gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Is the image guidance of ultrasonography beneficial for neurosurgical routine?

Ist die navigierte Ultraschalltechnologie in der operativen Routine von Vorteil?

Meeting Abstract

  • corresponding author D. Miller - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • S. Heinze - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • O. Bozinov - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • W. Tirakotai - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • H. Bertalanffy - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • U. Sure - Klinik für Neurochirurgie, Philipps-Universität Marburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.10.01

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Miller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Intraoperative ultrasound has been extensively used in neurosurgical procedures as it has the advantage of producing real-time images. However, images are often difficult to interpret. Ultrasound-navigation combines real-time sonographic data and image guidance. The intraoperative images, in alignment with preoperative MRI-scans, can compensate for brain shift and help in resection control and approach planning. It is thus a potentially valuable adjunct during the surgical excision of brain tumours. In the present study we evaluate our new sononavigation system and compare it to conventional intraoperative ultrasound.

Methods: From January to June 2005, 29 tumour patients were operated on with the aid of intraoperative ultrasound. Sononavigation was used in 13 cases, the non-navigated ultrasound technology in the remaining individuals. We compared our one-platform sononavigation system containing an integrated ultrasound device (VectorVision2, BrainLAB, Germany) with a high end ultrasound system (Aplio, Toshiba, Tokyo, Japan) that is not connected to a navigation platform. Special considerations were taken in regard to image quality, tumour demarcation, orientation and whether anatomical landmarks were easily visualized.

Results: The pathology could be visualized in all patients. The tumour was well defined in 12/16 non-navigated and 11/13 navigated cases, respectively. Although image quality was good in most cases, orientation remained difficult in 8/16 patients in whom conventional sonography was used. Image fusion for sononavigation was performed without difficulties in all cases and a good-quality ultrasound picture was achieved in 11/13 navigated patients. In our hands the orientation in the sononavigated cases was judged to be superior to non-navigated ultrasound.

Conclusions: Intraoperative ultrasound provides valuable real-time information during tumour removal but is sometimes difficult to read. In our hands, integration of the ultrasound into the navigation system facilitates anatomical understanding as the preoperative MRI-data set helps to interpret the sonographic data. Thus, we feel that this technology is beneficial for neurosurgical routine.