Artikel
Intraoperative cone-beam computed tomography for visualisation of tumour remnant in pituitary adenoma surgery
Intraoperative Cone-Beam-Computertomographie zur Visualisierung von Tumorresten bei Operationen von Hypophysenadenomen
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Cone-beam computed tomography (CBCT) provides high spatial resolution and is increasingly used for intraoperative real-time bone imaging. Unfortunately, soft-tissue contrast is often limited due to several imaging artifacts. This prospective feasibility study aimed to evaluate the applicability of CBCT for visualization of pituitary adenomas and tumor remnants after neurosurgical resection.
Methods: The study comprised six consecutive patients with sellar lesions suspicious for pituitary adenomas that underwent endoscopic neuronavigation-guided transnasal transsphenoidal surgery. Intraoperative contrast-enhanced CBCT (C-arm ARTIS Pheno, Siemens Healthcare GmbH, Erlangen, Germany) was used to visualize tumor masses before and after resection. Patients received early postoperative magnetic resonance imaging (MRI) to determine the extent of resection. Tumor remnant visualization was compared between CBCT and MRI.
Results: Intraoperative and postoperative imaging could be performed without complications in all six patients. Intraoperative CBCT allowed high-resolution imaging of the sellar lesions and reliably visualized tumor remnants. Comparison between intraoperative CBCT and early postoperative MRI revealed high diagnostic accuracy of CBCT.
Conclusion: Intraoperative CBCT is a promising tool to assess the extent of resection in pituitary adenoma surgery. Studies with a larger sample size are warranted to validate the value of CBCT in pituitary adenoma surgery.