Delineation of brain tumor margins using intraoperative sononavigation: Implications for tumor resection

Shinoura, Nobusada; Takahashi, Manabu; Yamada, Ryuzo

doi:10.1002/jcu.20219

Cited by 18 publications

(7 citation statements)

References 11 publications

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“…[34] Besides, in contrast to IGS, the IOUS is able to provide real-time imaging overcoming the problems of brain shift . In fact incorporation of the US in newer IGS systems [35,36] testifi es to the utility and superiority of the IOUS in this regard; much like a case of the poor helping the rich. Given these facts it is a pity that neurosurgeons in the developing world are either unaware of this potentially useful tool or are blinded by the glare of more glamorous technology.…”

Section: Discussionmentioning

confidence: 99%

Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

Moiyadi

Shetty

2011

Journal of Neurosciences in Rural Practice

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Background:Localization and delineation of extent of lesions is critical for safe maximal resection of brain and spinal cord tumors. Frame-based and frameless stereotaxy and intraoperative MRI are costly and not freely available especially in economically constrained nations. Intraoperative ultrasound has been around for a while but has been relegated to the background. Lack of objective evidence for its usefulness and the perceived “user unfriendliness” of US are probably responsible for this. We recount our experience with this “forgotten” tool and propose an objective assessment score of its utility in an attempt to revive this practice.Materials and Methods:Seventy seven intraoperative ultrasound (IOUS) studies were carried out in patients with brain and spinal cord tumors. Seven parameters were identified to measure the “utility” of the IOUS and a “utility score” was devised (minimum 0 and maximum 7). Individual parameter and overall scores were calculated for each case.Results:IOUS was found to be useful in many ways. The median overall score was 6 (mean score 5.65). There were no scores less than 4 with the majority demonstrating usefulness in 5 or more parameters (91%). The use of the IOUS significantly influenced the performance of the surgery in these cases without significantly prolonging surgery.Conclusions:The IOUS is a very useful tool in intraoperative localization and delineation of lesions and planning various stages of tumor resection. It is easy, convenient, reliable, widely available, and above all a cost-effective tool. It should be increasingly used by neurosurgeons in the developing world where costlier intraoperative localization and imaging is not available freely.

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Section: Discussionmentioning

confidence: 99%

Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

Moiyadi

Shetty

2011

Journal of Neurosciences in Rural Practice

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“…Ultrasound image quality was classified as poor when impossible to visualize tumor borders, as medium when difficult but possible, and as good when visualization of tumor boundaries was clear, like done earlier 19 and by others. 23,24 Extent of surgical resection Tumor delineation in WHO grade IV glioma was estimated from the volume within the gadolinium enhancing areas on T1-weighted MR images. In WHO grade II and III gliomas tumor borders were defined based on the FLAIR sequence due to variable contrast enhancement.…”

Section: Methodsmentioning

confidence: 99%

The Diagnostic Properties of Intraoperative Ultrasound in Glioma Surgery and Factors Associated with Gross Total Tumor Resection

et al. 2018

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“…The walls of the resection cavity are usually hyper-echoic which makes it difficult to identify residual tumor, especially in the presence of edema/gliosis, with the risk of overestimating tumor volume. It is in this context that ioMRI may be superior in differentiating tumor from normal tissue [56,57].…”

Section: • • Intraoperative Ultrasoundmentioning

confidence: 99%

Recent technological advances in pediatric brain tumor surgery

et al. 2016

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X-rays and ventriculograms were the first imaging modalities used to localize intracranial lesions including brain tumors as far back as the 1880s. Subsequent advances in preoperative radiological localization included computed tomography (CT; 1971) and MRI (1977). Since then, other imaging modalities have been developed for clinical application although none as pivotal as CT and MRI. Intraoperative technological advances include the microscope, which has allowed precise surgery under magnification and improved lighting, and the endoscope, which has improved the treatment of hydrocephalus and allowed biopsy and complete resection of intraventricular, pituitary and pineal region tumors through a minimally invasive approach. Neuronavigation, intraoperative MRI, CT and ultrasound have increased the ability of the neurosurgeon to perform safe and maximal tumor resection. This may be facilitated by the use of fluorescing agents, which help define the tumor margin, and intraoperative neurophysiological monitoring, which helps identify and protect eloquent brain.

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Delineation of brain tumor margins using intraoperative sononavigation: Implications for tumor resection

Abstract: Sononavigation can help categorize the sonographic tumor margins into 3 different patterns, and this categorization can assist in determining which imaging modalities are needed to better delineate the tumor margins for subsequent resection.

Cited by 18 publications

References 11 publications

Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

The Diagnostic Properties of Intraoperative Ultrasound in Glioma Surgery and Factors Associated with Gross Total Tumor Resection

Recent technological advances in pediatric brain tumor surgery

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