Abstract
Favorable clinical outcomes in adult and pediatric neurosurgical oncology generally depend on the extent of tumor resection (EOR). Maximum safe resection remains the main aim of surgery in most intracranial tumors. Despite the accuracy of intraoperative magnetic resonance imaging (iMRI) in the detection of residual intraoperatively, it is not widely implemented worldwide owing to enormous cost and technical difficulties. Over the past years, intraoperative ultrasound (IOUS) has imposed itself as a valuable and reliable intraoperative tool guiding neurosurgeons to achieve gross total resection (GTR) of intracranial tumors.
Being less expensive, feasible, doesn’t need a high level of training, doesn’t need a special workspace, and being real time with outstanding temporal and spatial resolution; all the aforementioned advantages give a superiority for IOUS in comparison to iMRI during resection of brain tumors.
In this chapter, we spot the light on the technical nuances, advanced techniques, outcomes of resection, pearls, and pitfalls of the use of IOUS during the resection of brain tumors.
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References
Chandler WF, Knake JE. Intraoperative use of ultrasound in neurosurgery. Neurosurgery. 1984;31:550–63.
Reid M. Ultrasonic visualization of a cervical cord cystic astrocytoma. Am J Roentgenol. 1978;131:907–8.
Coburger J, König RW. Intraoperative findings in brain tumor surgery. In: Prada F, Solbiati L, Martegani A, DiMeco F, editors. Intraoperative ultrasound (IOUS) in neurosurgery: from standard B-mode to elastosonography. Cham: Springer International Publishing; 2016. p. 41–58.
Unsgaard G, Gronningsaeter A, Ommedal S, Nagelhus Hernes TA. Brain operations guided by real-time two-dimensional ultrasound: new possibilities as a result of improved image quality. Neurosurgery. 2002;51:402–11. discussion 411–412.
Dixon L, Lim A, Grech-Sollars M, Nandi D, Camp S. Intraoperative ultrasound in brain tumor surgery: a review and implementation guide. Neurosurg Rev. 2022;45:2503–15.
Sweeney JF, Smith H, Taplin A, Perloff E, Adamo MA. Efficacy of intraoperative ultrasonography in neurosurgical tumor resection. J Neurosurg Pediatr. 2018;21:504–10.
Del Bene M, Perin A, Casali C, Legnani F, Saladino A, Mattei L, Vetrano IG, Saini M, DiMeco F, Prada F. Advanced ultrasound imaging in glioma surgery: beyond gray-scale B-mode. Front Oncol. 2018;8:576.
Serra C, Stauffer A, Actor B, Burkhardt J-K, Ulrich NH-B, Bernays R-L, Bozinov O. Intraoperative high frequency ultrasound in intracerebral high-grade tumors. Ultraschall Med. 2012;33:E306–12.
Aleo D, Elshaer Z, Pfnür A, Schuler PJ, Fontanella MM, Wirtz CR, Pala A, Coburger J. Evaluation of a navigated 3D ultrasound integration for brain tumor surgery: first results of an ongoing prospective study. Curr Oncol. 2022;29:6594–609.
Saß B, Zivkovic D, Pojskic M, Nimsky C, Bopp MHA. Navigated intraoperative 3D ultrasound in glioblastoma surgery: analysis of imaging features and impact on extent of resection. Front Neurosci. 2022;16:883584.
Roth J, Biyani N, Beni-Adani L, Constantini S. Real-time neuronavigation with high-quality 3D ultrasound SonoWand® in pediatric neurosurgery. PNE. 2007;43:185–91.
de Quintana-Schmidt C, Salgado-Lopez L, Aibar-Duran JA, Alvarez Holzapfel MJ, Cortes CA, Alvarado JDP, Rodriguez RR, Teixidó JM. Neuronavigated ultrasound in neuro-oncology: a true real-time intraoperative image. World Neurosurg. 2022;157:e316–26.
Frassanito P, Stifano V, Bianchi F, Tamburrini G, Massimi L. Enhancing the reliability of intraoperative ultrasound in pediatric space-occupying brain lesions. Diagnostics (Basel). 2023;13:971.
Mair R, Heald J, Poeata I, Ivanov M. A practical grading system of ultrasonographic visibility for intracerebral lesions. Acta Neurochir. 2013;155:2293–8.
Smith JS, Chang EF, Lamborn KR, Chang SM, Prados MD, Cha S, Tihan T, Vandenberg S, McDermott MW, Berger MS. Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. JCO. 2008;26:1338–45.
El Beltagy MA, Atteya MME. The benefits of navigated intraoperative ultrasonography during resection of fourth ventricular tumors in children. Childs Nerv Syst. 2013;29:1079–88.
Yeole U, Singh V, Mishra A, Shaikh S, Shetty P, Moiyadi A. Navigated intraoperative ultrasonography for brain tumors: a pictorial essay on the technique, its utility, and its benefits in neuro-oncology. Ultrasonography. 2020;39:394–406.
