ArticleFrontiers in oncology2022
Is intraoperative ultrasound more efficient than magnetic resonance in neurosurgical oncology? An exploratory cost-effectiveness analysis.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Multimodal imaging and AI in brain tumor surgery: current tools and emerging integration.npj biomedical innovations · 2026Review
- Measurement and classification of dielectric properties in human brain tissues: differentiating glioma from normal tissues using machine learning.Physical and engineering sciences in medicine · 2026Article
- A staged adoption pathway for intraoperative imaging in brain tumor surgery: cost-effectiveness and accessibility in resource-limited neurosurgical settings.Frontiers in surgery · 2026Review
- The efficacy of minimally invasive intraoperative ultrasound in endoscopic pituitary surgery.Pituitary · 2025Article
- Review
- Inter-observer agreement in interpreting intraoperative ultrasonography during brain tumour surgery.Frontiers in surgery · 2025Article
- A preclinical study of a novel dual-modality contrast agent in rodent models.Frontiers in bioengineering and biotechnology · 2025Article
- Non-navigated 2D intraoperative ultrasound: An unsophisticated surgical tool to achieve high standards of care in glioma surgery.Journal of neuro-oncology · 2024Article
- Surgical Management and Advances in the Treatment of Glioma.Seminars in neurology · 2023Review
- Enhancing the Reliability of Intraoperative Ultrasound in Pediatric Space-Occupying Brain Lesions.Diagnostics (Basel, Switzerland) · 2023Article
- Mapping Resection Progress by Tool-Tip Tracking during Brain Tumor Surgery for Real-Time Estimation of Residual Tumor.Cancers · 2023Article
- Application of intraoperative ultrasound in the resection of high-grade gliomas.Frontiers in neurology · 2023Review
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Intraoperative imaging is a chief asset in neurosurgical oncology, it improves the extent of resection and postoperative outcomes. Imaging devices have evolved considerably, in particular ultrasound (iUS) and magnetic resonance (iMR). Although iUS is regarded as a more economically convenient and yet effective asset, no formal comparison between the efficiency of iUS and iMR in neurosurgical oncology has been performed. Methods: A cost-effectiveness analysis comparing two single-center prospectively collected surgical cohorts, classified according to the intraoperative imaging used. iMR (2013-2016) and iUS (2021-2022) groups comprised low- and high-grade gliomas, with a maximal safe resection intention. Units of health gain were gross total resection and equal or increased Karnofsky performance status. Surgical and health costs were considered for analysis. The incremental cost-effectiveness ratio (ICER) was calculated for the two intervention alternatives. The cost-utility graphic and the evolution of surgical duration with the gained experience were also analyzed. Results: 50 patients followed an iMR-assisted operation, while 17 underwent an iUS-guided surgery. Gross total resection was achieved in 70% with iMR and in 60% with iUS. Median postoperative Karnofsky was similar in both group (KPS 90). Health costs were € 3,220 higher with iMR, and so were surgical-related costs (€ 1,976 higher). The ICER was € 322 per complete resection obtained with iMR, and € 644 per KPS gained or maintained with iMR. When only surgical-related costs were analyzed, ICER was € 198 per complete resection with iMR and € 395 per KPS gained or maintained. Conclusion: This is an unprecedented but preliminary cost-effectiveness analysis of the two most common intraoperative imaging devices in neurosurgical oncology. iMR, although being costlier and time-consuming, seems cost-effective in terms of complete resection rates and postoperative performance status. However, the differences between both techniques are small. Possibly, iMR and iUS are complementary aids during the resection: iUS real-time images assist while advancing towards the tumor limits, informing about the distance to relevant landmarks and correcting neuronavigation inaccuracy due to brain shift. Yet, at the end of resection, it is the iMR that reliably corroborates whether residual tumor remains.
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