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Surgical Planning for Treating Metastatic Tumors

At Johns Hopkins, we use the latest and best technology to diagnose and treat patients. As a result of these wonderful tools and experience, patients can do extremely well after surgery. Often times, patients are home from surgery within 48 hours. Below are two examples of how we use advanced diagnostic tools to plan surgery for metastatic brain tumors.

Functional MRIs (fMRI):

Patients can undergo Functional MRIs (fMRI) to help delineate a roadmap of important structures (such as areas that control the arms, legs, or speech) prior to surgery. The example shown below demonstrates a tumor near the area for extremity movement. The blue and red areas specify the part of the brain that moves the arms and legs.

fMRI of metastatic brain tumor
An example of an fMRI used for planning surgery

Diffusion Tensor Imaging (DTI)

In addition, patients can receive a scan called Diffusion Tensor Imaging (DTI). This scan allows the surgeon and treating team to visualize the circuitry (or wiring) of the brain to guide the surgery. In the image below, the green demonstrates wires that connect the front and back of the brain; the red delineates the wires that connect the right and left side of the brain; and finally, the blue shows the wires that connect the brain to the rest of the body. These images can then be loaded into navigation systems that are used in the operating room to serve as a "GPS" and map for the surgeon.

metastatic brain tumor scans
Example of DTI scans of a metastatic brain tumor used for treatment planning

In addition, at Johns Hopkins, we utilize the most modern surgical techniques. We routinely use approaches such as the small key-hole craniotomy. We also employ the latest techniques (microsurgery) and tools (such as image-guided surgery and minimally invasive endoscopy) to ensure excellent outcomes.

Whole-brain radiation and stereotactic radiosurgery may be combined to most effectively target individual tumors and also reduce the chance of tumor growth outside of the areas targeted by radiosurgery.

Learn more about treatment for metastatic brain and spine tumors.

For more information, contact the Johns Hopkins Metastatic Brain Tumor Center at 410-955-6406.


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As many as one third of patients with primary lung, breast, kidney, colon and skin cancers may develop brain metastases. Hear from Johns Hopkins neurosurgeon Michael Lim as he talks about the latest treatment options available for people with brain metastases.

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