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Navigated intraoperative ultrasound in pediatric brain tumors. | LitMetric

AI Article Synopsis

  • The study aimed to assess how effective navigated intraoperative ultrasound (iUS) is compared to intraoperative magnetic resonance imaging (iMRI) for diagnosing and detecting tumor remnants in pediatric neurosurgery.
  • It involved 24 children undergoing tumor removal, with iUS images collected both before and after tumor resection to evaluate accuracy using specific statistical measures.
  • Results showed a strong correlation between iUS and iMRI in estimating tumor volume pre-surgery, and high sensitivity and good specificity in detecting leftover tumors post-surgery, highlighting iUS as a valuable tool in neurosurgery.

Article Abstract

Purpose: The aim of this study was to evaluate the diagnostic value and accuracy of navigated intraoperative ultrasound (iUS) in pediatric oncological neurosurgery as compared to intraoperative magnetic resonance imaging (iMRI).

Methods: A total of 24 pediatric patients undergoing tumor debulking surgery with iUS, iMRI, and neuronavigation were included in this study. Prospective acquisition of iUS images was done at two time points during the surgical procedure: (1) before resection for tumor visualization and (2) after resection for residual tumor assessment. Dice similarity coefficients (DSC), Hausdorff distances 95th percentiles (HD95) and volume differences, sensitivity, and specificity were calculated for iUS segmentations as compared to iMRI.

Results: A high correlation (R = 0.99) was found for volume estimation as measured on iUS and iMRI before resection. A good spatial accuracy was demonstrated with a median DSC of 0.72 (IQR 0.14) and a median HD95 percentile of 4.98 mm (IQR 2.22 mm). The assessment after resection demonstrated a sensitivity of 100% and a specificity of 84.6% for residual tumor detection with navigated iUS. A moderate accuracy was observed with a median DSC of 0.58 (IQR 0.27) and a median HD95 of 5.84 mm (IQR 4.04 mm) for residual tumor volumes.

Conclusion: We found that iUS measurements of tumor volume before resection correlate well with those obtained from preoperative MRI. The accuracy of residual tumor detection was reliable as compared to iMRI, indicating the suitability of iUS for directing the surgeon's attention to areas suspect for residual tumor. Therefore, iUS is considered as a valuable addition to the neurosurgical armamentarium.

Trial Registration Number And Date: PMCLAB2023.476, February 12th 2024.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322494PMC
http://dx.doi.org/10.1007/s00381-024-06492-8DOI Listing

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