Feasibility of Intra- and Post-operative Microdialysis During Neurosurgery for Central Nervous System Lesions

PRIMARY OBJECTIVE: I. Determine biomarkers of in situ gliomas across a diverse patient cohort using intra- or post-operative microdialysis to sample extracellular metabolites and other analytes. SECONDARY OBJECTIVE: I. Evaluate the yield and specificity of microdialysate D-2HG as a candidate tumor biomarker to differentiate between IDH-mutated and IDH-wildtype gliomas. II. Identify biomarkers of tumor-associated processes including brain edema, brain infiltration with non-enhancing tumor, and tumor-associated hypoxia or necrosis. III. Determine the contribution of blood-brain barrier disruption to metabolite abundance within enhancing gliomas. EXPLORATORY/CORRELATIVE OBJECTIVES: I. Perform untargeted metabolomics of tumor microdialysate to elucidate extracellular biomarkers reflective of human central nervous system malignancy subtype, grade, and tumor region. II. Banking of microdialysate specimens for future analyses. OUTLINE: Patients are assigned to 1 of 2 cohorts. COHORT I: Patients undergo microdialysis over 15 minutes during standard of care biopsy or resection. Patients also undergo magnetic resonance imaging (MRI) during screening and may undergo MRI on study. COHORT II: Patients undergo microdialysis over 15 minutes after standard of care biopsy or resection. Patients also undergo MRI and computed tomography (CT) on study. After completion of study, patients are followed up for 42 days.