Ability of navigated 3D ultrasound to delineate gliomas and metastases – comparison of image interpretations with histopathology

Unsgaard, Geirmund; Selbekk, Tormod; Müller, Tomm B.; Ommedal, Steinar; Torp, Sverre Helge; Myhr, Gunnar; Bang, Jon; Hernes, Toril A. Nagelhus

doi:10.1007/s00701-005-0624-1

Cited by 120 publications

(78 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Intraoperative ultrasonography provides reliable real-time updates of the operative field ("live anatomy"). 4,10,14,25,34,35,37 The limitation of ultrasound in delineating residual tumor is mainly related to 2 issues: image quality and anatomical orientation. Recent advances in ultrasound technology have significantly improved resolution.…”

Section: Discussionmentioning

confidence: 99%

“…Good-quality ultrasound images have been shown to be comparable to MR images in delineating brain tumors. 6,34 Therefore, in our opinion, little advantage is gained by using the preoperatively acquired MR images (especially once brain shift has occurred). Also, in many cases, logistical challenges make it difficult to organize preoperative MRI.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance

Moiyadi¹,

Shetty²

2016

FOC

View full text Add to dashboard Cite

OBJECTIVE Navigated 3D ultrasound is a novel intraoperative imaging adjunct permitting quick real-time updates to facilitate tumor resection. Image quality continues to improve and is currently sufficient to allow use of navigated ultrasound (NUS) as a stand-alone modality for intraoperative guidance without the need for preoperative MRI. METHODS The authors retrospectively analyzed cases involving operations performed at their institution in which a 3D ultrasound navigation system was used for control of resection of brain tumors in a “direct” 3D ultrasound mode, without preoperative MRI guidance. The usefulness of the ultrasound and its correlation with postoperative imaging were evaluated. RESULTS Ultrasound was used for resection control in 81 cases. In 53 of these 81 cases, at least 1 intermediate scan (range 1–3 intermediate scans) was obtained during the course of the resection, and in 50 of these 53 cases, the result prompted further resection. In the remaining 28 cases, intermediate scans were not performed either because the first ultrasound scan performed after resection was interpreted as showing no residual tumor (n = 18) and resection was terminated or because the surgeon intentionally terminated the resection prematurely due to the infiltrative nature of the tumor and extension of disease into eloquent areas (n = 10) and the final ultrasound scan was interpreted as showing residual disease. In an additional 20 cases, ultrasound navigation was used primarily for localization and not for resection control, making the total number of NUS cases where radical resection was planned 101. Gross-total resection (GTR) was planned in 68 of these 101 cases and cytoreduction in 33. Ultrasound-defined GTR was achieved in 51 (75%) of the cases in which GTR was planned. In the remaining 17, further resection had to be terminated (despite evidence of residual tumor on ultrasound) because of diffuse infiltration or proximity to eloquent areas. Of the 33 cases planned for cytoreduction, NUS guidance facilitated ultrasound-defined GTR in 4 cases. Overall, ultrasound-defined GTR was achieved in 50% of cases (55 of 111). Based on the postoperative imaging (MRI in most cases), GTR was achieved in 58 cases (53%). Final (postresection) ultrasonography was documented in 78 cases. The findings were compared with the postoperative imaging to ascertain concordance in detecting residual tumor. Overall concordance was seen in 64 cases (82.5%), positive concordance was seen in 33 (42.5%), and negative in 31 (40%). Discordance was seen in 14 cases—with ultrasound yielding false-positive results in 7 cases and false-negative results in 7 cases. Postoperative neurological worsening occurred in 15 cases (13.5%), and in most of these cases, it was reversible by the time of discharge. CONCLUSIONS The results of this study demonstrate that 3D ultrasound can be effectively used as a stand-alone navigation modality during the resection of brain tumors. The ability to provide repeated, high-quality intraoperative updates is useful for guiding resection. Attention to image acquisition technique and experience can significantly increase the quality of images, thereby improving the overall utility of this modality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance

Moiyadi¹,

Shetty²

2016

FOC

View full text Add to dashboard Cite

show abstract

“…Intraoperative neurosurgical techniques to maximize resection (e.g. image-guided surgery, [58] ultrasonography, [59] and introduction of fluorescence-guided surgery [60] ) and to minimize neurological deficits by electrophysiological techniques [58] improved the likelihood of complete and safe removal of metastases. A combination of surgery plus radiation in patients with up to three CNS metastases can improve survival and preserve functional independence, as outlined in two prospective studies [61,62] and three retrospective studies.…”

Section: Local Therapeutic Strategies: Neurosurgical Intervention Andmentioning

confidence: 99%

Interdisciplinary management of central nervous system metastasis and neoplastic meningitis: recent developments and future perspectives

Tabatabai¹,

Koch²,

Roggia³

et al. 2016

JCMT

View full text Add to dashboard Cite

The incidence of metastatic disease in the central nervous system (CNS) is rising. According to current estimates, up to a third of adult cancer patients will suffer from CNS metastasis. Clinical evidence-based data from prospective randomized trials are rare, however, because CNS metastasis patients were often excluded from clinical trial participation. The management of CNS metastasis patients is therefore rather ill-defined and an interdisciplinary challenge. Recent basic and translational science data have begun contributing to a more profound understanding of the molecular mechanisms leading to invasion of tumor cells into the CNS. This report reviews advances, challenges, and perspectives in this field.

show abstract

“…These images can then be displayed with the corresponding MR images to better orient the user, an attractive solution for most neurosurgeons. To assess the usefulness of 3D US in detected tumor, Unsgaard et al (2005) compared 3D ultrasound with preoperative MR images in 28 tumor cases and found that ultrasound was at least as good as MRI in identifying tumor borders. Other studies have also validated the a c c u r a c y o f U S i n b r a i n t u m o r s u r g e r y .…”

Section: Ultrasound Co-registered With Mrimentioning

confidence: 99%

“…Similarly, van Velthoven et al [23] found that ultrasound is as reliable as MRI to delineate gliomas, metastases and meningiomas. In fact, it may even be superior to MRI in defining low-grade tumor boundaries (Unsgaard et al, 2005). Three dimensional US may be useful in identifying tumor, but does its lead to an increased extent of resection?…”

Section: Ultrasound Co-registered With Mrimentioning

confidence: 99%

Emerging Imaging and Operative Techniques for Glioma Surgery

Châtillon¹,

Petrecca²

2012

Advances in Cancer Management

View full text Add to dashboard Cite

Ability of navigated 3D ultrasound to delineate gliomas and metastases – comparison of image interpretations with histopathology

Abstract: Reformatted images from 3D US volumes give a good delineation of metastases and the solid part of gliomas before starting the resection. Navigated 3D US is at least as reliable as navigated 3D MR to delineate gliomas and metastases.

Cited by 120 publications

References 21 publications

Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance

Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance

Interdisciplinary management of central nervous system metastasis and neoplastic meningitis: recent developments and future perspectives

Emerging Imaging and Operative Techniques for Glioma Surgery

Contact Info

Product

Resources

About