Intraoperative Optical Imaging in Patient-Specific Brain Tumor Surgery

The neurosurgical treatment of brain tumors requires a case-by-case balance between achieving the most complete tumor resection possible and preserving functionally important areas of the brain. Extensive resection may be associated with improved oncological outcomes but carries the risk of postoperative neurological deficits, particularly in tumors located near eloquent areas. Therefore, precise mapping of the patient-specific relationship between the tumor, cortical functions, and fiber tracts is of central importance for surgical planning and intraoperative decision-making. A particular focus of our research is on intraoperative optical imaging. The goal is to develop and evaluate noninvasive, marker-free methods that can visualize functional cortical activity during neurosurgical procedures. The focus is particularly on functions such as motor, sensory, and language functions. Since the localization of these functions varies from person to person and may be altered by tumor-induced displacement or functional reorganization, optical imaging techniques are intended to help identify functionally relevant areas directly within the surgical field on a patient-specific basis. Optical imaging offers the potential to provide additional functional information directly under intraoperative conditions. Thus, it may contribute to a more precise delineation of resectable and functionally critical tissue areas. The data obtained are systematically compared with established pre- and intraoperative methods. These include, among others, structural MRI, functional MRI, diffusion tensor imaging, and transcranial magnetic stimulation. These modalities serve primarily to validate and contextualize the research findings obtained through optical imaging. The long-term goal is to expand the intraoperative information base in brain tumor surgery and thereby support a more individualized surgical strategy. The focus is on improving the balance between oncologically sound tumor resection and the best possible preservation of neurological functions.