Figure 3.

Staged surgical approach for a right fronto-temporo-insular glioma. (A) Preoperative MRI depicting a hypo signal T1 lesion, with sharp contours. The preoperative volume was of 112 cm³. (B) 1st IoMRI reporting a tumor remnant at the inner and posterior part of the insula and in the frontal lobe of 38 cm³. Additional resection was performed. (C) 2nd IoMRI, the tumor residue was of 11 cm³. Due to the presence of the internal capsule at the superior part of the lesion the end of surgery was decided. (D) Postoperative control at 3 months, with less perioperative signal abnormalities the residue was reassessed, with a volume of 6 cm³, corresponding to an EOR of 95% (using IntelliSpace Portal, Philips, module “tumor tracking.” version 9.0 (www.philips.fr).