Brain Mapping Technology Enhances Precision in Brain Tumor Resection

Maximizing tumor resection while preserving speech and motor function remains difficult because malignant cells often infiltrate brain tissue beyond visible margins. Neurologic deficits after resection can undermine recovery and long-term quality of life. To help address this challenge, a next-generation neurosurgical navigation platform has been introduced to support preoperative planning and real-time intraoperative decisions. The approach centers on the preservation of function as surgeons pursue maximal safe resection.

At the University of Rochester Medical Center (URMC; Rochester, NY, USA), the platform, called MindTrace, is being deployed to anticipate how alternative operative paths could affect critical functions after tumor removal. The system was developed through URMC’s Translational Brain Mapping Program, which applies cognitive and brain science tools to complex neurosurgical care. Development continued with collaborators at Carnegie Mellon University, with support from the National Institutes of Health and the National Science Foundation.

MindTrace integrates functional magnetic resonance imaging (fMRI), direct brain-stimulation mapping, and neuropsychological testing into a unified interface. In the operating room, teams can visualize functional anatomy in real time, replay stimulation trials, verify mapping locations, and rapidly gauge the likely consequences of removing additional tissue. Immediate feedback is intended to guide decision-making while protecting eloquent regions of the cortex.

Following URMC’s lead, the technology is now in use at six major U.S. medical centers. URMC reports completing more than a dozen procedures with the system during awake tumor surgeries, where patient participation in mapping helps tailor resections. Related research published in Science Advances describes how fine-grained intraoperative performance measures can be leveraged to improve brain surgery.

URMC teams are working to incorporate machine learning for real-time risk assessment and predictive modeling. Future iterations are intended to alert surgeons as they approach regions supporting speech and cognition. The platform is embedded within a coordinated model of brain tumor and epilepsy care at URMC that links Neurosurgery, Neuro-Oncology, and Neuropsychology.

“We can walk them through what the data mean for their individual situation,” said Tyler Schmidt, DO, surgical director of the Metastatic Brain and Spinal Tumor Program within the Wilmot Cancer Institute at the University of Rochester Medical Center. “That transparency helps reduce fear and creates a true partnership in decision-making. This is particularly important for awake surgeries in brain tumor patients, as those patients’ ability to collaborate in their own brain mapping represents a critical step for ensuring the best outcome from a very complex procedure.”

“It’s not just about removing a tumor,” said Webster H. Pilcher, MD, PhD, chair of Neurosurgery at the University of Rochester Medical Center. “It’s about preserving who that patient is—their language, movement, and personality. MindTrace helps increase the level of precision and confidence with which we can define surgical plans for each patient.”

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