ArticleActa neurochirurgica2026
Integration of intraoperative ultrasound and depth-electrode electrocorticography for resection guidance in epilepsy surgery: technical workflow and feasibility.
Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComplete resection of the epileptogenic zone (EZ) is the strongest predictor of seizure freedom in drug-resistant epilepsy (DRE). However, even in MRI-positive cases with anatomo-electro-clinical concordance, the EZ may not be clearly delineated, complicating intraoperative decision-making. Intraoperative ultrasound (ioUS) provides real-time anatomical feedback, while depth-electrode intraoperative electrocorticography (iECoG) enables electrophysiological delineation of epileptogenic tissue beyond the cortical surface, sampling deep regions not accessible to subdural electrodes. Their integration may improve intraoperative precision in defining resection limits and optimizing resective surgery.
methodsThis study describes the workflow and feasibility of combining ioUS and depth-electrode iECoG for intraoperative guidance in MRI-positive focal DRE with an ill-defined EZ. In all cases, concordant anatomo-electro-clinical data identified a single EZ for which SEEG was not required, yet the suspected EZ remained poorly delineated. ioUS was used for real-time lesion visualization, verification of electrode trajectories, and guidance of resection depth and extent. Pre- and post-resective depth-electrode iECoG and ioUS were used in combination to delineate the resection margins, by identifying interictal epileptiform discharges (IEDs) and confirming lesion boundaries and resection completeness.
resultsSix patients underwent resective surgery using the combined ioUS-iECoG workflow. The technique was feasible and safe in all cases, with no intraoperative or postoperative complications (37 depth-electrode insertions). iECoG revealed IEDs in four patients (66%), prompting resection extension in two. MRI confirmed complete resection in all cases. At last follow-up (6-40 months), 5/6 patients were seizure-free (Engel I). Histopathology revealed FCD IIb in three cases, a gliotic lesion related to an encephalocele in one, a gliotic scar post-arachnoid cyst marsupialization in another, and a tuberous sclerosis-related lesion in a case of tuberous-sclerosis-complex.
conclusionThe integration of ioUS and depth-electrode iECoG offers real-time anatomical and electrophysiological data, refining EZ delineation and resection assessment in complex MRI-positive epilepsy cases where SEEG is not clinically indicated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.