FUNCTIONAL MRI AND TRACTOGRAPHY-GUIDED SURGERY IN PEDIATRIC BRAIN TUMORS: IMPROVING OUTCOMES IN ELOQUENT BRAIN AREAS

Аннотация

This study evaluates the impact of functional MRI (fMRI) and MR- tractography on surgical outcomes in children with brain tumors in eloquent areas. A cohort of 100 pediatric patients was assessed, including 60 patients who underwent fMRI and tractography-guided surgery and 40 control patients treated without functional imaging. The integration of advanced imaging allowed for individualized surgical planning, resulting in reduced complications, shorter hospitalization, and higher functional preservation. Gross total resection was achieved in 82% of cases with imaging guidance. Postoperative neurological deterioration occurred in only 6.7%, compared to 25% in the control group. Functional imaging improved confidence in surgical decisions. Keywords: Pediatric neuro-oncology, functional MRI, tractography, eloquent cortex, neurosurgical outcomes, brain tumor resection, neuroimaging. Relevance Pediatric brain tumors in eloquent regions represent a significant neurosurgical challenge due to the high risk of neurological sequelae. Advanced neuroimaging techniques, such as functional MRI and MR-tractography, offer precise mapping of language, sensory, and motor pathways. Despite their proven utility in adults, their routine use in pediatric practice remains limited. This study demonstrates that these imaging modalities substantially increase surgical precision while decreasing complication rates and hospitalization time. By comparing outcomes of patients operated with and without preoperative functional imaging, the research provides valuable evidence supporting the standardization of such tools in pediatric neurosurgery. The study also explores the relationship between imaging data and postoperative recovery, quality of life, and neurocognitive performance, offering a comprehensive view of the long- term benefits. These findings are relevant for developing safer, more effective surgical protocols and national recommendations in the treatment of pediatric brain tumors involving functionally critical brain regions. Objective: 80 MODELS AND METHODS IN MODERN SCIENCE International scientific-online conference To evaluate how fMRI and MR-tractography improve surgical planning and neurological outcomes in children with brain tumors located in eloquent brain regions.