Preoperative imaging (MRI, functional MRI, CT)

In the current era of neuroimaging, presurgical mapping of brain tumors involves a multimodality approach including high-resolution anatomic imaging, MR perfusion imaging, blood oxygen level-dependent functional MRI, and diffusion tensor imaging. In this chapter, we focus primarily on the functional and physiologic imaging modalities for both characterization of de novo brain tumors and presurgical mapping. We include brief discussions of the basic principles underlying such imaging methods and then describe their application specifically to the evaluation of brain tumors. Both advantages and limitations of such techniques are discussed, and examples of their clinical applications are included in the figures. Although there are certainly numerous other clinical applications of these methods outside of neuro-oncology, we will limit our discussion to evaluation of brain tumors. These advanced imaging methods have revolutionized the neurosurgical planning strategies for resection of such lesions.