MODELS AND METHODS IN MODERN SCIENCE
International scientific-online conference
80
FUNCTIONAL MRI AND TRACTOGRAPHY-GUIDED SURGERY IN
PEDIATRIC BRAIN TUMORS: IMPROVING OUTCOMES IN
ELOQUENT BRAIN AREAS
Akramov O.Z.
National Children's Medical Center" Children's Neurosurgery Department,
Parkent Street, 294, Tashkent, Uzbekistan
https://doi.org/10.5281/zenodo.15261220
Abstract
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:
MODELS AND METHODS IN MODERN SCIENCE
International scientific-online conference
81
To evaluate how fMRI and MR-tractography improve surgical planning and
neurological outcomes in children with brain tumors located in eloquent brain
regions.
Materials and Methods
The study included 100 children (ages 1–17) with tumors in motor, visual,
or speech-related brain areas. Sixty patients underwent preoperative fMRI and
MR-tractography with integration into neuronavigation systems. Forty control
patients received conventional MRI only. Tumor size, proximity to functional
tracts, and resection volume were assessed. Postoperative outcomes were
evaluated using neurological scoring systems and quality-of-life questionnaires.
Statistical comparisons were made between groups for extent of resection,
complication rates, and recovery time. Neurocognitive testing was repeated at 3
and 12 months. Radiation and anesthesia time for imaging were recorded to
assess procedural safety in younger children.
Results (100 words):
Functional imaging enabled gross total resection in 82% of patients,
compared to 61% in the control group. Neurological deficits occurred in 6.7% of
imaging-guided cases versus 25% in controls. Mean hospitalization duration
was 6.3 days (vs. 11.5 days). Language function improved or remained stable in
93% of children with left-hemisphere tumors using fMRI guidance. At 12-month
follow-up, 78% of patients in the imaging group scored above average on
neurocognitive assessments, compared to 52% in controls. No complications
were reported from imaging procedures. These results demonstrate that
integrating fMRI and tractography significantly improves safety and functional
outcomes.
Conclusion
Preoperative planning using fMRI and tractography enhances surgical
safety and effectiveness in children with brain tumors in eloquent areas.
Compared to standard imaging, this approach results in higher rates of complete
tumor removal, fewer postoperative deficits, and better long-term
neurocognitive outcomes. It also reduces hospitalization and recovery time,
offering tangible benefits for families and healthcare systems. The study
supports broader adoption of advanced neuroimaging in pediatric neurosurgery
and highlights the importance of preserving function without compromising
oncological goals. These tools should be considered essential for planning
interventions in complex brain tumor cases involving speech, motor, or visual
centers in children.
MODELS AND METHODS IN MODERN SCIENCE
International scientific-online conference
82
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