Current Status and Advances in Intraoperative Adjuncts for Glioma Surgery

Abstract

Gliomas, arising from glial cells or their precursors, represent the most prevalent primary tumors of the central nervous system (CNS), accounting for approximately 40% of all CNS neoplasms and up to 80% of malignant brain tumors. These tumors are characterized by high recurrence rates, substantial mortality, and limited curative potential. Maximal safe resection remains the cornerstone of glioma management and a critical determinant of patient survival. However, the diffusely infiltrative nature of gliomas obscures tumor–brain boundaries, rendering complete resection challenging. In response, a range of intraoperative adjunct technologies has rapidly evolved to enhance the extent of resection while preserving neurological function. This review systematically summarizes recent advances in intraoperative imaging, functional mapping, and emerging optical techniques, highlighting their roles in improving surgical precision, minimizing complications, and prolonging survival. The integration of multimodal strategies is expected to further advance precision neurosurgery for glioma.