OBJECTIVE: The purpose of the study was to compare the ability of navigated 3D ultrasound to distinguish tumour and normal brain tissue at the tumour border zone in subsequent phases of resection. MATERIALS AND METHODS: Biopsies were sampled in the tumour border zone as seen in the US images before and during surgery. After resection, biopsies were sampled in the resection cavity wall. Histopathology was compared with the surgeon's image findings. RESULTS: Before resection, the tumour border was delineated by ultrasound with high specificity and sensitivity (both 95%). During resection, ultrasound had acceptable sensitivity (87%), but poor specificity (42%), due to biopsies falsely classified as tumour by the surgeon. After resection, sensitivity was poor (26%), due to tumour or infiltrated tissue in several biopsies deemed normal by ultrasound, but the specificity was acceptable (88%). CONCLUSIONS: Our study shows that although glioblastomas are well delineated prior to resection, there seem to be overestimation of tumour tissue during resection. After resection tumour remnants and infiltrated brain tissue in the resection cavity wall may be undetected. We believe that the benefits of intraoperative ultrasound outweigh the shortcomings, but users of intraoperative ultrasound should keep the limitations shown in our study in mind.
OBJECTIVE: The purpose of the study was to compare the ability of navigated 3D ultrasound to distinguish tumour and normal brain tissue at the tumour border zone in subsequent phases of resection. MATERIALS AND METHODS: Biopsies were sampled in the tumour border zone as seen in the US images before and during surgery. After resection, biopsies were sampled in the resection cavity wall. Histopathology was compared with the surgeon's image findings. RESULTS: Before resection, the tumour border was delineated by ultrasound with high specificity and sensitivity (both 95%). During resection, ultrasound had acceptable sensitivity (87%), but poor specificity (42%), due to biopsies falsely classified as tumour by the surgeon. After resection, sensitivity was poor (26%), due to tumour or infiltrated tissue in several biopsies deemed normal by ultrasound, but the specificity was acceptable (88%). CONCLUSIONS: Our study shows that although glioblastomas are well delineated prior to resection, there seem to be overestimation of tumour tissue during resection. After resection tumour remnants and infiltrated brain tissue in the resection cavity wall may be undetected. We believe that the benefits of intraoperative ultrasound outweigh the shortcomings, but users of intraoperative ultrasound should keep the limitations shown in our study in mind.
Authors: Inês Machado; Matthew Toews; Elizabeth George; Prashin Unadkat; Walid Essayed; Jie Luo; Pedro Teodoro; Herculano Carvalho; Jorge Martins; Polina Golland; Steve Pieper; Sarah Frisken; Alexandra Golby; William Wells Iii; Yangming Ou Journal: Neuroimage Date: 2019-08-22 Impact factor: 6.556
Authors: Jan Coburger; Angelika Scheuerle; Thomas Kapapa; Jens Engelke; Dietmar Rudolf Thal; Christian R Wirtz; Ralph König Journal: Neurosurg Rev Date: 2015-04-10 Impact factor: 3.042
Authors: Rahul Sastry; Wenya Linda Bi; Steve Pieper; Sarah Frisken; Tina Kapur; William Wells; Alexandra J Golby Journal: J Neuroimaging Date: 2016-08-19 Impact factor: 2.486