Basic Principles of Intraoperative Ultrasound Applied to Brain Tumor Surgery

Modern optical and spectral technologies represent powerful approaches for a molecular characterization of tissues enabling delineating pathological tissues but also a label-free grading and staging of tumors in terms of computer-assisted histopathology. First, currently used tools for intraoperative tumor assessment are described. Next, the requirements for intraoperative tissue visualization from a medical and optical point of view are specified. Then, optical and spectral techniques are introduced that are already approved or close to being used in standard clinical practice for ex vivo and in vivo monitoring, and proof-of concept studies utilizing linear and nonlinear spectroscopy and imaging modalities are presented. Combining several spectroscopic mechanisms in multi-contrast approaches constitutes further advances. Modern artificial intelligence and deep learning concepts have emerged to analyze spectroscopic and imaging datasets and have contributed to the progress of each technique. Finally, an outlook for opportunities and prospects of clinical translation is given.

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Extent of Resection for Supratentorial Gliomas Using the B-mode Ultrasound as an Intraoperative Aid

Jacobo,

Vazquez-Gregorio,

Aristizabal

et al. 2024

Cureus

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Background: The cornerstone of glioma treatment is the surgical resection of the visible tumor, knowing fully that the disease extends beyond what magnetic resonance imaging (MRI) is able to show and the efficacy of the surgery is highly dependent on the surgeon's expertise. Different intraoperative technologies have emerged to aid in the goal of optimizing the extent of resection for glial tumors. Intraoperative ultrasound (iUS) is an attractive option due to its low cost and real-time imaging. This paper aims to illustrate the utility of this technology as an intraoperative aid for the resection of supratentorial gliomas. Methods: This is an observational and retrospective study that included patients who received surgical resection for supratentorial gliomas using iUS as the only imaging intraoperative aid. Adult patients with supratentorial gliomas who were taken into surgery for tumor resection were included in the analysis. Demographic and clinical variables of the patients at the time of diagnosis were collected, including sex and age. Tumor morphological variables were collected, including the affected lobes, tumor volume, histological and molecular diagnosis, and extent of resection. The IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used for the statistical analysis. Results: A total of 44 patients were included in the analysis. Thirty-six patients (81.8%) had a high-grade glioma as the final diagnosis. The extent of resection achieved was over 90% in 70.5% of the cases. Conclusion: iUS by itself has been proven to be a valuable tool to improve the localization and resection of supratentorial gliomas.

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Basic Principles of Intraoperative Ultrasound Applied to Brain Tumor Surgery

Cited by 3 publications

References 35 publications

Multimodality Structural and Functional Monitoring in Brain Tumor Surgery: The Role of IONM and IOUS

Multimodality Structural and Functional Monitoring in Brain Tumor Surgery: The Role of IONM and IOUS

Opportunities of optical and spectral technologies in intraoperative histopathology

Extent of Resection for Supratentorial Gliomas Using the B-mode Ultrasound as an Intraoperative Aid

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