Moffitt Onco Update

Surgical Navigation Between Brain Tumors: A Balancing Act

November 15, 2015

Surgical Navigation Between Brain Tumors.jpg Neuro tractography is a 3D modeling technique used to visually represent neural tracts

Arnold Etame, MD, PhD

Brain tumors can either destroy or displace critical white matter pathways that control important functions such as movement, speech or vision. Prior to removing brain tumors, it is very important for the neurosurgeon to have an idea of the location of critical white matter fibers with respect to the tumor. Such information should enable the surgeon to select a surgical path to the tumor that minimizes damage and therefore improve outcomes for patients.

Figures: MRI-guided stereotactic images for tumor resection. The tumor (orange object) is located in the movement area. The movement fibers are appreciated (blue). Knowing the relationship of fibers to the tumor, as well as performing the surgery while patients are awake is essential for safe maximum resection of tumor.
Figures: MRI-guided stereotactic images for tumor resection. The tumor (orange object) is located in the movement area. The movement fibers are appreciated (blue). Knowing the relationship of fibers to the tumor, as well as performing the surgery while patients are awake is essential for safe maximum resection of tumor.

Thanks to technological advances in MRI-guided neurosurgery techniques for brain tumors, Moffitt Cancer Center employs 3-D representations of both tumor and critical white matter pathways (see Figures) that enable the neurosurgeons to navigate in real-time during surgery, thereby staying cognizant of the relationship between tumor and white matter pathways. Using tractography and other innovative technologies, we can safely remove tumors that are located next to movement, speech and vision pathways with very good outcomes.