Two-dimensional high-end ultrasound imaging compared to intraoperative MRI during resection of low-grade gliomas

Gerganov, Venelin M.; Samii, Amir; Giordano, Mario; Samii, Madjid; Fahlbusch, Rudolf

doi:10.1016/j.jocn.2010.08.017

Cited by 54 publications

(23 citation statements)

References 26 publications

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“…So far, in using cioUS, a common drawback is the significant drop of accuracy during surgery. The increase of surgical-induced artifacts in this US modality renders discrimination of pathological tissue from blood or normal brain tissue difficult [3,4].…”

Section: Introductionmentioning

confidence: 99%

Linear array ultrasound in low-grade glioma surgery: histology-based assessment of accuracy in comparison to conventional intraoperative ultrasound and intraoperative MRI

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Linear array ultrasound in low-grade glioma surgery: histology-based assessment of accuracy in comparison to conventional intraoperative ultrasound and intraoperative MRI

et al. 2015

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“…However, the obtained images cannot reliably differentiate between tumor and artifact or between tumor and normal brain. 6 As a result, the reliability of intraoperative ultrasonography has been questioned. 3,17,22 Intraoperative MRI is clearly the most reliable method for determining tumor margins during surgery.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative stereotactic injection of Indigo Carmine dye to mark ill-defined tumor margins: a prospective Phase I–II study

Margetis

Rajappa

Tsiouris

et al. 2015

JNS

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OBJECT A critical goal in neurosurgical oncology is maximizing the extent of tumor resection while minimizing the risk to normal white matter tracts. Frameless stereotaxy and white matter mapping are indispensable tools in this effort, but deep tumor margins may not be accurately defined because of the “brain shift” at the end of the operation. The authors investigated the safety and efficacy of a technique for marking the deep margins of intraaxial tumors with stereotactic injection of Indigo Carmine dye. METHODS Investigational New Drug study approval for a prospective study in adult patients with gliomas was obtained from the FDA (Investigational New Drug no. 112680). At surgery, 1–3 stereotactic injections of 0.01 ml of Indigo Carmine dye were performed through the initial bur holes into the deep tumor margins before elevation of the bone flap. White light microscopic resection was conducted in standard fashion by using frameless stereotactic navigation until the injected margins were identified. The resection of the injected tumor margins and the extent of resection of the whole tumor volume were determined by using postoperative volumetric MRI. RESULTS In total 17 injections were performed in 10 enrolled patients (6 male, 4 female), whose mean age was 49 years. For all patients, the injection points were identified intraoperatively and tumor was resected at these points. The staining pattern was reproducible; it was a sphere of stained tissue approximately 5 mm in diameter. A halo of stained tissue and a backflow of dye through the needle tract were also noted, but these were clearly distinct from the staining pattern of the injection point, which was vividly colored and demarcated. Postoperative MR images verified the resection of all injection points. The mean extent of resection of the tumor as a whole was 97.1%. For 1 patient, a brain abscess developed on postoperative Day 16 and needed additional surgical treatment. CONCLUSIONS Stereotactic injection of Indigo Carmine dye can be used to demarcate multiple deep tumor margins, which can be readily identified intraoperatively by using standard white light microscopy. This technique may enhance the accuracy of frameless stereotactic navigation and increase the extent of resection of intraaxial tumors.

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“…[31][32][33] The two-dimensional (2-D) US image acquisition is significantly faster than ioMRI and scans can be performed multiple times during surgery, without major interruption of the workflow. 24 US imaging can be also integrated with neuronavigation systems. 34 Today the technology and image quality of ultrasound have been improved significantly, providing the surgeon with a useful way to identify tumors and make a preliminary classification of low-grade or high-grade glioma.…”

Section: Intraoperative Ultrasoundmentioning

confidence: 99%

“…37 However, two shortcomings are that ioUS provides lower sensitivity and specificity in the detection of small or superficial tumor remnants. 24 Furthermore, the image acquisition and interpretation are subjective and require adequate training and experience. 24 Other confounding factors that may affect the interpretation of the ioUS image are the presence of dropouts from blood, cottonoids, or proteinaceous fluid, which can all reduce the ultrasound image quality, or the contrast of the disrupted BBB.…”

Section: Intraoperative Ultrasoundmentioning

confidence: 99%

See 1 more Smart Citation

Review of the potential of optical technologies for cancer diagnosis in neurosurgery: a step toward intraoperative neurophotonics

Vasefi

MacKinnon²,

Farkas

et al. 2016

Neurophoton

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Two-dimensional high-end ultrasound imaging compared to intraoperative MRI during resection of low-grade gliomas

Cited by 54 publications

References 26 publications

Linear array ultrasound in low-grade glioma surgery: histology-based assessment of accuracy in comparison to conventional intraoperative ultrasound and intraoperative MRI

Linear array ultrasound in low-grade glioma surgery: histology-based assessment of accuracy in comparison to conventional intraoperative ultrasound and intraoperative MRI

Intraoperative stereotactic injection of Indigo Carmine dye to mark ill-defined tumor margins: a prospective Phase I–II study

Review of the potential of optical technologies for cancer diagnosis in neurosurgery: a step toward intraoperative neurophotonics

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