Work

Value of Intraoperative Computed Tomography in Intra-Axial Brain Tumor Surgery: A Systematic Review

Year: 2025

Type: review

Abstract: BACKGROUND: Real-time intraoperative imaging with neuronavigation is a valuable adjunct in the surgical management of intra-axial brain tumors. While intraoperative magnetic resonance imaging is the gold standard, recent advances in technology have explored the utility of intraoperative computed tomography (iCT) as an alternative. METHODS: A systematic review was conducted by searching multiple databases, including MEDLINE, PubMed, Scopus, Cochrane Library, and Web of Science, for studies published from 1982 to 2024. Studies that evaluated the use of iCT in intra-axial brain tumor surgeries and reported on outcomes such as the extent of tumor resection, residual tumor detection, and postoperative complications were included. RESULTS: Thirteen studies met the inclusion criteria. Overall, recent improvements in iCT's soft tissue imaging quality have increased its utility in intra-axial brain tumor surgeries. iCT was found to improve tumor resection accuracy in some instances, helping neurosurgeons detect residual tumors and refine surgical strategies. However, conclusions about its impact on long-term outcomes are limited by the lack of data on molecular tumor characteristics and adjuvant therapies. CONCLUSION: Further high-quality prospective work is needed to validate the role of iCT in improving key outcome parameters in neuro-oncology. Until then, iCT remains an adjunct whose use can be considered in selected cases. Continued research on iCT is warranted to determine further indications in intra-axial brain tumor surgery.

Source: World Neurosurgery

DOI: 10.1016/j.wneu.2025.124029