Moiyadi AV, Shetty P. Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance. Neurosurg Focus. 2016;40:E5.
Rasmussen I-A, Lindseth F, Rygh OM, Berntsen EM, Selbekk T, Xu J, Nagelhus Hernes TA, Harg E, Håberg A, Unsgaard G. Functional neuronavigation combined with intra-operative 3D ultrasound: initial experiences during surgical resections close to eloquent brain areas and future directions in automatic brain shift compensation of preoperative data. Acta Neurochir. 2007;149:365–78.
Tao A, Chen X, Zhang L, Chen Y, Cao D, Guo Z, Chen J. Application of intraoperative contrast-enhanced ultrasound in the resection of brain tumors. Curr Med Sci. 2022;42:169–76.
Prada F, Bene MD, Fornaro R, et al. Identification of residual tumor with intraoperative contrast-enhanced ultrasound during glioblastoma resection. Neurosurg Focus. 2016;40:E7.
Chan HW, Bamber J, Dorward N, Chakraborty A, Uff C. Ultrasound elastography. In: Prada F, Solbiati L, Martegani A, DiMeco F, editors. Intraoperative ultrasound (IOUS) in neurosurgery: from standard B-mode to elastosonography. Cham: Springer International Publishing; 2016. p. 173–87.
Prada F, Del Bene M, Rampini A, et al. Intraoperative strain elastosonography in brain tumor surgery. Oper Neurosurg. 2019;17:227.
Prada F, Del Bene M, Moiraghi A, DiMeco F. Echographic brain semeiology and topographic anatomy according to surgical approaches. In: Prada F, Solbiati L, Martegani A, DiMeco F, editors. Intraoperative ultrasound (IOUS) in neurosurgery: from standard B-mode to elastosonography. Cham: Springer International Publishing; 2016. p. 29–39.
Prada F, Bene MD, Mauri G, Lamperti M, Vailati D, Richetta C, Saini M, Santuari D, Kalani MYS, DiMeco F. Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note. Neurosurg Focus. 2018;45:E6.
El Beltagy MA, Aggag M, Kamal M. Role of intraoperative ultrasound in resection of pediatric brain tumors. Childs Nerv Syst. 2010;26:1189–93.
Singhal A, Ross Hengel A, Steinbok P, Doug Cochrane D. Intraoperative ultrasound in pediatric brain tumors: does the surgeon get it right? Childs Nerv Syst. 2015;31:2353–7.
Kremer P, Tronnier V, Steiner HH, Metzner R, Ebinger F, Rating D, Hartmann M, Seitz A, Unterberg A, Wirtz CR. Intraoperative MRI for interventional neurosurgical procedures and tumor resection control in children. Childs Nerv Syst. 2006;22:674–8.
Ulrich NH, Burkhardt J-K, Serra C, Bernays R-L, Bozinov O. Resection of pediatric intracerebral tumors with the aid of intraoperative real-time 3-D ultrasound. Childs Nerv Syst. 2012;28:101–9.
Giussani C, Trezza A, Ricciuti V, Di Cristofori A, Held A, Isella V, Massimino M. Intraoperative MRI versus intraoperative ultrasound in pediatric brain tumor surgery: is expensive better than cheap? A review of the literature. Childs Nerv Syst. 2022;38:1445–54.
Mahboob S, McPhillips R, Qiu Z, et al. Intraoperative ultrasound-guided resection of gliomas: a meta-analysis and review of the literature. World Neurosurg. 2016;92:255–63.
Moiyadi AV. Objective assessment of intraoperative ultrasound in brain tumors. Acta Neurochir. 2014;156:703–4.
van Velthoven V. Intraoperative ultrasound imaging: comparison of pathomorphological findings in US versus CT, MRI and intraoperative findings. In: Bernays RL, Imhof H-G, Yonekawa Y, editors. Intraoperative imaging in neurosurgery. Vienna: Springer; 2003. p. 95–9.
Gerganov VM, Samii A, Akbarian A, Stieglitz L, Samii M, Fahlbusch R. Reliability of intraoperative high-resolution 2D ultrasound as an alternative to high-field strength MR imaging for tumor resection control: a prospective comparative study: clinical article. J Neurosurg. 2009;111:512–9.
Selbekk T, Jakola AS, Solheim O, Johansen TF, Lindseth F, Reinertsen I, Unsgård G. Ultrasound imaging in neurosurgery: approaches to minimize surgically induced image artefacts for improved resection control. Acta Neurochir. 2013;155:973–80.
Erdoğan N, Tucer B, Mavili E, Menkü A, Kurtsoy A. Ultrasound guidance in intracranial tumor resection: correlation with postoperative magnetic resonance findings. Acta Radiol. 2005;46:743–9.
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El Beltagy, M.A., Elbaroody, M. (2024). The Value of Intraoperative Ultrasound in Brain Surgery. In: Di Rocco, C. (eds) Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 50. Springer, Cham. https://doi.org/10.1007/978-3-031-53578-9_6
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