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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Comparison of 3D navigated ultrasound and early post-operative MRI in resection control of metastase

Der Aussagewert des intraoperativen 3D-navigierten Ultraschalls bei der Resektionskontrolle von Hirnmetastasen im Vergleich zum frühen postoperativen MRT

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  • corresponding author Matteo Mario Bonsanto - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • C. R. Wirtz - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • R. Metzner - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • J. Hamer - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • H. H. Steiner - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • P. Schramm - Neuroradiologische Klinik der Universität Heidelberg, Heidelberg
  • A. Unterberg - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg
  • V. Tronnier - Neurochirurgische Klinik der Universität Heidelberg, Heidelberg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 10.106

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0389.shtml

Published: April 23, 2004

© 2004 Bonsanto et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

A navigated 3D ultrasound system with a 4-8 MHz phased-array probe was analyzed in comparison with high-field magnetic resonance imaging, for the prediction value in resection control of metastases.

Methods

In 17 patients with single metastases of different origins, 3D navigated ultrasound was used for intraoperative resection control and compared with an early postoperative MRI. At the end of the operation, the resection was classified based on the 3D ultrasound information as follows total, subtotal and unclear resection status. This information was compared with early postoperative high-field MRI (1.5 tesla) image information, performed between day 1 to 5 after the operation.

Results

The 3D navigated ultrasound showed a subtotal resection in 5 cases (29%) and a total resection in 8 cases (47%). As unclear cases 4 (24%) were classified based on the 3D ultrasound images at the end of the operation. Early postoperative MRI showed a subtotal resection in 3 (18%), a total resection in 11 (64 %) and 3 (18%) patients are classified as unclear cases. Based on the image information, congruence of findings between 3D navigated ultrasound and the early postoperative MRI was found in 10 cases (59 %). The 3D ultrasound images information was false negative in 2 (12 %) cases. Based on the 3D ultrasound image information, a total resection was postulated but the early postoperative MRI showed tumor residuals. Based on the 3D ultrasound information, the subgroup of the 4 cases classified, as unclear, showed a complete metastasis resection on the early postoperative MRI in 3 cases. One case out of this group was classified as unclear on both image modalities.

Conclusions

3D ultrasound offers an intraoperative online imaging modality that is useful for resection control during surgery of metastases. The prediction value on the completeness of the resection is close to the image information given by an early postoperative MRI.