Structural and Functional Imaging in Glioma Management

Abstract

The goal of glioma surgery is maximal safe resection in order to provide optimal tumor control and survival benefit to the patient. There are multiple imaging modalities beyond traditional contrast-enhanced magnetic resonance imaging (MRI) that have been incorporated into the preoperative workup of patients presenting with gliomas. The aim of these imaging modalities is to identify cortical and subcortical areas of eloquence, and their relationship to the lesion. In this article, multiple modalities are described with an emphasis on the underlying technology, clinical utilization, advantages, and disadvantages of each. functional MRI and its role in identifying hemispheric dominance and areas of language and motor are discussed. The nuances of magnetoencephalography and transcranial magnetic stimulation in localization of eloquent cortex are examined, as well as the role of diffusion tensor imaging in defining normal white matter tracts in glioma surgery. Lastly, we highlight the role of stimulated Raman spectroscopy in intraoperative histopathological diagnosis of tissue to guide tumor resection. Tumors may shift the normal arrangement of functional anatomy in the brain; thus, utilization of multiple modalities may be helpful in operative planning and patient counseling for successful surgery.

Recent developments and applications of ambient mass spectrometry imaging in pharmaceutical research: an overview

“…105 Because many CNS medications only have an impact upon accessing the brain, it can be particularly difficult to create CNS medications and explain when and how the biological processes might take place for a specific medical treatment. 106 While operational and structural diagnostic imaging (MRI, fMRI, CT, and PET) serves an increasingly important role in clinical investigation as well as the creation of CNS drugs, these methods merely offer visuals of the physical makeup of brain tissue instead of molecular analysis, 107 have inadequate spatial detail, and can track a tiny amount of different substances. 108 The LC-MS analytical technique's preliminary processing of tissue samples is intrusive and unsafe for the microregions of the brain.…”

Raman spectroscopy: A prospective intraoperative visualization technique for gliomas

“…Although the intraoperative frozen section is an intraoperative adjunct providing the pathology of the excised tissues to the surgeon, due to the high water content of the brain tissue and the softness of the tissue, the Intraoperative frozen section for gliomas is frequently confused by the morphology of the tissues, which prevents the pathologist from reaching a more valid conclusion. With Raman spectroscopy, it is possible to achieve intraoperative results in just a few tens of seconds, while keeping the accuracy close to that of postoperative FFPE pathology (11,(48)(49)(50). In summary, Raman spectroscopy as an intraoperative technique has the great advantages of being more rapid, label-free, accurate, and non-invasive than current intraoperative diagnostic methods.…”

A temporo-spatial pharmacometabolomics method to characterize pharmacokinetics and pharmacodynamics in the brain microregions by using ambient mass spectrometry imaging

“…At present, the common techniques used to study the brain include several types of functional brain imaging, such as functional magnetic resonance imaging (fMRI) 12 and positron emission tomography (PET) 13 , 14 , and structural brain imaging such as magnetic resonance imaging (MRI) 15 , computerized tomography (CT) 16 , single photon emission computed tomography (SPECT) 17 , and other CT technologies. Although structural and functional imaging technology plays an increasingly important role in disease research and CNS drug development, these technologies only provide images of the structure of brain tissue without analysis at the molecular level 18 , with low spatial resolution and with limited types of substances that can be monitored 19 . On the other hand, intracerebral drug analysis often uses tissue homogenates or microdialysis sampling based high-performance liquid chromatography mass spectrometry (HPLC‒MS) technology.…”