Resection of pediatric intracerebral tumors with the aid of intraoperative real-time 3-D ultrasound

Abstract

Purpose Intraoperative ultrasound (IOUS) has become a useful tool employed daily in neurosurgical procedures. In pediatric patients, IOUS offers a radiation-free and safe imaging method. This study aimed to evaluate the use of a new real-time 3-D IOUS technique (RT-3-D IOUS) in our pediatric patient cohort. Material and methods Over 24 months, RT-3-D IOUS was performed in 22 pediatric patients (8 girls and 14 boys) with various brain tumors. These lesions were localized by a standard navigation system followed by analyses before, intermittently during, and after neurosurgical resection using the iU22 ultrasound system (Philips, Bothell, USA) connected to the RT-3-D probe (X7-2). Results In all 22 patients, real-time 3-D ultrasound images of the lesions could be obtained during neurosurgical resection. Based on this imaging method, rapid orientation in the surgical field and the approach for the resection could be planned for all patients. In 18 patients (82%), RT-3-D IOUS revealed a gross total resection with a favorable neurological outcome. Conclusion RT-3-D IOUS provides the surgeon with advanced orientation at the tumor site via immediate live two-plane imaging. However, navigation systems have yet to be combined with RT-3-D IOUS. This combination would further improve intraoperative localization.

3T Intraoperative MRI for Management of Pediatric CNS Neoplasms

“…[19][20][21][22][23] Few uses of sonography have been shown in pediatric tumors. 24,25 Sonography is highly operatordependent, and proper orientation with respect to the resection cavity can be difficult. iMRI allows spatial localization of the resection cavity and possible residual tumor, in a manner that easily compares with preoperative imaging and can serve as a comparison study for postoperative follow-up scans.…”

Resection of pediatric brain tumors: Intraoperative ultrasound revisited

“…described 22 cases where real-time 3DUS was used achieving complete resection in 82%. [20] The US correctly predicted this in 18 of 19 cases. There was no additional morbidity with these extended resections.…”

Towards a 3D modeling of brain tumors by using endoneurosonography and neural networks

“…Thus, it is necessary to complement such images with additional medical imaging techniques, such as MRI, CT, PET, or US. Compared to other techniques, ultrasound images are cheaper, faster, and easier to obtain in intra-operative scenarios [17,10,14]. The best-known application of US is the prenatal ultrasound, but it is widely used in applications such as the detection of tumors and vessel diseases in different parts of the body, including the brain.…”