Magnetic hyperthermia therapy (MHT) is a re-emerging treatment modality for brain tumors where magnetic nanoparticles (MNPs) are locally delivered to the brain and then activated with an external alternating magnetic field (AMF) to generate localized heat at a site of interest. Due to the recent advancements in technology and theory surrounding the intervention, clinical and pre-clinical trials have demonstrated that MHT may enhance the effectiveness of chemotherapy and radiation therapy (RT) for the treatment of brain tumors. The future clinical success of MHT relies heavily on designing MNPs optimized for both heating and imaging, developing reliable methods for the local delivery of MNPs, and designing AMF systems with integrated magnetic particle imaging (MPI) for use in humans. However, despite the progression of technological development, the clinical progress of MHT has been underwhelming. This review aims to summarize the current state-of-the-art of MHT and offers insight into the current barriers and potential solutions for moving MHT forward.

Background/Objectives: Glioblastoma (GBM) is the most common primary malignant central nervous system tumor, accounting for 50.9% of malignant CNS diagnoses and carrying a median survival of 15 months despite maximal standard therapy. High recurrence rates are driven by residual infiltrative tumor cells at the resection margin. Fluorescence-guided surgery (FGS) has emerged as a key innovation to improve intraoperative tumor visualization and maximize the extent of resection (EOR). This review examines the historical development, current clinical applications, and future directions of FGS in GBM surgery. Methods: A comprehensive literature review was conducted, covering the evolution of fluorophores (fluorescein, indocyanine green [ICG], and 5-aminolevulinic acid [5-ALA]), visualization technologies (wide- and narrow-field modalities), therapeutic adjuncts (photodynamic and sonodynamic therapies), and clinical adoption patterns and outcomes. Results: Early intraoperative fluorescence using fluorescein dates to 1947. ICG angiography has broad surgical utility, while 5-ALA received FDA approval in 2017, with phase III trials demonstrating gross total resection rates of 65% versus 36% with white-light surgery. Adjunct technologies—3D exoscopes, FGS-compatible loupes, and quantitative spectroscopy probes—enhance detection of residual tumor. Preliminary studies of intraoperative photodynamic and sonodynamic therapies show feasibility and potential survival benefits. Global adoption of 5-ALA FGS exceeds 75% among surveyed neurosurgeons. Conclusions: FGS significantly improves EOR in GBM surgery, translating into better patient outcomes. Ongoing clinical trials and technological refinements—novel fluorophores, quantitative imaging, and therapeutic applications—promise to further optimize tumor visualization and treatment.

Magnetic hyperthermia therapy (MHT) is a promising treatment modality for brain tumors using magnetic nanoparticles (MNPs) locally delivered to the tumor and activated with an external alternating magnetic field (AMF) to generate antitumor effects through localized heating. Magnetic particle imaging (MPI) is an emerging technology offering strong signal-to-noise for nanoparticle localization. A scoping review was performed by systematically querying Pubmed, Scopus, and Embase. In total, 251 articles were returned, 12 included. Articles were analyzed for nanoparticle type used, MHT parameters, and MPI applications. Preliminary results show that MHT is an exciting treatment modality with unique advantages over current heat-based therapies for brain cancer. Effective application relies on the further development of unique magnetic nanoparticle constructs and imaging modalities, such as MPI, that can enable real-time MNP imaging for improved therapeutic outcomes.

