Ultrasound-guided versus traditional surgical resection of supratentorial gliomas in a limited-resources neurosurgical setting

Background Intraoperative ultrasonography (IOUS) represents a cheap and safe alternative to the more expensive intraoperative guidance modalities. In this study, we investigate the impact of introducing IOUS in the surgical management of supratentorial gliomas and compare its use objectively to ungu...

Full description

Saved in:

Bibliographic Details
Published in:	Egyptian journal of neurosurgery Vol. 33; no. 1; pp. 1 - 11
Main Authors:	Ibrahim, Aly, Abdel Ghany, Walid Ahmed, Elzoghby, Mohamed Atef, El-Shazly, Ayman, Simry, Hisham, Fakhr, Mohamed Alaa
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 16-11-2018 Springer Nature B.V SpringerOpen
Subjects:	Astrocytoma Extent of resection Glioblastoma Glioma Medicine Medicine & Public Health Neurosurgery Ultrasonic imaging Ultrasound Extent of resection Ultrasound Astrocytoma Glioblastoma
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Background Intraoperative ultrasonography (IOUS) represents a cheap and safe alternative to the more expensive intraoperative guidance modalities. In this study, we investigate the impact of introducing IOUS in the surgical management of supratentorial gliomas and compare its use objectively to unguided surgery. Methods We conducted a prospective cohort study comparing two groups of patients with supratentorial gliomas amenable to gross total resection. One group was operated using intraoperative ultrasound guidance while the other group was operated using a more traditional approach with no intraoperative image guidance. The main outcomes assessed were the extent of tumor resection (EOR) based on early postoperative MRI, the postoperative Karnofsky performance score (KPS), and the rate of complications. Results There were 17 patients in the ultrasound group and 13 in the control group. EOR was significantly better in the IOUS group. Gross total (GTR) and near-total (NTR) resection were achieved in 29% and 24% respectively in the IOUS group, while 0% and 8% respectively in the control group. The mean volumetric EOR was 83% and 66% in the IOUS and the control groups respectively. Ultrasound was able to detect residual tumor after surgeon perceived GTR in 76% of cases. Postoperative KPS was significantly better in the IOUS group. Conclusion IOUS guidance is superior to non-guided surgery in terms of EOR. Higher tumor resection confers a survival benefit according to previously published literature. This is particularly useful in a limited-resource setting, where neuronavigation and intraoperative MRI are not available.
ISSN:	2520-8225 2520-8225
DOI:	10.1186/s41984-018-0024-5