The use of image-guided technology provides a more accurate identification of tumor margins during the surgical removal of a tumor. Many tumors, such as astrocytomas and oligodendrogliomae, cannot be easily differentiated from normal brain tissue with the naked eye. Image-guidance technology allows for comparison of the tumor with the MRI images during surgery, so that tumor margins on the MRI can be correlated with tumor margins in the patient’s brain. The advantage of image-guided surgery is particularly useful when removing tumors that are in close proximity to the speech, motor, and visual centers of the brain, to avoid damage to normal brain tissue.
James, at age 35, was diagnosed with left frontal lobe grade II oligodendroglioma. He underwent a craniotomy and removal of the tumor and returned to full time employment and normal daily activities. Seven years later, a follow up brain scan showed signs of tumor regrowth, this time, closer to critical areas of speech and motor function. Further surgery in the area carried potential risks for loss of speech, and weakness of the right arm and leg.
James elected to have a second craniotomy with image guidance technique. He recovered without complications and a post operative MRI scan did not show any sign of residual tumor. Because the tumor had recurred after the first operation, James was advised and chose to have post-operative radiotherapy and chemotherapy.
18 months after his second craniotomy, his brain scans show no sign of the tumor returning, allowing James to continue to work full-time and enjoy a normal life.
With today’s modern image guidance technology, the neurosurgeon can be more aggressive in the removal of deep-seated brain tumors with less risk of injury to critical structures within the brain, preserving health and quality of life.