ArticleDiagnostics (Basel, Switzerland)2023
Enhancing the Reliability of Intraoperative Ultrasound in Pediatric Space-Occupying Brain Lesions.
Article in Diagnostics (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the effectiveness and the diagnostic accuracy of intraoperative ultrasound in the resection of low-grade gliomas.Journal of ultrasound · 2025Pooled it
- Cerebello-Pontine Angle Tumors in Children: An Update on Challenging Neoplasms.Diagnostics (Basel, Switzerland) · 2026Article
- Intraoperative Ultrasound as a Decision-Making Tool in Modern Gynecologic Oncology.Journal of personalized medicine · 2025Review
- 2D Intraoperative Ultrasound in Brain Metastasis Resection: A Matched Cohort Analysis from a Single-Center Experience.Cancers · 2025Article
- Comparison of different new ultrasonic technologies in resection assessment of neurosurgery.Quantitative imaging in medicine and surgery · 2025Article
- Pediatric cerebral ganglioglioma epilepsy surgery: enhancing seizure outcomes through optimized resection applying high-field intraoperative magnetic resonance imaging.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Surgery for pediatric low-grade gliomas within the vermis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Review
- Role of surgery in the treatment of pediatric low-grade glioma with various degrees of brain stem involvement.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Role of intraoperative ultrasound and MRI to aid grade of resection of pediatric low-grade gliomas: accumulated experience from 4 centers.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- The Value of Intraoperative Ultrasound in Brain Surgery.Advances and technical standards in neurosurgery · 2024Article
- Application of intraoperative ultrasound in the resection of high-grade gliomas.Frontiers in neurology · 2023Review
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Authors and funding
5 authors.
Funding
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Abstract
introductionIntraoperative ultrasound (IOUS) may aid the resection of space-occupying brain lesions, though technical limits may hinder its reliability.
methodsIOUS (MyLabTwice
resultsPre-IOUS allowed us to localize the lesion accurately in all of the cases (16 low-grade gliomas, 12 high-grade gliomas, eight gangliogliomas, seven dysembryoplastic neuroepithelial tumors, five cavernomas, and five other lesions, namely two focal cortical dysplasias, one meningioma, one subependymal giant cell astrocytoma, and one histiocytosis). In 10 deeply located lesions, IOUS with hyperechoic marker, eventually coupled with neuronavigation, was useful to plan the surgical route. In seven cases, the administration of contrast ensured a better definition of the vascular pattern of the tumor. Post-IOUS allowed the evaluation of EOR reliably in small lesions (<2 cm). In large lesions (>2 cm) assessing EOR is hindered by the collapsed surgical cavity, especially when the ventricular system is opened, and by artifacts that may simulate or hide residual tumors. The main strategies to overcome the former limit are inflation of the surgical cavity through pressure irrigation while insonating, and closure of the ventricular opening with Gelfoam before insonating. The strategies to overcome the latter are avoiding the use of hemostatic agents before IOUS and insonating through normal adjacent brain instead of corticotomy. These technical nuances enhanced the reliability of post-IOUS, with a total concordance to postoperative MRI. Indeed, the surgical plan was changed in about 30% of cases, as IOUS showed a residual tumor that was left behind.
conclusionIOUS ensures reliable real-time imaging in the surgery of space-occupying brain lesions. Limits may be overcome with technical nuances and proper training.
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