The Diagnostic Properties of Intraoperative Ultrasound in Glioma Surgery and Factors Associated with Gross Total Tumor Resection

Munkvold, Bodil Karoline Ravn; Jakola, Asgeir Store; Reinertsen, Ingerid; Sagberg, Lisa Millgård; Unsgård, Geirmund; Solheim, Ole

doi:10.1016/j.wneu.2018.03.208

Cited by 46 publications

(34 citation statements)

References 58 publications

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“…Munkvold et al reported a series of 144 gliomas operated using NUS. 8 Their cohort of gliomas had a higher proportion of LGGs (33% vs 17%) and more recurrent cases (40% vs 20%) compared with our series. Munkvold Values are presented as number (%) of patients unless otherwise indicated.…”

Section: Discussioncontrasting

confidence: 57%

Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

Shetty

Yeole

Singh

et al. 2021

Neurosurgical Focus

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OBJECTIVEIntraoperative imaging is increasingly being used for resection control in diffuse gliomas, in which the extent of resection (EOR) is important. Intraoperative ultrasound (iUS) has emerged as a highly effective tool in this context. Navigated ultrasound (NUS) combines the benefits of real-time imaging with the benefits of navigation guidance. In this study, the authors investigated the use of NUS as an intraoperative adjunct for resection control in gliomas.METHODSThe authors retrospectively analyzed 210 glioma patients who underwent surgery using NUS at their center. The analysis included intraoperative decision-making, diagnostic accuracy, and operative outcomes, particularly EOR and related factors influencing this.RESULTSUS-defined gross-total resection (GTR) was achieved in 57.6% of patients. Intermediate resection control scans were evaluable in 115 instances. These prompted a change in the operative decision in 42.5% of cases (the majority being further resection of unanticipated residual tumor). Eventual MRI-defined GTR rates were similar (58.6%), although the concordance between US and MRI was 81% (170/210 cases). There were 21 false positives and 19 false negatives with NUS, resulting in a sensitivity of 78%, specificity of 83%, positive predictive value of 77%, and negative predictive value of 84%. A large proportion of patients (13/19 patients, 68%) with false-negative results eventually had near-total resections. Tumor resectability, delineation, enhancement pattern, eloquent location, and US image resolution significantly influenced the GTR rate, though only resectability and eloquent location were significant on multivariate analysis.CONCLUSIONSNUS is a useful intraoperative adjunct for resection control in gliomas, detecting unanticipated tumor residues and positively influencing the course of the resection, eventually leading to higher resection rates. Nevertheless, resection is determined by the innate resectability of the tumor and its relationship to eloquent location, reinforcing the need to combine iUS with functional mapping techniques to optimize resections.

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Section: Discussioncontrasting

confidence: 57%

Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

Shetty

Yeole

Singh

et al. 2021

Neurosurgical Focus

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“…As the most prevalent cancer in the central nervous system because of the noticeable incidence rate, fast relapse and limited survival , gliomas are characterized by persistent growth, reinforced migration and invasion, and multiple molecular and cytogenetic aberrances . Standard glioma therapy consists of surgery before radiotherapy and chemotherapy . Nevertheless, drug resistance is a difficult challenge to overcome .…”

mentioning

confidence: 99%

RETRACTED: CDKL5 promotes proliferation, migration, and chemotherapeutic drug resistance of glioma cells via activation of the PI3K/AKT signaling pathway

2020

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Gliomas, the most prevalent cancer in the central nervous system, are characterized by high morbidity and mortality, emphasizing the need to understand their etiology. Here, we report that cyclin‐dependent kinase‐like 5 (CDKL5) is highly expressed in gliomas, and CDKL5 overexpression promotes invasion, proliferation, migration and drug (β‐lapachone) resistance of glioma cells. In vitro, CDKL5 overexpression enhanced invasion, growth and migration of glioma cells, and stimulated the phosphoinositide 3‐kinase (PI3K)/AKT axis. Furthermore, CDKL5 overexpression in vivo promoted glioma proliferation, whereas CDKL5 knockdown had opposing effects. The effect of CDKL5 on drug resistance was eliminated if the PI3K/AKT axis was suppressed, and cisplatin combined with the PI3K/AKT suppressor XL147 remarkably prohibited proliferation in xenografts overexpressing CDKL5. Collectively, our findings suggest that CDKL5 acts through the PI3K/AKT axis in glioma cells, and indicate a possible role for CDKL5 in glioma therapy.

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“…They determined that tumor volume and tumor depth were the main factors that influenced the sensitivity for intraoperative US to detect residual tumor; small superficial tumors being more likely to be completely resected. 29 One can infer that the impact of the usage of intraoperative US on the clinical course of patients with brain tumors is related to the ability to locate and better resect these lesions.…”

Section: Discussion Intraoperative Ultrasound In Neurosurgerymentioning

confidence: 99%

Basic Principles of Intraoperative Ultrasound Applied to Brain Tumor Surgery

Jacobo

Avendaño

Moreno-Jiménez

et al. 2020

Indian Journal of Neurosurgery

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Intraoperative ultrasound (US) has been shown to possess great value in assessing tumor volume and localization, especially for primary resection of gliomas and metastatic lesions. Given that US is a technology that is highly user dependent, many surgeons have encountered problems with the usage of this technology, as well as interpretation of intraoperative US images, limiting its full potential. This article focuses on the basic knowledge a neurosurgeon must acquire to properly use and interpret intraoperative US to improve tumor localization and extent of resection during brain tumor surgery.

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The Diagnostic Properties of Intraoperative Ultrasound in Glioma Surgery and Factors Associated with Gross Total Tumor Resection

Abstract: The specificity of intraoperative US is good, but sensitivity for detecting the last milliliter is low compared with postoperative MRI. Tumor volume and tumor depth are the predictors of achieving gross total resection, although ultrasound image quality was not.

Cited by 46 publications

References 58 publications

Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

RETRACTED: CDKL5 promotes proliferation, migration, and chemotherapeutic drug resistance of glioma cells via activation of the PI3K/AKT signaling pathway

Basic Principles of Intraoperative Ultrasound Applied to Brain Tumor Surgery

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