe Verdi, 8, 10124 Turin, Italy
Interests: neurobiology; neurobiology and brain physiology; neurodegeneration; synaptic plasticity; neuroanatomy; neurodegenerative diseases; neural plasticity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is well established today that the extent of resection correlates with increased survival in primary brain tumors and that the goal of surgery is maximal safe resection to allow for the most radical tumor removal while preserving the patient's neurological integrity. To achieve maximal safe resection, both preoperative planning with advanced imaging techniques, such as functional magnetic resonance imaging (both resting state and task-based) or fiber tracking, and new intraoperative visualization technologies, such as the use of fluorophores (associated or not with confocal microscopy), or intraoperative visualization techniques such as intra-op ultrasound, CT or MRI, are essential. For these reasons, we aim for this Special Issue to provide an update on the technologies available in primary brain tumor surgery. 

Dr. Andrea Bianconi
Dr. Pietro Fiaschi
Prof. Dr. Diego Garbossa
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glioma
  • glioblastoma
  • brain metastasis
  • diffusion tensor imaging
  • fiber tracking
  • functional MRI
  • intraoperative fluorescence
  • intraoperative MRI
  • intraoperative ultrasound

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Published Papers (4 papers)

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Research

17 pages, 282 KiB  
Article
Intraoperative Seizures in Glioma Surgery: Is It Really Only an Intraoperative Issue?
by Giada Pauletto, Annacarmen Nilo, Christian Lettieri, Mariarosaria Valente, Marco Vindigni, Miran Skrap, Tamara Ius and Lorenzo Verriello
Cancers 2025, 17(9), 1478; https://doi.org/10.3390/cancers17091478 - 27 Apr 2025
Viewed by 126
Abstract
Intraoperative seizures (IOS) represent a complication during surgery of diffuse low-grade gliomas (DLGGs), particularly in cases of awake craniotomy, history of tumor-related epilepsy (TRE), and cortical mapping [...] Full article
(This article belongs to the Special Issue Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors)
15 pages, 13349 KiB  
Article
Significance of 5-ALA-Guided Fluorescence in Resection of Invasive Intracranial Meningiomas: Findings from a Prospective Clinical Study
by Masahide Matsuda, Narushi Sugii, Noriaki Sakamoto, Akinari Yamano and Eiichi Ishikawa
Cancers 2025, 17(7), 1191; https://doi.org/10.3390/cancers17071191 - 31 Mar 2025
Viewed by 266
Abstract
Background: In cases of intracranial meningiomas invading into surrounding tissues, determining the resection boundary can be challenging and often makes complete resection difficult. In such situations, the introduction of novel intraoperative techniques to identify infiltrative tumor components is desirable to improve the extent [...] Read more.
Background: In cases of intracranial meningiomas invading into surrounding tissues, determining the resection boundary can be challenging and often makes complete resection difficult. In such situations, the introduction of novel intraoperative techniques to identify infiltrative tumor components is desirable to improve the extent of tumor resection. Methods: A prospective clinical study was conducted on patients with intracranial meningiomas suspected of infiltration into the surrounding tissues. After completing the tumor resection under conventional white-light microscopy, intraoperative fluorescence diagnosis using 5-aminolevulinic acid (5-ALA) was performed to determine whether additional resection of the unintended residual tumor was feasible. Results: Intraoperative fluorescence diagnosis enabled additional resection of the residual tumor in 38.5% of the 13 enrolled cases and 45.5% of the 11 cases in which the tumor exhibited fluorescence positivity. Among the additional resected specimens, tumor infiltration was observed in all fluorescence-positive lesions of the bone and dura mater, whereas tumor cells were detected in only 33.3% of the fluorescence-positive areas in the adjacent brain parenchyma. Conclusions: Intraoperative fluorescence diagnosis using 5-ALA enhanced the extent of the resection of invasive meningiomas. Future large-scale studies are warranted to determine whether 5-ALA fluorescence diagnosis contributes to reducing tumor recurrence and improving overall survival in patients with invasive intracranial meningiomas. Full article
(This article belongs to the Special Issue Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors)
