Connectome-Guided Neuronavigation Using Advanced Diffusion MRI for Brain Tumor Surgery in Critical Brain Areas

What this Trial Is About

Researchers are evaluating a new surgical approach called connectome-guided network-based navigation for brain tumor surgery in areas of the brain responsible for important functions, known as eloquent regions. This approach uses advanced diffusion MRI to create personalized maps of the brains white matter pathways and networks. The goal is to see how often this network-based information changes surgical plans compared to traditional anatomy-based methods and to assess early neurological outcomes after surgery. The study involves patients undergoing surgery to remove gliomas or brain metastases located in or near eloquent brain regions. The approach integrates patient-specific brain network maps into clinical neuronavigation systems to guide preoperative planning and decisions during surgery. This includes the use of advanced image processing pipelines and integration with intraoperative monitoring, sometimes combined with awake craniotomy and direct brain stimulation. The surgical team uses these brain maps to plan the craniotomy and the tumor removal while aiming to preserve critical brain functions. Participants undergo preoperative and postoperative MRI scans, including diffusion imaging, and neurological assessments at hospital discharge and three months after surgery. The study measures how often surgical plans change due to network-based information, the presence of lasting neurological deficits at three months, the extent of tumor removal, and the closeness of surgery to important white matter tracts. The feasibility of using this advanced imaging and navigation approach in a busy clinical setting is also evaluated. Participants remain under clinical follow-up at the hospital after surgery.

Connectome-guided Onco-functional Resection With Tractography-Extended Neuronavigation in Brain Tumor Surgery