Literature Review on Effective Use of Modern Modalities in Management of Intra-Axial Brain Lesions

Abstract

The significant health burden caused by intra-axial brain lesions and the difficulties associated with their diagnosis and treatment have prompted a large number of researchers and practitioners to investigate various diagnostic and treatment modalities for their effectiveness and safety. This study focuses on evaluating different pre-, intra- and postoperative techniques and analyzes their advantages and limitations to ultimately improve the management of this type of brain lesion. Through a critical analysis of various scientific sources, this research aimed to synthesize existing knowledge on the topic. Magnetic resonance imaging plays a crucial role in diagnosing and managing brain tumors. Functional MRI identifies functional brain areas, but tumor-induced blood flow changes can affect its reliability. Connectome analysis provides information on functional localization and brain networks, which became possible using diffusion tensor imaging, that visualizes white matter pathways, aiding in tumor boundary delineation and surgical planning. Studies suggest this method can predict tumor histology and prognosis. Intraoperative MRI improves the extent of tumor resection and potentially patient survival. But due to its limitations it has alternative intraoperative techniques, like intraoperative ultrasound, fluorescence-guided surgery, direct electrical stimulation, deep brain stimulation, but evidence for most of these methods is limited for most brain tumors. Only ultrasound showed real-time tumor visualization and residual disease analysis offering high accuracy and is relatively inexpensive compared to ioMRI. This study can be useful to neurosurgeons, neuro-oncologists, neurologists, neuro-radiologists, and will demonstrate prospects for further research.