Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer

Jiang, Cheng; Lin, Yongjuan; Li, Huiying; Xie, Yu; Yu, Tingting; Feng, Jingyu; Huang, Mengxi; Guo, Aibin; Shen, Haiyun; Zhang, YiDan; Yin, Zhenyu

doi:10.1002/cam4.5484

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…The correlation between ONSD measured on CT and ICP was r = 0.5, p < 0.05. 16 Jiang et al 17 were able to demonstrate similar findings when correlating ONSD with cerebrospinal fluid pressure in patients with leptomeningeal metastasis. However, the non-linearity of the relationship between ONSD and ICP has to be considered.…”

Section: Discussionmentioning

confidence: 61%

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Feucht,

Kerscher,

Ruff

et al. 2023

Cancer Medicine

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IntroductionGlioblastoma (GBM) is a tumor with rapid growth and a possible relationship to elevated intracranial pressure (ICP). High ICP may not always be associated with clinical signs. A non‐invasive technique for assessment of ICP is measuring the optic nerve sheath diameter (ONSD). Identifying patients who need immediate intervention is of importance in neuro‐oncological care. The goal of this study is to assess the available magnetic resonance imaging (MRI) of patients with GBM with respect to pre‐ and postoperative ONSD.Methods and MaterialsRetrospective data analysis was performed on all patients operated for GBM at a tertiary care center between 2010 and 2020. Two pre and one postoperative MRI had to be available. Clinical data and ONSD at multiple time points were analyzed and correlated, as well as preoperative volumetrics.ResultsSixty‐seven patients met the inclusion criteria. Clinical signs of elevated ICP were seen in 25.4% (n = 17), while significant perifocal edema was present in 67.2% (n = 45) of patients. Clinical signs of preoperatively elevated ICP were associated with significantly elevated ONSD at diagnosis (p < 0.001) as well as preoperative tumor volume (p < 0.001). Significant perifocal edema at the time of diagnosis was associated with elevated ONSD (p = 0.029) and higher tumor volume (p = 0.003). In patients with significant edema, ONSD increased significantly between preoperative MRIs (p = 0.003/005). In patients with clinical signs of raised ICP, ONSD also increased, whereas it was stable in asymptomatic patients (yes: 5.01+/−4.17 to 5.83+/−0.55 mm, p = 0.010, no: 5.17+/−0.46 mm to 5.38+/−0.41 mm, p = 0.81). A significant increase of ONSD from diagnosis to preoperative MRI and a significant decrease until 3 months postoperatively were observed (p < 0.001).ConclusionsONSD might help identify high ICP in patients with GBM. In this first‐of‐its kind study, we observed a significant increase of ONSD preoperatively, likely associated with edema. Postoperatively, ONSD decreased significantly until 3 months after surgery and increased again at 12 months. Further prospective data collection is warranted.

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Section: Discussionmentioning

confidence: 61%

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Feucht,

Kerscher,

Ruff

et al. 2023

Cancer Medicine

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“…To the Editor, We read with great interest the article by Jiang et al concerning the use of bedside ocular ultrasonography (US) for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non-small-cell lung cancer. 1 Our congratulations go to the authors for their intriguing paper. However, we would also like to provide some feedback through our comments.…”

Section: E T T E R T O T H E E D I T O R Could B-scan Technique Compr...mentioning

confidence: 98%

“…We read with great interest the article by Jiang et al concerning the use of bedside ocular ultrasonography (US) for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer. 1 …”

Section: Figurementioning

confidence: 99%

Could B‐scan technique compromise a promising clinical study?

2023

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Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review

et al. 2023

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Background Elevated intracranial pressure (eICP) is a serious medical emergency that requires prompt identification and monitoring. The current gold standards of eICP detection require patient transportation, radiation, and can be invasive. Ocular ultrasound has emerged as a rapid, non-invasive, bedside tool to measure correlates of eICP. This systematic review seeks to explore the utility of ultrasound detected optic disc elevation (ODE) as an ultrasonographic finding of eICP and to study its sensitivity and specificity as a marker of eICP. Methods This systematic review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We systematically searched PubMed, EMBASE, and Cochrane Central for English articles published before April 2023; yielding 1,919 total citations. After eliminating duplicates, and screening the records, we identified 29 articles that addressed ultrasonographically detected ODE. Results The 29 articles included a total of 1249 adult and pediatric participants. In patients with papilledema, the mean ODE ranged between 0.6 mm and 1.2 mm. Proposed cutoff values for ODE ranged between 0.3 mm and 1 mm. The majority of studies reported a sensitivity between 70 and 90%, and specificity ranged from 69 to 100%, with a majority of studies reporting a specificity of 100%. Conclusions ODE and ultrasonographic characteristics of the optic disc may aid in differentiating papilledema from other conditions. Further research on ODE elevation and its correlation with other ultrasonographic signs is warranted as a means to increase the diagnostic accuracy of ultrasound in the setting of eICP.

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Bedside ocular ultrasonography for diagnosing increased intracranial pressure in patients with leptomeningeal metastases from non‐small‐cell lung cancer

Cited by 3 publications

References 25 publications

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Retrospective longitudinal assessment of optic nerve sheath diameter in patients with malignant glioma

Could B‐scan technique compromise a promising clinical study?

Ultrasound detected increase in optic disk height to identify elevated intracranial pressure: a systematic review

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