Intraoperative Imaging and Optical Visualization Techniques for Brain Tumor Resection: A Narrative Review

SIMPLE SUMMARY: Brain tumors are difficult to treat, and surgeons need the best tools to safely remove them. This review looks at the various technologies that help surgeons see tumors more clearly during surgery. These technologies range from special microscopes and exoscopes to advanced imaging like handheld molecular diagnostic tools. While these tools have made surgery safer and more effective, they are not without challenges, such as complex usage and interpretation. Our aim is to present an overview of these technologies, discuss their pros and cons, and look at the future, where artificial intelligence and virtual reality could make these surgeries even more precise. This research could guide future innovations that improve patient outcomes. ABSTRACT: Advancements in intraoperative visualization and imaging techniques are increasingly central to the success and safety of brain tumor surgery, leading to transformative improvements in patient outcomes. This comprehensive review intricately describes the evolution of conventional and emerging technologies for intraoperative imaging, encompassing the surgical microscope, exoscope, Raman spectroscopy, confocal microscopy, fluorescence-guided surgery, intraoperative ultrasound, magnetic resonance imaging, and computed tomography. We detail how each of these imaging modalities contributes uniquely to the precision, safety, and efficacy of neurosurgical procedures. Despite their substantial benefits, these technologies share common challenges, including difficulties in image interpretation and steep learning curves. Looking forward, innovations in this field are poised to incorporate artificial intelligence, integrated multimodal imaging approaches, and augmented and virtual reality technologies. This rapidly evolving landscape represents fertile ground for future research and technological development, aiming to further elevate surgical precision, safety, and, most critically, patient outcomes in the management of brain tumors.