Augmented reality intraoperative tractography for diffuse glioma resection adjacent to the corticospinal tract: a case series with preliminary results.

This study explores the use of augmented reality (AR) for intraoperative guidance during the microsurgical resection of diffuse gliomas, especially those located near the critical corticospinal tract. AR provides surgeons with a three-dimensional view of essential brain structures in real time, overcoming the limitations of traditional navigation systems and potentially improving surgical precision. In our case series involving five patients, we combined AR-based visualization with neurophysiological monitoring, allowing precise mapping of the corticospinal tract relative to the tumor. This approach contributed to complete tumor removal in most cases, while also preserving motor function in all patients. Our findings suggest that AR technology can enhance spatial understanding during complex surgeries, minimizing the risk to critical neural pathways. While our initial results are promising, demonstrating reliable alignment accuracy and improved outcomes, further studies on larger patient groups are necessary to fully understand and validate AR's role in neurosurgery. This research underscores AR's potential to improve both safety and outcomes, adding valuable tools for intraoperative navigation.