Critical Assessment of Cancer Characterization and Margin Evaluation Techniques in Brain Malignancies: From Fast Biopsy to Intraoperative Flow Cytometry

SIMPLE SUMMARY: This review delves into novel techniques in brain malignancy management. Fast biopsy techniques offer a rapid and minimally invasive diagnosis, while intraoperative flow cytometry provides real-time cellular insights during surgeries. Intraoperative MRI integrates real-time imaging into surgical procedures, and 5-aminolevulinic acid enhances tumor visualization through fluorescence. Each method presents unique advantages, from speed and precision to enhanced visualization, but also comes with inherent challenges. As technology advances, these techniques are poised for further refinement, promising improved patient outcomes. Collaborative research will be instrumental in driving future innovations in brain tumor diagnosis and treatment. ABSTRACT: Brain malignancies, given their intricate nature and location, present significant challenges in both diagnosis and treatment. This review critically assesses a range of diagnostic and surgical techniques that have emerged as transformative tools in brain malignancy management. Fast biopsy techniques, prioritizing rapid and minimally invasive tissue sampling, have revolutionized initial diagnostic stages. Intraoperative flow cytometry (iFC) offers real-time cellular analysis during surgeries, ensuring optimal tumor resection. The advent of intraoperative MRI (iMRI) has seamlessly integrated imaging into surgical procedures, providing dynamic feedback and preserving critical brain structures. Additionally, 5-aminolevulinic acid (5-ALA) has enhanced surgical precision by inducing fluorescence in tumor cells, aiding in their complete resection. Several other techniques have been developed in recent years, including intraoperative mass spectrometry methodologies. While each technique boasts unique strengths, they also present potential limitations. As technology and research continue to evolve, these methods are set to undergo further refinement. Collaborative global efforts will be pivotal in driving these advancements, promising a future of improved patient outcomes in brain malignancy management.