gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Contrast enhanced ultrasound during brain tumor surgery – on the path to resection control

Kontrastmittelunterstützter Ultraschall bei Hirntumor-Operationen – eine neue Methode der Resektionskontrolle

Meeting Abstract

  • corresponding author M. Engelhardt - Neurochirurgische Abteilung, Knappschaftskrankenhaus, Ruhr-Universität Bochum
  • C. Hansen - Institut für Hochfrequenztechnik, Ruhr-Universität Bochum
  • C. Brenke - Neurochirurgische Abteilung, Knappschaftskrankenhaus, Ruhr-Universität Bochum
  • I. Pechlivanis - Neurochirurgische Abteilung, Knappschaftskrankenhaus, Ruhr-Universität Bochum
  • A. Harders - Neurochirurgische Abteilung, Knappschaftskrankenhaus, Ruhr-Universität Bochum
  • H. Ermert - Institut für Hochfrequenztechnik, Ruhr-Universität Bochum
  • K. Schmieder - Neurochirurgische Abteilung, Knappschaftskrankenhaus, Ruhr-Universität Bochum

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.09.01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc184.shtml

Veröffentlicht: 11. April 2007

© 2007 Engelhardt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: The aim of this study was to adapt ultrasonographic techniques developed for brain perfusion in cerebral ischemia diagnostics into an intraoperative setting during neurosurgical brain tumor resection. It was intended to use tumor perfusion for online navigation and resection control. The aim of this study was to evaluate the feasibility of the method for delineation of the tumor and for resection control in the intraoperative setting.

Methods: During surgery, patients underwent several contrast-enhanced ultrasonographic investigations (Phase Inversion Harmonic Imaging, fitted model function). An endocavity-curved array [6.5EC10, 6.5 MHz] was used. The ultrasound contrast agent Sonovue® (Bracco) was administered intravenously as a bolus injection. During off-line analysis, time-intensity curves as well as perfusion maps were calculated and parameters such as peak intensity were locally extracted to characterize perfusion. At the end of the tumor resection, a final examination was done and compared to postoperative MRI or CT data sets.

Results: Twenty patients (age 18-76, mean 57 years) with brain tumors of different histology (gliomas, metastasis and meningiomas) were investigated with contrast-enhanced ultrasonography during surgery. In two patients no images could be analysed due to technical problems. In 18 cases the contrast enhancement was detectable and tumor identification was possible, 16 tumors could clearly be differentiated from normal brain and surrounding structures. Overall tissue differentiation with contrast agent was superior compared to conventional B-mode ultrasound imaging. In the first 6 patients, the results of the comparison with postoperative radiological examinations showed a good correlation in terms of resection control.

Conclusions: Intraoperative contrast-enhanced ultrasonography enabled visualization of cerebral tumors in high spatial resolution. Especially in displaying tumor borders, this technique could emerge to a low cost solution for intraoperative resection control.