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Contributors
DANIEL K. RESNICK, MD, MS (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 20, 2020 Category: Neurosurgery Source Type: research

Contents
Michael A. Vogelbaum (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 20, 2020 Category: Neurosurgery Source Type: research

Forthcoming Issues
Glioblastoma, Part II: Molecular and Clinical Trials (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 20, 2020 Category: Neurosurgery Source Type: research

Use of Intraoperative Fluorophores
Fluorescence-guided surgery provides surgeons with improved visualization of tumor tissue in the operating room to allow for maximal safe resection of brain tumors. Multiple fluorescent agents have been studied for fluorescence-guided surgery. Both nontargeted and targeted fluorescent agents are currently being used for glioblastoma multiforme visualization and resection. Fluorescence detection in the visible light or near infrared spectrum is possible. Visualization device advancements have permitted greater detection of fluorescence down to the cellular level, which may provide even greater ability for the neurosurgeon t...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Alexander J. Schupper, Constantinos Hadjipanayis Source Type: research

Role of Resection in Glioblastoma Management
Whenever possible, maximal safe resection is the first intervention for management of glioblastoma. Resection offers tissue for diagnosis, decompression of the brain, cytoreduction, and has been associated with prolonged survival in numerous retrospective studies. In this review, we provide a critical overview of the literature associating glioblastoma resection with survival. We discuss techniques that enhance extent of resection, and the role of clinical and surgeon-variables. At last, we analyze the covariates and confounders that might influence the relationship between extent of resection and survival for glioblastoma...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Mark W. Youngblood, Roger Stupp, Adam M. Sonabend Source Type: research

Advancing Imaging to Enhance Surgery
Conventional magnetic resonance imaging (cMRI) has an established role as a crucial disease parameter in the multidisciplinary management of glioblastoma, guiding diagnosis, treatment planning, assessment, and follow-up. Yet, cMRI cannot provide adequate information regarding tissue heterogeneity and the infiltrative extent beyond the contrast enhancement. Advanced magnetic resonance imaging and PET and newer analytical methods are transforming images into data (radiomics) and providing noninvasive biomarkers of molecular features (radiogenomics), conveying enhanced information for improving decision making in surgery. Thi...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Marco Riva, Egesta Lopci, Lorenzo G. Gay, Marco Conti Nibali, Marco Rossi, Tommaso Sciortino, Antonella Castellano, Lorenzo Bello Source Type: research

Functional Mapping for Glioma Surgery, Part 1
Although intraoperative mapping of brain areas was shown to promote greater extent of resection and reduce functional deficits, this was shown only recently for some noninvasive techniques. Yet, proper surgical planning, indication, and patient consultation require reliable noninvasive techniques. Because functional magnetic resonance imaging, tractography, and neurophysiologic methods like navigated transcranial magnetic stimulation and magnetoencephalography allow identifying eloquent areas prior to resective surgery and tailor the surgical approach, this article provides an overview on the individual strengths and limit...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Sebastian Ille, Sandro M. Krieg Source Type: research

Surgical Adjuncts for Glioblastoma
This article summarizes the approaches and therapeutics that have been evaluated to date, and challenge s that remain to be overcome. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Sara Hartnett, Derek Kroll, Michael A. Vogelbaum Source Type: research

Stereotactic Laser Ablation of Glioblastoma
The previous decade has seen an expansion in the use of laser interstitial thermal therapy (LITT) for a variety of pathologies. LITT has been used to treat both newly diagnosed and recurrent glioblastoma (GBM), especially in deep-seated, difficult-to-access lesions where open resection is otherwise infeasible or in patients who would not tolerate craniotomy. This review aims to describe the current state of the technology and operative technique, as well as summarize the outcomes data and future research regarding LITT as a treatment of GBM. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Matthew M. Grabowski, Balint Otvos, Alireza M. Mohammadi Source Type: research

Radiosurgery for Glioblastoma
Glioblastoma (GBM) is infiltrative neoplasm with limited treatment options and poor overall survival. Stereotactic radiosurgery (SRS) allows spatially precise and conformal delivery of high doses of radiation. Salvage SRS for locally recurrent GBM was shown to improve patient survival and have more favorable safety profile than repeated surgical resection. Boost SRS after fractionated radiation therapy is sometimes attempted; however, Radiation Therapy Oncology Group 93 –05 randomized clinical trial did not demonstrate benefits of upfront SRS that was administered before fractionated radiation. Administration of bevacizu...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Adomas Bunevicius, Jason P. Sheehan Source Type: research

Surgery for Glioblastoma in Elderly Patients
The management of glioblastoma in the elderly population represents a field of growing interest owing a longer life expectancy. In this age group, more than in the young adult, biological age is much more important than chronologic one. The date of birth should not exclude a priori access of treatments. Maximal safe resection is proved to be the first option when performance status and general health is good. Adjuvant therapy and decision about management of recurrence should be choose in a multidisciplinary group according to performance of the patients and O6-methylguanine-DNA methyl-transferase methylation. (Source: Neu...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Marco Conti Nibali, Lorenzo G. Gay, Tommaso Sciortino, Marco Rossi, Manuela Caroli, Lorenzo Bello, Marco Riva Source Type: research

Functional Mapping for Glioma Surgery, Part 2
This article describes techniques used for motor and language mapping including awake mapping considerations in addition to less traditional intraoperative testing paradigms for cognition. It also discusses complications associated with mapping and insights into complication avoidance. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Ramin A. Morshed, Jacob S. Young, Anthony T. Lee, Shawn L. Hervey-Jumper Source Type: research

Window of Opportunity Clinical Trials to Evaluate Novel Therapies for Brain Tumors
This article provides an overview of window of opportunity trials, including novel designs for incorporating biologic end points into early stage trials in context of brain tumors, and examples of successfully executed window of opportunity trials for glioblastoma. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Visish M. Srinivasan, Chibawanye Ene, Brittany Parker Kerrigan, Frederick F. Lang Source Type: research

Intraoperative Imaging for High-Grade Glioma Surgery
This article discusses intraoperative imaging techniques used during high-grade glioma surgery. Gliomas can be difficult to differentiate from surrounding tissue during surgery. Intraoperative imaging helps to alleviate problems encountered during glioma surgery, such as brain shift and residual tumor. There are a variety of modalities available all of which aim to give the surgeon more information, address brain shift, identify residual tumor, and increase the extent of surgical resection. The article starts with a brief introduction followed by a review of with the latest advances in intraoperative ultrasound, intraopera...
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Thomas Noh, Martina Mustroph, Alexandra J. Golby Source Type: research

Challenges Associated with Reoperation in Patients with Glioma
This article reviews indications, challenges, and recommendations for repeat surgery in the patient with glioma. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 4, 2020 Category: Neurosurgery Authors: Rasheed Zakaria, Jeffrey S. Weinberg Source Type: research