Advanced magnetic resonance imaging techniques in brain tumours surgical planning

Abstract

Morphologicalassessment using Computed Tomo-graphy (CT) or Magnetic Resonance Imaging (MRI)is still the workhorse of tumor detection and diagnosis. In particular, MRIprovides detailed information about cerebral tumor anatomy, cellular metabolismand hemodynamic features, making it a fundamental tool for a correct diagnosis,treatment and monitoring of the disease. Various new functional imaging modalitiesassessing tissue microstructure and physiology have increased the scope ofneuro imaging and raised expectations among clinicians. This article providesan overview of themost advanced MR imaging techniques (functionalMRI, perfusion-weighted imaging, diffusion-weighted imaging and MR spectroscopy) now available for neurosurgicalplanning and their role in brain tumors assessment. Their pros and cons areanalyzed in order to find out which one may be chosen as best diagnostic pre-surgical protocol.At the moment none of the single techniques can be considered the goldenstandard; only the integration of advanced and conventional MR imaging provesto be a reliable tool in the hands of the neuro-radiologist and neurosurgeon,thus maximazing tumorresection and function preservation.