How to cut low-grade gliomas for a possible cure

Gliomas grow aggressively within the brain tissue, like tree roots rooting into the soil, with fewer roots the further away from the trunk they are. In the current medical model, low-grade gliomas are diagnosed mainly by cranial MRI. On the MRI image, the tumor is shown to come with the help of brain tissue and tumor signal differences. Literature reports that the difference between the tumor and the brain tissue can only be seen on MRI when the tumor cell density is greater than 500 cells/mm3, i.e., the tumor is not visible in areas where the tumor cell density is less than 500 cells/mm3. Magnetic resonance underestimates the actual extent of low-grade gliomas, and the fact that the tumor cells extend beyond the area of imaging abnormality means that resection of the tumor according to the imaging boundaries is not sufficient. Our surgical goal should not be satisfied with resecting the imaging abnormal portion, but rather expanding the resection to the periphery, all the way to the adjacent functional border, which means that the maximum safe resection is achieved. About 70% of gliomas are less than 2 cm away from the functional zone in one or more directions, due to the presence of the functional zone, which limits the ideal extended resection. Approximately 30% of low-grade gliomas are located in nonfunctional areas, and it is expected to achieve a radical or curative resection with a range of no less than 2 cm beyond the abnormal imaging boundary. For low-grade gliomas far from the functional zone, we need to take advantage of this favorable location and give patients the opportunity to be cured by surgery through super-expanded resection.