Intraoperative Contrast-Enhanced Ultrasound for Brain Tumor Surgery

Prada, Francesco; Perin, Alessandro; Martegani, Alberto; Aiani, Luca; Solbiati, Luigi; Lamperti, Massimo; Casali, Cecilia; Legnani, Federico; Mattei, Luca; Saladino, Andrea; Saini, Marco; DiMeco, Francesco

doi:10.1227/neu.0000000000000301

Cited by 179 publications

(213 citation statements)

References 38 publications

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“…[13][14][15][16][17][18][19][20] In general, the US contrast agent is prepared and injected through a peripheral vein. Different vascular phases are analyzed: basal, arterial, peak, parenchymal, and venous.…”

Section: Multimodal Ious and Applications For Real-time Venous Imaginmentioning

confidence: 99%

“…Anatomical features are derived by observing the flow of bubbles and the vessel-enhancement position with regard to the lesion. 17,18 The examination can be repeated several times to understand the functional vascular anatomy.…”

Section: Multimodal Ious and Applications For Real-time Venous Imaginmentioning

confidence: 99%

“…23 CEUS allows one to analyze tissue perfusion. 17,18 Microbubble quantification is performed using off-line dedicated software, providing information about parenchymal and lesion perfusion with multiparametric representations of time-intensity curves, as described in Fig. 4, and measuring the echo intensity enhancement in a given period of time in the selected region of interest.…”

Section: Characterization Of Brain Perfusion Changes Associated With mentioning

confidence: 99%

“…Its use in neurosurgery has been recently included in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines. 13,[16][17][18]20 In this paper, we provide technical background on which modalities to apply when evaluating the venous circulation in neurosurgical procedures, and we review different clinical scenarios, demonstrating how the combination of different US modalities has the potential to detect all those dynamic changes that take place within the venous system during cranial surgery, and discuss the importance of the assessment of the extracranial venous system and its impact on cerebral venous drainage.…”

mentioning

confidence: 99%

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Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note

Prada

Bene

Mauri

et al. 2018

Neurosurgical Focus

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The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. Contrast-enhanced US allows one to perform real-time angiosonography showing both the functional and the anatomical aspects of vessels.In this technical report, the authors demonstrate the different applications of multimodal ioUS in neurosurgery for identifying the anatomical and functional characteristics of the venous compartment. They discuss the general principles and technical nuances of ioUS and analyze their potential implications for the study of various venous districts during neurosurgical procedures.

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Section: Multimodal Ious and Applications For Real-time Venous Imaginmentioning

confidence: 99%

Section: Multimodal Ious and Applications For Real-time Venous Imaginmentioning

confidence: 99%

Section: Characterization Of Brain Perfusion Changes Associated With mentioning

confidence: 99%

mentioning

confidence: 99%

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Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note

Prada

Bene

Mauri

et al. 2018

Neurosurgical Focus

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“…2,4,6,14,18 The use of ultrasound for imaging in neurosurgery has been promoted by several groups that have explored the use of B-mode and Doppler mode as well as elastography mode and contrastenhanced ultrasound. 7,13,16,21 Cross-disciplinary research within ultrasound imaging has quite a long history in Trondheim. In the mid-1970s scientists at NTH (Norwegian Institute of Technology, now NTNU) and SINTEF started to develop ultrasound Doppler technology for cardiac examinations.…”

Section: Ultrasound Imaging In Neurosurgerymentioning

confidence: 99%

Editorial: Ultrasound-guided neurosurgery: experiences from 20 years of cross-disciplinary research in Trondheim, Norway

Selbekk

Solheim

Unsgård

2016

FOC

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Resection and survival data from a clinical trial of glioblastoma multiforme‐specific IRDye800‐BBN fluorescence‐guided surgery

Chi

et al. 2020

Bioengineering & Transla Med

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Supra-maximum surgical tumor resection without neurological damage is highly valuable for treatment and prognosis of patients with glioblastoma multiforme (GBM). We developed a GBM-specific fluorescence probe using IRDye800CW (peak absorption/ emission, 778/795 nm) and bombesin (BBN), which (IRDye800-BBN) targets the gastrin-releasing peptide receptor, and evaluated the image-guided resection efficiency, sensitivity, specificity, and survivability. Twenty-nine patients with newly diagnosed GBM were enrolled. Sixteen hours preoperatively, IRDye800-BBN (1 mg in 20 ml sterile water) was intravenously administered. A customized fluorescence surgical navigation system was used intraoperatively. Postoperatively, enhanced magnetic resonance images were used to assess the residual tumor volume, calculate the resection extent, and confirm whether complete resection was achieved. Tumor tissues and nonfluorescent brain tissue in adjacent noneloquent boundary areas were harvested and assessed for diagnostic accuracy. Complete resection was achieved in 82.76% of patients. The median extent of resection was 100% (range, 90.6-100%). Eighty-nine samples were harvested, including 70 fluorescence-positive and 19 fluorescencenegative samples. The sensitivity and specificity of IRDye800-BBN were 94.44% (95% CI, 85.65-98.21%) and 88.24% (95% CI, 62.25-97.94%), respectively. Twenty-five Kunshan He, Chongwei Chi, Deling Li, and Jingjing Zhang authors contributed equally to this work.

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Intraoperative Contrast-Enhanced Ultrasound for Brain Tumor Surgery

Cited by 179 publications

References 38 publications

Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note

Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note

Editorial: Ultrasound-guided neurosurgery: experiences from 20 years of cross-disciplinary research in Trondheim, Norway

Resection and survival data from a clinical trial of glioblastoma multiforme‐specific IRDye800‐BBN fluorescence‐guided surgery

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