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Cancers
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Advances of Brain Mapping in Cancer Research
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Advances of Brain Mapping in Cancer Research

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 12654

Special Issue Editors

Prof. Dr. Bernhard Meyer

E-Mail Website
Guest Editor
Department of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Interests: brain mapping; glioma; intraoperative imaging; intraoperative neuromonitoring; primary spine tumor; robotics; spinal navigation; spinal instrumentation; transcranial magnetic stimulation
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sandro Krieg

E-Mail Website
Co-Guest Editor
Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Interests: awake craniotomy; brain mapping; glioma; intraoperative imaging; intraoperative neuromonitoring; robotics; spinal navigation; spinal instrumentation; transcranial magnetic stimulation
Special Issues, Collections and Topics in MDPI journals
Dr. Sebastian Ille

E-Mail Website
Co-Guest Editor
Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Interests: awake craniotomy; brain mapping; glioma; intraoperative imaging; intraoperative neuromonitoring; robotics; spinal navigation; spinal instrumentation; transcranial magnetic stimulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

After its initialization by Horsley, Cushing, and others, as well as the advancement by Penfield, Ojemann, and colleagues to standards still partially held today, neurosurgery, basic neurological research, and multiple other specialties could not be imagined without brain mapping. Cancer research continues to reveal the substantial development of invasive, non-invasive, and processing techniques aiming to achieve the maximum extent of resection or even supramaximal resection while preserving functionality and to extend our general knowledge of brain functions.

The purpose of this Special Issue is to give a comprehensive overview summarizing the latest advances in: 1) techniques for brain mapping and monitoring of functionality; 2) the processing and evaluation of obtained data using methods such as connectome analysis, intraoperative imaging, and tractography; 3) intraoperative applications and basic research; 4) the impact of enabling function-guided brain tumor resection on patients’ oncological outcomes; 5) the ability of brain mapping to visualize plasticity and functional reorganization; 6) and prehabilitation and rehabilitation methods. This Special Issue welcomes both original research articles and reviews.

Prof. Dr. Bernhard Meyer
Prof. Dr. Sandro Krieg
Dr. Sebastian Ille
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • awake craniotomy
  • brain mapping
  • connectomics
  • direct electrical stimulation
  • glioma
  • intraoperative imaging
  • intraoperative neuromonitoring
  • intraoperative tasks
  • tractography
  • transcranial magnetic stimulation

Published Papers (6 papers)

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Research

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15 pages, 2694 KiB  
Article
Virtual Reality-Assisted Awake Craniotomy: A Retrospective Study
by Florian Bernard, Anne Clavreul, Morgane Casanova, Jérémy Besnard, Jean-Michel Lemée, Gwénaëlle Soulard, Renaud Séguier and Philippe Menei
Cancers 2023, 15(3), 949; https://doi.org/10.3390/cancers15030949 - 02 Feb 2023
Cited by 1 | Viewed by 1783
Abstract
Background: Awake craniotomy (AC) with brain mapping for language and motor functions is often performed for tumors within or adjacent to eloquent brain regions. However, other important functions, such as vision and visuospatial and social cognition, are less frequently mapped, at least partly [...] Read more.
Background: Awake craniotomy (AC) with brain mapping for language and motor functions is often performed for tumors within or adjacent to eloquent brain regions. However, other important functions, such as vision and visuospatial and social cognition, are less frequently mapped, at least partly due to the difficulty of defining tasks suitable for the constrained AC environment. Objective: The aim of this retrospective study was to demonstrate, through illustrative cases, how a virtual reality headset (VRH) equipped with eye tracking can open up new possibilities for the mapping of language, the visual field and complex cognitive functions in the operating room. Methods: Virtual reality (VR) tasks performed during 69 ACs were evaluated retrospectively. Three types of VR tasks were used: VR-DO80 for language evaluation, VR-Esterman for visual field assessment and VR-TANGO for the evaluation of visuospatial and social functions. Results: Surgery was performed on the right hemisphere for 29 of the 69 ACs performed (42.0%). One AC (1.5%) was performed with all three VR tasks, 14 ACs (20.3%) were performed with two VR tasks and 54 ACs (78.3%) were performed with one VR task. The median duration of VRH use per patient was 15.5 min. None of the patients had “VR sickness”. Only transitory focal seizures of no consequence and unrelated to VRH use were observed during AC. Patients were able to perform all VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the VRH directly. Conclusions: This preliminary experiment shows that VR approaches can provide neurosurgeons with a way of investigating various functions, including social cognition during AC. Given the rapid advances in VR technology and the unbelievable sense of immersion provided by the most recent devices, there is a need for ongoing reflection and discussions of the ethical and methodological considerations associated with the use of these advanced technologies in AC and brain mapping procedures. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
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13 pages, 4224 KiB  
Article
Resection of Low-Grade Gliomas in the Face Area of the Primary Motor Cortex and Neurological Outcome
by Katharina Lutz, Levin Häni, Cédric Kissling, Andreas Raabe, Philippe Schucht and Kathleen Seidel
Cancers 2023, 15(3), 781; https://doi.org/10.3390/cancers15030781 - 27 Jan 2023
Viewed by 1458
Abstract
Objective: During surgery on low-grade gliomas (LGG), reliable data relevant to the primary motor cortex (M1) for the face area are lacking. We analyzed the impact of tumor removal within the M1 face area on neurological deficits. Methods: We included LGG patients with [...] Read more.
Objective: During surgery on low-grade gliomas (LGG), reliable data relevant to the primary motor cortex (M1) for the face area are lacking. We analyzed the impact of tumor removal within the M1 face area on neurological deficits. Methods: We included LGG patients with resection within the M1 face area between May 2012 and November 2019. The primary endpoint was postoperative facial motor function. Secondary endpoints were postoperative aphasia, dysarthria, and dysphagia. Surgery was performed either with the awake protocol or under anesthesia with continuous dynamic mapping. The alarm criteria were speech arrest or a mapping threshold of 3 mA or less. Resection was completed in five patients. The resection was stopped due to the alarm criteria in three patients and for other reasons (vascular supply, patient performance) in four patients. A total of 66.7% (n = 8) presented with new-onset facial paresis (62.5% left LGG) and 41.7% (n = 5) with aphasia (all left LGG) postoperatively. After one year, all eight patients had recovered from the facial paresis. Tumor removal within the M1 face area was not associated with permanent facial motor deficits. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
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Review

