Advanced magnetic resonance imaging techniques in brain tumours surgical planning

Abstract

Morphological assessment using Computed Tomo-graphy (CT) or Magnetic Resonance Imaging (MRI) is still the workhorse of tumor detection and diagnosis. In particular, MRI provides detailed information about cerebral tumor anatomy, cellular metabolism and hemodynamic features, making it a fundamental tool for a correct diagnosis, treatment and monitoring of the disease. Various new functional imaging modalities assessing tissue microstructure and physiology have increased the scope of neuro imaging and raised expectations among clinicians. This article provides an overview of t he most advanced MR im aging techniques (functional MRI, perfusion-weighted imaging, diffusion-weighted imaging and MR spectroscopy) now available for neurosurgical planning and their role in brain tumors assessment. Their pros and cons are analyzed 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 golden standard; only the integration of advanced and conventional MR imaging proves to be a reliable tool in the hands of the neuro-radiologist and neurosurgeon, thus maximazing tumor resection and function preservation.