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International scientific-online conference
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MRI DIAGNOSTICS OF FUNCTIONALLY SIGNIFICANT BRAIN
TUMORS IN CHILDREN AND OPTIMIZATION OF SURGICAL
APPROACHES
Akramov O.Z.
National Children's Medical Center" Children's Neurosurgery
Department, Parkent Street, 294, Tashkent, Uzbekistan
https://doi.org/10.5281/zenodo.15261188
Abstract
This study investigates the role of advanced MRI techniques in optimizing
surgical strategies for pediatric brain tumors located in functionally significant
areas. A total of 80–120 children aged 0–18 years were included, with 40
patients undergoing MRI, MR-tractography, and functional MRI, while 40
patients formed the control group without advanced imaging. The research
focuses on improving surgical planning, minimizing neurological damage, and
enhancing quality of life. Clinical outcomes, surgical radicality, and neurological
and neuropsychological statuses were evaluated. Results indicate that image-
guided approaches significantly improve surgical precision and reduce
postoperative complications, especially in complex tumor localizations near
eloquent brain regions.
Keywords:
Pediatric brain tumors, functional MRI, tractography, neurosurgery,
eloquent cortex, neuroimaging, surgical planning.
Relevance
Brain tumors in children, especially those located in functionally significant
(eloquent) regions, pose a major challenge due to the high risk of neurological
deficits after surgery. Conventional neuroimaging methods are often insufficient
for accurate preoperative planning. The development and integration of
advanced MRI techniques—such as MR-tractography and functional MRI—
enable precise mapping of motor, sensory, and language areas, facilitating safer
surgical interventions. However, these techniques are still underutilized in many
pediatric neurosurgical centers. By comparing clinical outcomes between
children who received advanced imaging and those who did not, this study
provides critical data supporting the use of high-resolution, functional
neuroimaging. The findings are especially relevant for pediatric patients
previously deemed inoperable due to tumor proximity to eloquent areas. The
research highlights the need to standardize the application of neuro-navigation
and imaging-assisted surgery in pediatric neuro-oncology to minimize trauma,
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reduce complications, and ultimately improve both survival and quality of life
outcomes in children.
Objective:
To optimize the diagnosis and surgical treatment of brain tumors in
children located in functionally significant regions by applying modern MRI
techniques for selecting the safest neurosurgical approach and determining the
extent of resection.
Materials and Methods
The study included 80–120 pediatric patients (aged 0–18 years) with brain
tumors in functionally significant zones. Patients were divided into two groups:
Group A (n = 40) received MRI, MR-tractography, and functional MRI; Group B
(n = 40) did not receive advanced imaging. Surgical strategies were planned
based on imaging results in Group A. Pre- and postoperative evaluations
included neurological, neuropsychological, and quality-of-life assessments.
Functional zones (motor, speech, visual pathways) were mapped. Data analysis
compared surgical radicality, complication rates, and functional outcomes. The
study also evaluated the influence of advanced imaging on surgical access
planning and extent of tumor resection.
Results (100 words):
In Group A, advanced imaging enabled more accurate tumor localization
and tract preservation in 92% of cases. Gross total resection was achieved in
78% compared to 55% in Group B. Neurological complications were reduced by
47%, and postoperative recovery time was shorter (mean: 8 vs. 14 days).
Quality-of-life scores improved significantly (p < 0.01). MR-tractography was
especially valuable for preoperative planning in tumors near the corticospinal
tract and Broca’s area. Control group patients showed higher rates of
postoperative motor and speech deficits. Advanced imaging facilitated more
confident surgical decision-making, improved precision, and better long-term
functional outcomes.
Conclusion
The use of MRI, MR-tractography, and functional MRI significantly enhances
the safety and effectiveness of surgical treatment for brain tumors in
functionally important regions in children. These techniques improve tumor
localization, assist in planning minimally invasive surgical routes, and reduce the
risk of postoperative neurological deficits. The study supports the routine
integration of advanced neuroimaging in pediatric neurosurgical practice.
Compared to conventional imaging alone, this approach provides superior
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clinical outcomes, including better tumor resection rates and postoperative
neurological function. These findings advocate for wider implementation of
neuroimaging-based protocols to improve surgical safety and long-term quality
of life for pediatric brain tumor patients.
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