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17 pages, 370 KiB  
Review
Technical Aspects of Motor and Language Mapping in Glioma Patients
by Nadeem N. Al-Adli, Jacob S. Young, Youssef E. Sibih and Mitchel S. Berger
Cancers 2023, 15(7), 2173; https://doi.org/10.3390/cancers15072173 - 06 Apr 2023
Cited by 4 | Viewed by 1891
Abstract
Gliomas are infiltrative primary brain tumors that often invade functional cortical and subcortical regions, and they mandate individualized brain mapping strategies to avoid postoperative neurological deficits. It is well known that maximal safe resection significantly improves survival, while postoperative deficits minimize the benefits [...] Read more.
Gliomas are infiltrative primary brain tumors that often invade functional cortical and subcortical regions, and they mandate individualized brain mapping strategies to avoid postoperative neurological deficits. It is well known that maximal safe resection significantly improves survival, while postoperative deficits minimize the benefits associated with aggressive resections and diminish patients’ quality of life. Although non-invasive imaging tools serve as useful adjuncts, intraoperative stimulation mapping (ISM) is the gold standard for identifying functional cortical and subcortical regions and minimizing morbidity during these challenging resections. Current mapping methods rely on the use of low-frequency and high-frequency stimulation, delivered with monopolar or bipolar probes either directly to the cortical surface or to the subcortical white matter structures. Stimulation effects can be monitored through patient responses during awake mapping procedures and/or with motor-evoked and somatosensory-evoked potentials in patients who are asleep. Depending on the patient’s preoperative status and tumor location and size, neurosurgeons may choose to employ these mapping methods during awake or asleep craniotomies, both of which have their own benefits and challenges. Regardless of which method is used, the goal of intraoperative stimulation is to identify areas of non-functional tissue that can be safely removed to facilitate an approach trajectory to the equator, or center, of the tumor. Recent technological advances have improved ISM’s utility in identifying subcortical structures and minimized the seizure risk associated with cortical stimulation. In this review, we summarize the salient technical aspects of which neurosurgeons should be aware in order to implement intraoperative stimulation mapping effectively and safely during glioma surgery. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
14 pages, 1447 KiB  
Review
Beyond Avoiding Hemiplegia after Glioma Surgery: The Need to Map Complex Movement in Awake Patient to Preserve Conation
by Fabien Rech and Hugues Duffau
Cancers 2023, 15(5), 1528; https://doi.org/10.3390/cancers15051528 - 28 Feb 2023
Cited by 4 | Viewed by 1361
Abstract
Improving the onco-functional balance has always been a challenge in glioma surgery, especially regarding motor function. Given the importance of conation (i.e., the willingness which leads to action) in patient’s quality of life, we propose here to review the evolution of its intraoperative [...] Read more.
Improving the onco-functional balance has always been a challenge in glioma surgery, especially regarding motor function. Given the importance of conation (i.e., the willingness which leads to action) in patient’s quality of life, we propose here to review the evolution of its intraoperative assessment through a reminder of the increasing knowledge of its neural foundations—based upon a meta-networking organization at three levels. Historical preservation of the primary motor cortex and pyramidal pathway (first level), which was mostly dedicated to avoid hemiplegia, has nonetheless shown its limits to prevent the occurrence of long-term deficits regarding complex movement. Then, preservation of the movement control network (second level) has permitted to prevent such more subtle (but possibly disabling) deficits thanks to intraoperative mapping with direct electrostimulations in awake conditions. Finally, integrating movement control in a multitasking evaluation during awake surgery (third level) enabled to preserve movement volition in its highest and finest level according to patients’ specific demands (e.g., to play instrument or to perform sports). Understanding these three levels of conation and its underlying cortico-subcortical neural basis is therefore critical to propose an individualized surgical strategy centered on patient’s choice: this implies an increasingly use of awake mapping and cognitive monitoring regardless of the involved hemisphere. Moreover, this also pleads for a finer and systematic assessment of conation before, during and after glioma surgery as well as for a stronger integration of fundamental neurosciences into clinical practice. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
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16 pages, 1419 KiB  
Review
Graph Theory Measures and Their Application to Neurosurgical Eloquence
by Onur Tanglay, Nicholas B. Dadario, Elizabeth H. N. Chong, Si Jie Tang, Isabella M. Young and Michael E. Sughrue
Cancers 2023, 15(2), 556; https://doi.org/10.3390/cancers15020556 - 16 Jan 2023
Cited by 3 | Viewed by 2815
Abstract
Improving patient safety and preserving eloquent brain are crucial in neurosurgery. Since there is significant clinical variability in post-operative lesions suffered by patients who undergo surgery in the same areas deemed compensable, there is an unknown degree of inter-individual variability in brain ‘eloquence’. [...] Read more.
Improving patient safety and preserving eloquent brain are crucial in neurosurgery. Since there is significant clinical variability in post-operative lesions suffered by patients who undergo surgery in the same areas deemed compensable, there is an unknown degree of inter-individual variability in brain ‘eloquence’. Advances in connectomic mapping efforts through diffusion tractography allow for utilization of non-invasive imaging and statistical modeling to graphically represent the brain. Extending the definition of brain eloquence to graph theory measures of hubness and centrality may help to improve our understanding of individual variability in brain eloquence and lesion responses. While functional deficits cannot be immediately determined intra-operatively, there has been potential shown by emerging technologies in mapping of hub nodes as an add-on to existing surgical navigation modalities to improve individual surgical outcomes. This review aims to outline and review current research surrounding novel graph theoretical concepts of hubness, centrality, and eloquence and specifically its relevance to brain mapping for pre-operative planning and intra-operative navigation in neurosurgery. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
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Other