Background: Neurosurgery demands exceptional precision due to the brain’s complex and delicate structures, necessitating precise targeting of pathological targets. Achieving optimal outcomes depends on the surgeon’s ability to accurately differentiate between healthy and pathological tissues during operations. Raman spectroscopy (RS) has emerged as a promising innovation, offering real-time, in vivo non-invasive biochemical tissue characterization. This literature review evaluates the current research on RS applications in intraoperative neurosurgery, emphasizing its potential to enhance surgical precision and patient outcomes. Methods: Following PRISMA guidelines, a comprehensive systematic review was conducted using PubMed to extract relevant peer-reviewed articles. The inclusion criteria focused on original research discussing real-time RS applications with human tissue samples in or near the operating room, excluding retrospective studies, reviews, non-human research, and other non-relevant publications. Results: Our findings demonstrate that RS significantly improves tumor margin delineation, with handheld devices achieving high sensitivity and specificity. Stimulated Raman Histology (SRH) provides rapid, high-resolution tissue images comparable to traditional histopathology but with reduced time to diagnosis. Additionally, RS shows promise in identifying tumor types and grades, aiding precise surgical decision-making. RS techniques have been particularly beneficial in enhancing the accuracy of glioma surgeries, where distinguishing between tumor and healthy tissue is critical. By providing real-time molecular data, RS aids neurosurgeons in maximizing the extent of resection (EOR) while minimizing damage to normal brain tissue, potentially improving patient outcomes and reducing recurrence rates. Conclusions: This review underscores the transformative potential of RS in neurosurgery, advocating for continued innovation and research to fully realize its benefits. Despite its substantial potential, further research is needed to validate RS’s clinical utility and cost-effectiveness.

Introduction: Traumatic brain injury (TBI) poses a significant public health challenge with profound impacts at individual, family, community, and societal levels. Early during the COVID-19 pandemic, the neighborhood of Elmhurst, Queens in New York City was a hotspot dubbed the “epicenter of the epicenter” of the crisis in the United States, requiring major changes in healthcare resource allocation. This study investigates how different phases of the COVID-19 pandemic affected the incidence, severity, and clinical outcomes of TBI in this geographical area. Methods: TBI admissions to NYC Health + Hospitals/Elmhurst, a Level 1 Trauma Center, during the first six months of 2019, 2020, and 2021 were retrospectively analyzed. Data were grouped into three periods: pre-pandemic (1/1/19–6/30/19 and 1/1/20–2/29/20) [Group 1], first COVID-19 wave (3/1/20–6/30/20) [Group 2], and second COVID-19 wave (1/1/21–6/30/21) [Group 3]. Univariate analyses were conducted to explore factors potentially associated with TBI outcomes; variables that reached statistical significance (p < 0.05) were included in a binary logistic regression analysis dichotomized into good outcome (discharge to home or acute rehabilitation disposition) and poor outcome (discharge to skilled nursing facility/subacute rehabilitation, hospice, or in-hospital mortality). Results: Analysis of 443 TBI patients (median age 56 [range 38, 73]; mean admissions/week 5.6 ± 2.7) demonstrated no significant variance in age (H = 0.92; p = 0.63), sex (χ² = 1.4, p = 0.51), or ethnicity (χ² = 17.1; p = 0.07) across groups. Group 2 had significantly fewer weekly admissions (3.9 ± 2.6) compared to Groups 1 (5.9 ± 2.2; p = 0.02) and 3 (6.1 ± 2.9; p = 0.01). Over the course of the pandemic, the proportion of uninsured patients decreased from 15 to 4%, while Medicaid and Medicare coverage rates rose from 25 to 41% and 20% to 28%, respectively (p < 0.001). A binary logistic regression model dichotomized by discharge outcome for all 443 TBI patients confirmed that increasing age (OR = 0.95; 95% CI 0.93–0.97; p < 0.001) and Injury Severity Score (OR = 0.88; 95% CI 0.83–0.93; p < 0.001) were inversely correlated with good outcome, while higher Glasgow Coma Scale (OR = 1.26; 95% CI 1.17–1.36; p < 0.001) was positively correlated. Of particular interest, Black/Hispanic ethnicity (OR = 0.36; 95% CI 0.19–0.66; p = 0.002) and public health insurance (Medicaid/Medicare) coverage (OR = 0.83; 95% CI 0.68–1.00; p = 0.05) were both associated with less favorable outcomes. Neither group designation, patient sex, COVID-19 status, or need for neurosurgical intervention was correlated with outcome (p > 0.05). Conclusion: Despite the changes in TBI admission patterns throughout New York City during the COVID-19 pandemic, the quality of patient outcomes at our institution remained relatively consistent across the pandemic’s different phases, as assessed by discharge disposition. However, two important socioeconomic factors—ethnicity and health insurance status—were significantly associated with outcome, underscoring the need for systemic changes to address ongoing disparities in neurotrauma care.