Intraoperative ultrasound in low-grade glioma surgery

There is increasing evidence that the extent of tumor removal in low-grade glioma surgery is related to patient survival time. Thus, the goal of resecting the largest amount of tumor possible without leading to permanent neurological sequelae is a challenge for the neurosurgeon. Electrical stimulation of the brain to detect cortical and axonal areas involved in motor, language, and cognitive function and located within the tumor or along its boundaries has become an essential tool in combination with awake craniotomy. Based on a literature review, discussions within the European Low-Grade Glioma Group, and illustrative clinical experience, the authors of this paper provide an overview for neurosurgeons, neurophysiologists, linguists, and anesthesiologists as well as those new to the field about the stimulation techniques currently being used for mapping sensorimotor, language, and cognitive function in awake surgery for low-grade glioma. The paper is intended to help the understanding of these techniques and facilitate a comparison of results between users.

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Cortical and subcortical functional neuroanatomy for low-grade glioma surgery

Neurochirurgie ◽

10.1016/j.neuchi.2016.10.001 ◽

2017 ◽

Vol 63 (3) ◽

pp. 117-121

Author(s):

L. Chenin ◽

M. Lefranc ◽

S. Velut ◽

P. Foulon ◽

E. Havet ◽

...

Keyword(s):

Low Grade Glioma ◽

Low Grade ◽

Functional Neuroanatomy ◽

Glioma Surgery

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QOL-02EPILEPSY FOLLOWING LOW GRADE GLIOMA SURGERY: SINGLE CENTRE EXPERIENCE

Neuro-Oncology ◽

10.1093/neuonc/nov230.02 ◽

2015 ◽

Vol 17 (suppl 5) ◽

pp. v188.2-v188

Author(s):

Erjon Agushi ◽

Elvira Lekka ◽

Rajiv Mohanraj ◽

Christos Gkolemis ◽

Konstantina Karabatsou

Keyword(s):

Low Grade Glioma ◽

Low Grade ◽

Single Centre ◽

Glioma Surgery ◽

Single Centre Experience

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Extent of Glioma Resection on Intraoperative Ultrasound Correlates Well with Postoperative MRI Results

Journal of Surgical Oncology ◽

10.31487/j.jso.2019.04.01 ◽

2019 ◽

pp. 1-7

Author(s):

Ahmed Aly ◽

Radwan Noubi ◽

Mahmoud Ragab ◽

Khalid Abdelaziz ◽

Simon Howarth ◽

...

Keyword(s):

Surgical Resection ◽

Intraoperative Imaging ◽

Intraoperative Ultrasound ◽

Extent Of Resection ◽

Control Group ◽

P Value ◽

Low Grade ◽

Ultrasound Images ◽

Glioma Surgery ◽

Number Of Patients

Background: Maximal surgical resection is thought to confer survival benefit for both high- and low-grade gliomas. Intraoperative imaging assists with achieving maximal surgical resection. Different intraoperative imaging modalities have been implemented, but intra-operative MRI has a high cost that may limit its uptake in resource scarce healthcare systems. Objectives: This study aims to evaluate intraoperative ultrasound as a surrogate for intra and post-operative MRI for assessing the extent of resection of glioma. Methods: A partially prospective comparative study, which compares a prospective cohort group with a historical control group. We evaluated 74 glioma patients, who all underwent surgery in a regional UK Neurosurgical centre between October 2013 and October 2017. The study population was divided into 2 groups based on the use of ultrasound to guide the resection. We compared the size of the lesion prior and after excision to evaluate the extent of resection and undertook comparison with post-operative MRI. Results: The mean extent of resection on the ultrasound images was 96.1 % and 97.7 % on the postoperative MR. Using Spearman’s correlation; extent of resection on the ultrasound images was strongly correlated with the extent of resection on the postoperative MR images (P=value <0.001). The use of intraoperative ultrasound was associated with a significant increase in the number of patients in whom 95% or greater extent of resection was achieved (Fisher’s exact test P= value 0.033). Conclusion: Intra-operative ultrasonography could provide a reliable and cheaper alternative to intraoperative MRI to improve the extent of resection in glioma surgery.

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