Innovations in Brain Tumor Surgery: Techniques and Outcomes

Topic Information

Dear Colleagues,

Brain tumors represent a diverse and challenging category of diseases that require specialized diagnostic and therapeutic strategies. Advancements in imaging, surgery, radiation therapy, and drug development are improving outcomes for many patients. However, the prognoses remain largely dependent on the tumor type and stage, and continued research is crucial for developing more effective treatments. This Topic focuses on the latest advancements in the field of brain tumor surgery, highlighting groundbreaking techniques and their impact on patient outcomes. As brain tumor treatments continue to evolve, a key focus of the issue is the role of innovative technologies in improving the precision, safety, and efficacy of surgical interventions. Research areas may include (but are not limited to) the following:

• Advances in Preoperative Planning and Imaging;
• Cutting-Edge Intraoperative Technologies;
• Personalized Surgical Approaches;
• Postoperative Advancements;
• Clinical Outcomes and Future Directions.

We encourage submissions of original research articles, reviews, and clinical studies that present important developments in brain tumor surgery, leading to more precise, effective, and less invasive treatments. The ongoing development and integration of new tools and techniques will continue to enhance our ability to treat complex brain tumors, ultimately improving patient outcomes and survival rates.

Prof. Dr. Maria Caffo
Prof. Dr. Teresa Somma
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Brain Sciences brainsci	2.8	5.6	2011	17.6 Days	CHF 2200	Submit
Cancers cancers	4.4	8.8	2009	19.1 Days	CHF 2900	Submit
Journal of Clinical Medicine jcm	2.9	5.2	2012	18.5 Days	CHF 2600	Submit
Neurology International neurolint	3.0	4.8	2009	21.5 Days	CHF 1800	Submit
Diagnostics diagnostics	3.3	5.9	2011	21.6 Days	CHF 2600	Submit
Therapeutics therapeutics	-	-	2024	15.0 days *	CHF 1000	Submit
Current Oncology curroncol	3.4	4.9	1994	22.8 Days	CHF 2200	Submit

* Median value for all MDPI journals in the second half of 2025.

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Published Papers (3 papers)

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All Brain Sciences Cancers JCM Neurology International Diagnostics Therapeutics Current Oncology

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15 pages, 2428 KB  

Open AccessArticle

Pituitary Neuroendocrine Tumors Extending Primarily Below the Sella and into the Clivus: A Distinct Growth Pattern with Specific Challenges

by Lennart W. Sannwald, Nina Kreße, Nadja Grübel, Andreas Knoll, Johannes Roßkopf, Michal Hlavac, Christian R. Wirtz and Andrej Pala

Curr. Oncol. 2026, 33(1), 36; https://doi.org/10.3390/curroncol33010036 - 8 Jan 2026

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Abstract

Evaluation of pituitary neuroendocrine tumors remains complex depending on the exact growth pattern, involvement of critical neurovascular structures, pituitary function and endocrinological activity of the tumor. A predominant growth into the sphenoid sinus and clivus poses specific challenges. We reviewed 557 surgeries for [...] Read more.

Evaluation of pituitary neuroendocrine tumors remains complex depending on the exact growth pattern, involvement of critical neurovascular structures, pituitary function and endocrinological activity of the tumor. A predominant growth into the sphenoid sinus and clivus poses specific challenges. We reviewed 557 surgeries for pituitary neuroendocrine tumors in an endonasal endoscopic technique performed between 1 January 2015 and 31 August 2025 to identify 13 cases (2.3%). Clinical, radiological and surgical data were selected by chart review. Thirteen cases aged from 31 to 68 years with almost exclusively non-functioning or clinically silent tumors (92%) were identified. Clival infiltration was restricted to the dorsum sellae in 2/13 (15%), spread to the floor of the sphenoid in 6/13 (46%) and extended inferior to the sphenoid in 5/13 (38%) cases with a high rate of cavernous sinus (62%) and sphenoid sinus infiltration (69%). Complete resection was achieved in 31%, and the residual tumor was clival/sphenoidal in 5/13 cases or within the cavernous sinus in 6/13 cases. The diaphragma sellae was reported to be intact in 92% of cases, and postoperative transient arginine vasopressin deficiency did not occur. Pituitary neuroendocrine tumors predominantly growing below the sella and infiltrating the clivus and sphenoid present specific challenges with a high rate of preoperative pituitary insufficiency, frequent cavernous sinus infiltration and postoperative tumor residuals in the cavernous sinus, sphenoid bone and clivus which are sometimes difficult to delineate. The surgical approach must be tailored specifically to treat the clival infiltration zone to reduce the risk of recurrence. Full article

(This article belongs to the Topic Innovations in Brain Tumor Surgery: Techniques and Outcomes)

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20 pages, 5431 KB  

Open AccessArticle

Predicting the Consistency of Vestibular Schwannoma and Its Implication in the Retrosigmoid Approach: A Single-Center Analysis

by Raffaele De Marco, Giovanni Morana, Silvia Sgambetterra, Federica Penner, Antonio Melcarne, Diego Garbossa, Michele Lanotte, Roberto Albera and Francesco Zenga

Curr. Oncol. 2025, 32(11), 647; https://doi.org/10.3390/curroncol32110647 - 19 Nov 2025

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Abstract

To explore the relationship between magnetic resonance imaging (MRI) parameters, including T2-weighted intensity and apparent diffusion coefficient (ADC), and intraoperative tumor characteristics, particularly consistency, in vestibular schwannomas (VSs). The association between tumor consistency, facial nerve (FN) function, and postoperative outcomes was analyzed. A [...] Read more.