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16 pages, 1185 KiB  
Systematic Review
Speech and Language Errors during Awake Brain Surgery and Postoperative Language Outcome in Glioma Patients: A Systematic Review
by Ellen Collée, Arnaud Vincent, Clemens Dirven and Djaina Satoer
Cancers 2022, 14(21), 5466; https://doi.org/10.3390/cancers14215466 - 07 Nov 2022
Cited by 6 | Viewed by 2201
Abstract
Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with gliomas in eloquent areas. Even though language is monitored carefully during surgery, many patients suffer from postoperative aphasia, with negative effects on their quality of life. Some perioperative factors [...] Read more.
Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with gliomas in eloquent areas. Even though language is monitored carefully during surgery, many patients suffer from postoperative aphasia, with negative effects on their quality of life. Some perioperative factors are reported to influence postoperative language outcome. However, the influence of different intraoperative speech and language errors on language outcome is not clear. Therefore, we investigate this relation. A systematic search was performed in which 81 studies were included, reporting speech and language errors during awake craniotomy with DES and postoperative language outcomes in adult glioma patients up until 6 July 2020. The frequencies of intraoperative errors and language status were calculated. Binary logistic regressions were performed. Preoperative language deficits were a significant predictor for postoperative acute (OR = 3.42, p < 0.001) and short-term (OR = 1.95, p = 0.007) language deficits. Intraoperative anomia (OR = 2.09, p = 0.015) and intraoperative production errors (e.g., dysarthria or stuttering; OR = 2.06, p = 0.016) were significant predictors for postoperative acute language deficits. Postoperatively, the language deficits that occurred most often were production deficits and spontaneous speech deficits. To conclude, during surgery, intraoperative anomia and production errors should carry particular weight during decision-making concerning the optimal onco-functional balance for a given patient, and spontaneous speech should be monitored. Further prognostic research could facilitate intraoperative decision-making, leading to fewer or less severe postoperative language deficits and improvement of quality of life. Full article
(This article belongs to the Special Issue Advances of Brain Mapping in Cancer Research)
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