gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

High frequency intraoperative ultrasound in malignant intra-axial cerebral lesions

Meeting Abstract

  • O. Bozinov - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Schweiz
  • J.K. Burkhardt - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Schweiz
  • N. Ulrich - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Schweiz
  • C. Serra - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 082

DOI: 10.3205/12dgnc469, URN: urn:nbn:de:0183-12dgnc4690

Published: June 4, 2012

© 2012 Bozinov et al.
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Outline

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Objective: To demonstrate a new concept of intraoperative use of high frequency Ultrasound (hfioUS) in maximizing the extent of resection (EOR) of intra-axial intracranial high-grade tumors.

Methods: 22 Patients harboring an intracranial high-grade tumor were retrospectively included in this study (14 primary tumors, 8 metastasis). 14 of them had a perilesional edema equal or greater to lesions volume, 3 had previously received radiotherapy. After macroscopical tumor debulking the small (11 x 31 mm) L15-7io (Philips, Bothell, USA) high-frequency probe (7–15 MHz) was introduced in the resection cavity and its walls were meticulously scanned searching for tumor remnants during resection. Postoperative MR scans were evaluated by a board-certified independent neuroradiologist to assessed the EOR.

Results: Gross total resection was achieved in 21 patients (95.5%). One patient had a small tumor remnant (6 x 4 x 3 mm) of a very large (80 x 60 x 74 mm) anaplastic astrocytoma, detected in the postoperative MR scan. A permanent postoperative hemiparesis was diagnosed in one patient with a metastasis in the motor area, all other patients recovered without permanent neurological deficits from the surgery.

Conclusions: In this study the hfioUS probe allowed a precise detection of the tumor and a detailed discrimination between normal, pathological and edematous tissue. The concept of high frequency close superficial intraoperative ultrasound scanning is superior to usual broad medium frequency scanning and thus a true alternative to high end intraoperative imaging.