Intraoperative abdominal ultrasound in oncologic imaging

Abstract

Significant advances in ultrasound technology have created new opportunities for its use in oncologic imaging. The advent of new transducers with focal beam technology and higher frequency has solidified the role of intraoperative sonography (IOUS) as an invaluable imaging modality in oncologic surgery of the liver, kidneys and pancreas. The ability to detect and characterize small lesions and the precise intraoperative localization of such tumors is essential for adequate surgical planning in segmental or lobar hepatic resections, metastasectomy, nephron-sparing surgery, and partial pancreatectomy. Also, diagnostic characterization of small equivocal lesions deemed indeterminate by conventional preoperative imaging such as multidetector computed tomography or magnetic resonance imaging, has become an important application of IOUS. This article will review the current applications of IOUS in the liver, kidneys and pancreas.

Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect

“…It is interesting to note that definitive histopathological diagnoses excluded the possibility of a neoplasm in some cases in the present study, including a number of lesions identified only by IOUS. These results reinforce the need for histopathological evaluation of all suspected lesions, identified by preoperative transabdominal ultrasound or IOUS (GASCHEN, 2009;MARCAL et al, 2013). The use of IOUS during abdominal surgery allows for the direct application of a highfrequency transducer on the surface of the organ(s) of interest, with no obstacle in the abdominal wall to the penetration of sound waves.…”

“…The ability of IOUS to provide real-time imaging of the organs of interest, with accurate small lesion detection and characterization, establishes the important role of IOUS in intraoperative guidance for either biopsy or resection (MARCAL et al, 2013). However, differentiation between malignant and benign lesions is not possible with only IOUS evaluation.…”

“…Role of IOUS in the real-time characterization of tumors and precise definition of their margins (MARCAL et al, 2013) was accomplished in our study, especially during the intraoperative examination of the dog with intestinal sarcoma (dog number 4). Lesion and its precise transition zone between the loss of mural detail and normal bowel were identified using IOUS.…”

“…Benefits of using this technique are intraoperative guidance and correct localization of lesions, assistance in determining lesion resection and surgical planning, metastatic assessment and local staging. These advantages make IOUS a helpful tool, mainly during oncologic surgery (HATA et al, 2011;MARCAL et al, 2013). In medicine, during oncological liver surgery, small non-palpable intraparenchymal tumors can only be detected by the use of IOUS (CERWENKA et al, 2004;HATA et al, 2011).…”

“…Currently, IOUS is used in medicine for diagnosis and guidance during surgical exploration in a variety of organs, especially in neurosurgery, pancreatic, renal and hepatobiliary surgery (KANE, 2004;MARCAL et al, 2013).…”