The cancer journal
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The use of intraoperative imaging (IOI) in neurosurgical practice is proving to be yet another important advance in the evolution of brain tumor resection, particularly for the most common adult primary brain tumor--glioblastoma (GBM). The number of surgeons using IOI continues to increase, and the experience to date affords an opportunity to assess the value of the various techniques used for IOI.
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Surgical resection is a critical aspect of the management of a patient with a glioblastoma (GBM). An intimate knowledge of the anatomy of a GBM, as well as familiarity with particular surgical techniques and adjunctive technologies is required for safe surgical resection. The goals of resection include diagnosis, relief of mass effect, and cytoreduction. ⋯ Even in functionally critical areas, "gross total" resections are possible if proper techniques are employed. It is recommended that a "gross total" resection of the enhancing portion of a GBM be performed whenever possible. With this philosophy, the mortality rate is 3% and the rate of major neurologic morbidity is less than 10%.