Neurosurgery Research on Brain Tumors: A Focus on Gliomas and Other Intra-axial Brain Tumors

Dear Colleagues,

Gliomas are primary intra-axial brain tumors that are commonly managed in neurosurgical clinical practice. In recent years, neuro-oncological care has improved, leading to an increased number of patients being diagnosed and treated for gliomas.

Research and technological advances involve several areas of neurosciences including the following:

• Neuroanatomy;
• Advanced neurosurgical technologies;
• Brain imaging (including both neuroradiology and nuclear medicine);
• Improvements in the management of adjuvant treatments;
• Interface between informatics and imaging.

Collaterally, gliomas impact the daily aspects of quality of life that influence decision making for each patient, sometimes despite molecular and radiological features of tumors.

First of all, advancements in neurosurgical practice have led to increased safety for patients that can be operated with a maximalized resection with a low risk of post-operative neurological deficits. Such achievements are related to technological progress due to the availability of intraoperative adjuncts like operative microscopes, 3D exoscopes, ultrasound, neuronavigation, MRI, neurophysiological monitoring, etc. Advances in surgical technologies and techniques are pushing the extent of tumor resection beyond common boundaries, reaching functionally eloquent bundles, although the role of extensive surgical resections still needs to be better clarified.

Moreover, technological progress in all disciplines other than neurosurgery and involved in the treatment of neuro-oncological patients is also responsible for the better care delivered to patients with brain tumors.

In particular, the availability of better MRI technologies has provided a clear anatomical definition of brain tumors and their relations with peritumoral health tissues. Moreover, the better depiction of eloquent cortical areas and subcortical bundles has also concurred, decreasing the rate of post-operative neurological deficits due to a better pre-operative planning. In addition, some improvements matching brain MRI with PET imaging have also concurred, defining the peritumoral infiltrative boundaries responsible for early tumor recurrence. Discoveries about the role of peritumoral tissue and tumor recurrence have pushed neuro-oncological surgery toward the concept of supramarginal resection. Further development will involve the use of artificial intelligence in order to achieve a better pre-operative histological and molecular definition. This would lead to a more accurate and tailored pre-operative planning and will avoid the need for purely bioptic procedures in a large part of the neuro-oncological cases.

Finally, over the years, increased efforts in basic research on patients have been applied for tailoring adjuvant treatments for each patient. Further efforts will be devoted for finding a single way to treat each patient. Molecular knowledge on gliomas has transitioned from the bench to the bed, and it will play a fundamental role in contrasting gliomas.

Although profuse efforts have been spent on the research of brain tumors, they still have a poor prognosis. Nowadays, surgery alone might not be the best way to approach brain tumors, and a multimodal approach might be the best care that can be offered to patients.

We are pleased to invite you to contribute to this Special Issue that aims to collect articles dedicated to advances in neurosurgical treatment of brain tumors, especially looking at advances in neurosurgery and neuro-oncology, neuroanatomy applied to neurosurgery, neuroradiology applied to neurosurgery, new molecular targets, or new tailored therapeutic approaches. This Special Issue is dedicated mainly to primary brain tumors like gliomas, but it may consider any other paper dedicated to other intra-axial brain tumors. 

This Special Issue aims to offer to clinicians an up-to-date overview of the most recent neuro-oncological advances in the treatment of patients with brain tumors.

• Advances in neuroanatomy applied to neurosurgery (for example, DTI tractography and functional MRI);
• Advances in neuroradiology applied to neuro-oncology in order to better define histological diagnosis, molecular patterns, and the prognosis of patients with brain tumors;
• Advances in the application of artificial intelligence to neurosurgery, neuroanatomy, and neuroradiology;
• Advances in neurosurgical approach for brain tumors (for example, new technologies);
• Applications of technologies to neurosurgery (for example, focusing on the role of intraoperative tools like US, MRI, neurophysiological monitoring, etc.);
• Tailored approaches to patients with brain tumors focusing on peculiar aspects like elderly patients, tumors in eloquent areas, etc;
• New potential druggable targets or communications on new discoveries about adjuvant treatments for brain tumors (especially gliomas);
• Impact of treatments on neuro-oncological outcomes and quality of life in order to better select patients for the best tailored therapy;
• Role of multimodal treatments for brain tumors.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: 

• Glioma;
• Neurophysiological monitoring;
• Neuropsychology;
• Intraoperative imaging (including iMRI and iOUS);
• Neuroanatomy;
• Outcome, prognosis, and quality of life;
• MRI (including fMRI, MR spectroscopy, perfusion, and DTI tractography);
• Radiogenomics;
• Multimodal treatments;
• Druggable targets;
• Artificial intelligence and deep learning.

Dr. Andrea Di Cristofori
Prof. Dr. Carlo Giussani
Dr. Cesare Zoia
Dr. Daniele Bongetta
Guest Editors

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• neurosurgery
• glioma
• neuropsychology
• neurophysiological monitoring
• intraoperative imaging (including iMRI and iOUS)
• neuroanatomy
• outcome
• prognosis and quality of life
• MRI (including fMRI, MR spectroscopy, perfusion and DTI tractography)
• radiogenomics
• multimodal treatments
• druggable targets
• artificial intelligence and deep learning