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11 pages, 1875 KiB  
Article
Combined Fluorescence-Guided Surgery with 5-Aminolevulinic Acid and Fluorescein in Glioblastoma: Technical Description and Report of 100 Cases
by Alessandro Pesaresi, Pietro La Cava, Marta Bonada, Pietro Zeppa, Antonio Melcarne, Fabio Cofano, Pietro Fiaschi, Diego Garbossa and Andrea Bianconi
Cancers 2024, 16(16), 2771; https://doi.org/10.3390/cancers16162771 - 6 Aug 2024
Cited by 2 | Viewed by 3503
Abstract
Background: Fluorescence-guided resection (FGR) of glioblastomas has been previously explored with the use of 5-amivelulinic acid (5-ALA) and sodium fluoresceine (SF), allowing us to maximize the extent of resection (EoR). In this study, we highlight the most relevant concerns regarding this technique and [...] Read more.
Background: Fluorescence-guided resection (FGR) of glioblastomas has been previously explored with the use of 5-amivelulinic acid (5-ALA) and sodium fluoresceine (SF), allowing us to maximize the extent of resection (EoR). In this study, we highlight the most relevant concerns regarding this technique and present the methods and results from the experience of our center. Methods: A case series of 100 patients operated on in AOU Città della Salute e della Scienza in Turin with a histological diagnosis of glioblastoma (grade IV, according to WHO 2021) was retrospectively analyzed. Both 5-ALA and SF were administered and intraoperatively assessed with an optical microscope. Results: 5-ALA is the only approved drug for FGR in glioblastoma, reporting an increased EoR. Nevertheless, SF can be positively used in addition to 5-ALA to reduce the risk of false positives without increasing the rate of adverse effects. In our experience, SF was used to guide the initial phase of resection while 5-ALA was used to visualize tumor spots within the surgical cavity. In 96% of cases, gross total resection was achieved, with supra-maximal resection in 11% of cases. Conclusions: Combined FGR using 5-ALA and SF seems to be a promising method of increasing the extent of resection and to improving the prognosis in glioblastoma patients. Full article
(This article belongs to the Special Issue Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors)
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21 pages, 8744 KiB  
Article
Enabling Navigation and Augmented Reality in the Sitting Position in Posterior Fossa Surgery Using Intraoperative Ultrasound
by Miriam H. A. Bopp, Alexander Grote, Marko Gjorgjevski, Mirza Pojskic, Benjamin Saß and Christopher Nimsky
Cancers 2024, 16(11), 1985; https://doi.org/10.3390/cancers16111985 - 23 May 2024
Cited by 3 | Viewed by 1373
Abstract
Despite its broad use in cranial and spinal surgery, navigation support and microscope-based augmented reality (AR) have not yet found their way into posterior fossa surgery in the sitting position. While this position offers surgical benefits, navigation accuracy and thereof the use of [...] Read more.
Despite its broad use in cranial and spinal surgery, navigation support and microscope-based augmented reality (AR) have not yet found their way into posterior fossa surgery in the sitting position. While this position offers surgical benefits, navigation accuracy and thereof the use of navigation itself seems limited. Intraoperative ultrasound (iUS) can be applied at any time during surgery, delivering real-time images that can be used for accuracy verification and navigation updates. Within this study, its applicability in the sitting position was assessed. Data from 15 patients with lesions within the posterior fossa who underwent magnetic resonance imaging (MRI)-based navigation-supported surgery in the sitting position were retrospectively analyzed using the standard reference array and new rigid image-based MRI-iUS co-registration. The navigation accuracy was evaluated based on the spatial overlap of the outlined lesions and the distance between the corresponding landmarks in both data sets, respectively. Image-based co-registration significantly improved (p < 0.001) the spatial overlap of the outlined lesion (0.42 ± 0.30 vs. 0.65 ± 0.23) and significantly reduced (p < 0.001) the distance between the corresponding landmarks (8.69 ± 6.23 mm vs. 3.19 ± 2.73 mm), allowing for the sufficient use of navigation and AR support. Navigated iUS can therefore serve as an easy-to-use tool to enable navigation support for posterior fossa surgery in the sitting position. Full article
(This article belongs to the Special Issue Intraoperative Visualization Techniques and Advanced Imaging in Brain Tumors)
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