ArticleNeurosurgical focus2016
Versatile utilization of real-time intraoperative contrast-enhanced ultrasound in cranial neurosurgery: technical note and retrospective case series.
Article in Neurosurgical focus, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Surgical management of Glioma Grade 4: technical update from the neuro-oncology section of the Italian Society of Neurosurgery (SINch®): a systematic review.Journal of neuro-oncology · 2023Pooled it
- Reliability of intraoperative ultrasound in detecting tumor residual after brain diffuse glioma surgery: a systematic review and meta-analysis.Neurosurgical review · 2020Pooled it
- Utility of Contrast-Enhanced Ultrasound for the Assessment of Skeletal Muscle Perfusion in Diabetes Mellitus: A Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2019Pooled it
- Intraoperative Ultrasound in Brain and Spine Surgery: Current Applications, Translational Value and Future Perspectives.NeuroSci · 2025Review
- Navigating the challenges: ultrasound innovations in brain glioma surgery.Frontiers in neurology · 2025Review
- Progress in the application of ultrasound in glioma surgery.Frontiers in medicine · 2024Review
- Clinical outcomes after microsurgical resection of giant lateral ventricular meningiomas.Neurosurgical review · 2023Article
- Emerging contrast-enhanced ultrasound applications in children.Pediatric radiology · 2021Review
- Application of Multiparametric Intraoperative Ultrasound in Glioma Surgery.BioMed research international · 2021Review
- Adaptive Physics-Based Non-Rigid Registration for Immersive Image-Guided Neuronavigation Systems.Frontiers in digital health · 2020Article
- New Hope in Brain Glioma Surgery: The Role of Intraoperative Ultrasound. A Review.Brain sciences · 2018Review
- Applications of Ultrasound in the Resection of Brain Tumors.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2017Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveIntraoperative contrast-enhanced ultrasound (iCEUS) offers dynamic imaging and provides functional data in real time. However, no standardized protocols or validated quantitative data exist to guide its routine use in neurosurgery. The authors aimed to provide further clinical data on the versatile application of iCEUS through a technical note and illustrative case series.
methodsFive patients undergoing craniotomies for suspected tumors were included. iCEUS was performed using a contrast agent composed of lipid shell microspheres enclosing perflutren (octafluoropropane) gas. Perfusion data were acquired through a time-intensity curve analysis protocol obtained using iCEUS prior to biopsy and/or resection of all lesions.
resultsThree primary tumors (gemistocytic astrocytoma, glioblastoma multiforme, and meningioma), 1 metastatic lesion (melanoma), and 1 tumefactive demyelinating lesion (multiple sclerosis) were assessed using real-time iCEUS. No intraoperative complications occurred following multiple administrations of contrast agent in all cases. In all neoplastic cases, iCEUS replicated enhancement patterns observed on preoperative Gd-enhanced MRI, facilitated safe tumor debulking by differentiating neoplastic tissue from normal brain parenchyma, and helped identify arterial feeders and draining veins in and around the surgical cavity. Intraoperative CEUS was also useful in guiding a successful intraoperative needle biopsy of a cerebellar tumefactive demyelinating lesion obtained during real-time perfusion analysis.
conclusionsIntraoperative CEUS has potential for safe, real-time, dynamic contrast-based imaging for routine use in neurooncological surgery and image-guided biopsy. Intraoperative CEUS eliminates the effect of anatomical distortions associated with standard neuronavigation and provides quantitative perfusion data in real time, which may hold major implications for intraoperative diagnosis, tissue differentiation, and quantification of extent of resection. Further prospective studies will help standardize the role of iCEUS in neurosurgery.
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