gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

First experiences with 3D-reconstructed navigated and contrast enhanced ultrasound in malignant brain tumor

Meeting Abstract

  • F. Arlt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig
  • D. Lindner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig
  • A. Müns - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig
  • C. Chalopin - Innovation Center Computer Assisted Surgery (ICCAS), Universität Leipzig
  • J. Meixensberger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.04.07

DOI: 10.3205/11dgnc015, URN: urn:nbn:de:0183-11dgnc0157

Published: April 28, 2011

© 2011 Arlt 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: Due to the technical capabilities in advanced application of ultrasound and high resolution real-time viewing intraoperative ultrasound technology turned out to be a simple tool in brain tumor surgery. However sensitivity and specificity of B-mode ultrasound is limited in detection of tumor remnants as well as in differentiation of oedema and vascular structures. Therefore, our investigations focused on contrast enhanced ultrasound and its impact on intraoperative imaging in a 3 D – navigated scenario.

Methods: Our preliminary series included fifteen glioma patients. Intraoperatively a 3 D-reconstructed transdural ultrasound after contrast agent application (SonoVue®) with a linear array respectively a phased array (Toshiba®) was performed and integrated into the neuronavigation (LOCALITE®). The ultrasound probe was tracked and calibrated. After resection another contrast enhanced US scan was performed to verify tumor remnants. 3 D-Ultrasound datasets were analysed in comparison to pre – and postoperative MRI – data.

Results: In all cases an uptake of the contrast agent was observed and the tumor margins and configuration could be identified. The real time - integration of the US data in the 3 D-neuronavigation was possible in all cases. The tumor as well as other anatomical structures could be identified in the compare panel with a minimal deviation up to 2 mm in comparison to the preoperative MRI. Additionally the contrast uptake revealed a high overlap to contrast enhanced MRI areas (Figure 1 [Fig. 1]).

Conclusions: The reconstructed 3 D-contrast enhanced ultrasound seems to be an additional, useful method for intraoperative tumor visualization as well as tumor remnants confirming an effective resection control in glioma surgery.