With this project, the study group wants to investigate whether a postoperative navigated transcranial magnetic stimulation (nTMS) motor map can improve stereotactic radiosurgery (SRS) planning in patients who underwent resection for a brain metastasis near the primary motor cortex. Specifically, the map could allow for more precise location of motor eloquent tissue, thereby minimizing the radiation dose on these areas while preserving high radiation dose on target tissue (i.e. tumor cells).
Informed consent
Age ≥ 18 years
Cerebral metastasis within or adjacent to the primary motor cortex (≤10 mm)
Resection of tumor
Contraindication to TMS (e.g. Cochlear Implant, other metallic or electrical implants, excluding teeth and post craniotomy, Meniere's disease, pacemaker, deep brain stimulation electrodes, refractory convulsion, symptomatic tinnitus, depression diagnosed by a specialist, psychosis)
Prior cerebral radiation therapy within the affected precentral gyrus/affecting the planned SRS plan
Planned whole brain radiotherapy
Second lesion within 2 cm ipsilateral in the primary motor cortex