The benefits of navigated intraoperative ultrasonography during resection of fourth ventricular tumors in children

El-Beltagy, Mohamed; Atteya, Mostafa M. E.

doi:10.1007/s00381-013-2103-y

Cited by 26 publications

(14 citation statements)

References 25 publications

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“…The expenditure of time for one intraoperative US data set is only 5 minutes [ 30 ]. El Beltagy and Atteya [ 40 ] demonstrate the benefits of intraoperative ultrasound during resection of fourth ventricular tumors in children. They were able to detect and correct tissue shifts at any time during stepwise tumor resection, update new scans, and verify new tumor size by a neuronavigated pointer.…”

Section: Clinical Experience With the State-of-the-art Intraoperatmentioning

confidence: 99%

Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

Bayer

Maier

Ostermeier

et al. 2017

International Journal of Biomedical Imaging

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Intraoperative brain shift during neurosurgical procedures is a well-known phenomenon caused by gravity, tissue manipulation, tumor size, loss of cerebrospinal fluid (CSF), and use of medication. For the use of image-guided systems, this phenomenon greatly affects the accuracy of the guidance. During the last several decades, researchers have investigated how to overcome this problem. The purpose of this paper is to present a review of publications concerning different aspects of intraoperative brain shift especially in a tumor resection surgery such as intraoperative imaging systems, quantification, measurement, modeling, and registration techniques. Clinical experience of using intraoperative imaging modalities, details about registration, and modeling methods in connection with brain shift in tumor resection surgery are the focuses of this review. In total, 126 papers regarding this topic are analyzed in a comprehensive summary and are categorized according to fourteen criteria. The result of the categorization is presented in an interactive web tool. The consequences from the categorization and trends in the future are discussed at the end of this work.

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Section: Clinical Experience With the State-of-the-art Intraoperatmentioning

confidence: 99%

Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

Bayer

Maier

Ostermeier

et al. 2017

International Journal of Biomedical Imaging

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“…Most frequent histology was low-grade glioma (81), followed by medulloblastoma (17), ependymoma (12) and high-grade glioma (10). Additional tumor subtypes included craniopharyngioma (6), germ cell tumors (5), choroid plexus tumors (3) and other less common tumors (20).…”

Section: Resultsmentioning

confidence: 99%

“…The use of iOUS resulted in a 16% increase in GTR achievement (96% vs 80%), while allowing a lower incidence of cerebellar mutism (3% vs 20%) without significant increase of the operative time. They reported ioUS usefulness in detecting residue in the region of the rostral vermis and the lateral recesses of the fourth ventricle (17). No information was provided concerning the patients' randomization process.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasound-Assisted Extent of Resection Assessment in Pediatric Neurosurgical Oncology

et al. 2021

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Central nervous system tumors represent the most frequent solid malignancy in the pediatric population. Maximal safe surgical resection is a mainstay of treatment, with significant prognostic impact for the majority of histotypes. Intraoperative ultrasound (ioUS) is a widely available tool in neurosurgery to assist in intracerebral disease resection. Despite technical caveats, preliminary experiences suggest a satisfactory predictive ability, when compared to magnetic resonance imaging (MRI) studies. Most of the available evidence on ioUS applications in brain tumors derive from adult series, a scenario that might not be representative of the pediatric population. We present our preliminary experience comparing ioUS-assisted resection assessment to early post-operative MRI findings in 154 consecutive brain tumor resections at our pediatric neurosurgical unit. A high concordance was observed between ioUS and post-operative MRI. Overall ioUS demonstrated a positive predictive value of 98%, a negative predictive value of 92% in assessing the presence of tumor residue compared to postoperative MRI. Overall, sensibility and specificity were 86% and 99%, respectively. On a multivariate analysis, the only variable significantly associated to unexpected tumor residue on postoperative MRI was histology. Tumor location, patient positioning during surgery, age and initial tumor volume were not significantly associated with ioUS predictive ability. Our data suggest a very good predictive value of ioUS in brain tumor resective procedures in children. Low-grade glioma, high-grade glioma and craniopharyngioma might represent a setting deserving specific endeavours in order to improve intraoperative extent of resection assessment ability.

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“…Subsequently, the same group reported results for posterior fossa tumors. [19] In this study, they compared navigated US with conventional microsurgery (and navigation) and found that the navigated US group had better GTR rates and lesser mutism postoperatively. Ulrich et al .…”

Section: Discussionmentioning

confidence: 99%

Resection of pediatric brain tumors: Intraoperative ultrasound revisited

2017

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Background:Extent of resection is a very important prognostic marker in most pediatric brain tumors. Intraoperative imaging facilitates resection control. Intraoperative ultrasound (IOUS) is a cost-effective alternative to intraoperative magnetic resonance, but scant literature addresses its utility in this context.Methods:We retrospectively reviewed all pediatric brain tumors operated at our center using navigated three-dimensional ultrasound (US). The utility of the US in resection control was recorded and extent of resection evaluated.Results:IOUS was used in 20 cases (3 for frameless biopsy and 17 for tumor resection control). It was 100% accurate in localizing all tumors and yielded 100% diagnosis in the biopsy cases. Technical limitations precluded its use in 2 of the 17 cases of tumor resection. In the remaining 15, it correctly predicted the residual tumor status in 13 cases (87%). A gross total resection was achieved overall in 12 cases (80%) with postoperative morbidity in only one case.Conclusions:IOUS is a useful tool to localize intracranial tumors and guide the resection reliably. Widespread use can improve its applicability and make it an effective intraoperative imaging tool in pediatric brain tumors.

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The benefits of navigated intraoperative ultrasonography during resection of fourth ventricular tumors in children

Cited by 26 publications

References 25 publications

Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

Intraoperative Ultrasound-Assisted Extent of Resection Assessment in Pediatric Neurosurgical Oncology

Resection of pediatric brain tumors: Intraoperative ultrasound revisited

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