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

Vibrography for the resection of gliomas

Vibrographie bei Gliomresektionen

Meeting Abstract

  • corresponding author M. Scholz - Klinik für Neurochirurgie, Ruhr-Universität Bochum
  • P. Schulte - Klinik für Neurochirurgie, Ruhr-Universität Bochum
  • K. Schmieder - Klinik für Neurochirurgie, Ruhr-Universität Bochum
  • H. Ermert - Institut für Hochfrequenztechnik, Ruhr-Universität Bochum
  • M. Engelhardt - Klinik für Neurochirurgie, Ruhr-Universität Bochum
  • A. Harders - Klinik für Neurochirurgie, 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.10.10

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc203.shtml

Published: April 11, 2007

© 2007 Scholz 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

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Objective: Vibrography is a special form of elastography adapted für usage during tumor neurosurgery. The aim of this study was the evaluation of vibrography for resection control in neurosurgery of gliomas.

Methods: The real-time vibrography system consisted of a conventional ultrasound system (Siemens Sonoline Omnia) with a custom-designed rf-interface and a 6.5 MHz endocavity curved array (Siemens 6.5EC10). The rf-data were digitized using a 50 MHz , 12-bit PCI analog/digital (A/D) converter for real-time or off-line processing. Static compression was replaced by low-frequency axial vibration of the probe. A special applicator equipped with a stepping motor moved the ultrasonic probe and produced a low frequency mechanical vibration of ~ 5-10 Hz with a vibration amplitude of 0.3 mm and slight preliminary compression (total <1 mm). During the last 3 years 63 patients were investigated with vibrography intraoperatively. In the last 12 cases in which we suggested the diagnosis glioma before the operation, we intended to perform several intraoperative measurements to evaluate the value of the described method as a resection control. Age of the patients was between 29-82 years (median 57). Tumor localization was as follows (4 frontal, 4 occipital, 1 insula, 1 temporal, 1 parietal, 1 temporoparietal).

Results: A genuine resection control with several measurements could only be performed in 7 cases. In 5 other cases different problems occurred, so only one or two intraoperative measurements were done. In two cases the surgeon was not willing to use the method because the tripod was described as bein too bulky. In two other cases, the correct probe position could not be found. In one patient a technical mistake was made so that correct imaging was not possible. Using intraoperative ultrasound as a gold standard, an additional image information with vibrography could only be obtained in one patient with an oligostrocytoma in which rest tumor could be detected. Vibrography was difficult in very large tumors in which normal surrounding brain could not be visualized as a control tissue and in cases where tumor material was deeper than 3 cm. Neurosurgical tumor resection was controlled by contrast CT or MRI.

Conclusions: Vibrography is possible in tumor neurosurgery but restricted to image a very focussed area of the resection cave. Positioning of the tripod is time-consuming and reduces the possibility of further ultrasonic examinations such as 3D or contrast ultrasound. For this reason modification of the technique should be investigated in the future.