To explore the relationship between magnetic resonance imaging (MRI) parameters, including T2-weighted intensity and apparent diffusion coefficient (ADC), and intraoperative tumor characteristics, particularly consistency, in vestibular schwannomas (VSs). The association between tumor consistency, facial nerve (FN) function, and postoperative outcomes was analyzed. A single-center retrospective analysis included newly diagnosed VS cases (2020–2023) with cisternal involvement (Samii T3a; volume ≥ 0.7 cm³). T2 and ADC maps from the perimetral region of interest were normalized, and tumors were categorized into 3 classes by combining qualitative consistency (soft, fibrous, or fibrous/hard), ultrasonic aspirator power, and adherence to neurovascular structures. FN function was assessed using the House–Brackmann scale at the immediate postoperative period and 12-month follow-up. MRIs of 33 VSs (18 solid and 15 cystic) were analyzed. Normalized values of both T2 (N-T2_mean) and ADC (N-ADC_min) maps predicted the classical radiological differentiation. N-ADC_min may have some role in predicting consistency (value 1.361, p = 0.017, accuracy 0.48) and demonstrated a significant association (p = 0.04) with the FN outcome in the immediate postoperative period. An augmented consistency could impair FN function by increasing the intrameatal pressure related to greater transmission of shocks derived from the dissection maneuvers of the cisternal component of the tumor. The possibility of non-invasively exploring VS consistency with a parameter easily calculable on MRI might be beneficial in surgical planning, modifying the timing of the opening of the meatus with respect to what could be the surgical routine in some centers. Full article

(This article belongs to the Topic Innovations in Brain Tumor Surgery: Techniques and Outcomes)

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24 pages, 1035 KB  

Open AccessSystematic Review

Metabolic Imaging as Future Technology and Innovation in Brain-Tumour Surgery: A Systematic Review

by Thomas Kapapa, Ralph König, Jan Coburger, Benjamin Mayer, Kornelia Kreiser and Volker Rasche

Curr. Oncol. 2025, 32(11), 597; https://doi.org/10.3390/curroncol32110597 - 24 Oct 2025

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Abstract

Background: Standard imaging in neurosurgery often fails to visualize infiltrative tumor regions that extend beyond contrast enhancement. Metabolic imaging using hyperpolarized 13C-MRI may offer new intraoperative insights into tumor biology. Objective: To systematically assess the clinical and technical evidence on hyperpolarized MRI for [...] Read more.

Background: Standard imaging in neurosurgery often fails to visualize infiltrative tumor regions that extend beyond contrast enhancement. Metabolic imaging using hyperpolarized 13C-MRI may offer new intraoperative insights into tumor biology. Objective: To systematically assess the clinical and technical evidence on hyperpolarized MRI for metabolic tumour characterization in patients with malignant brain tumors. Eligibility criteria: We included original human studies reporting on hyperpolarized 13C-MRI for perioperative and diagnostic use in brain tumor patients. Reviews, animal studies, and technical-only reports were excluded. Information sources: Searches were conducted in PubMed, Embase, and Web of Science on 26 December 2024. Risk of bias: Methodological quality was assessed using the QUADAS-2 tool. Synthesis of results: A qualitative synthesis was performed, and where feasible, random-effects meta-analysis was used to calculate standardized mean differences (SMDs) and heterogeneity statistics. Results: Three studies (n = 15 patients) met inclusion criteria. The bicarbonate-to-pyruvate ratio showed a significant difference between tumor and non-tumour brain (SMD = 1.34, p = 0.002), whereas pyruvate-to-lactate ratio (kPL) values showed minimal difference (SMD = 0.06, p = 0.730). Asmall effect was observed for kPL between tumor and normal-appearing white matter (SMD = –0.33). One study provided qualitative data only. Overall heterogeneity was high (I² = 69.4%). Limitations: Limitations include small sample sizes, heterogeneous methodologies, and limited availability of patient-level data. Interpretation: Hyperpolarized 13C-MRI shows metabolic differentiation between tumor and healthy tissue in certain parameters, especially bicarbonate metabolism. While promising, the technology requires further clinical validation before routine intraoperative application. Full article

(This article belongs to the Topic Innovations in Brain Tumor Surgery: Techniques and Outcomes)

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