Assessing the Effectiveness of 2D Non-Navigated Intraoperative Ultrasound in Glioma Surgery

Objective:

The objective of this retrospective study is to evaluate the effectiveness and utility of 2D non-navigated intraoperative ultrasound (ioUS) as a cost-effective method for guiding the surgical resection of gliomas and detecting residual tumor.

Methods:

The study will retrospectively analyze the records of consecutive adult patients diagnosed with gliomas who underwent craniotomy between June 2018 and June 2023. The patients' records must show that they underwent both intraoperative ultrasound and postoperative MRI.

Evaluation Criteria:

The primary evaluation metric will be the extent of resection (EOR), which will be determined using postoperative MRI scans as the gold standard. The EOR will be classified into gross total resection (GTR), near-total resection (NTR), subtotal resection (STR), and partial resection (PR) based on the MRI scans.

The study will also examine the sensitivity and specificity of ioUS in detecting residual tumor postoperatively. This analysis will help determine the accuracy of ioUS in predicting residual tumor that may not have been apparent during the surgical procedure.

Expected Outcomes:

The study aims to determine if ioUS can be a reliable and affordable tool for guiding the surgical resection of gliomas. If successful, ioUS, in conjunction with other intraoperative adjuncts, may provide a cost-effective method to aid neurosurgeons in achieving the maximum safe resection in glioma surgery.

The results of this study could have significant implications for the management of glioma patients, potentially leading to improved surgical outcomes, decreased postoperative complications, and ultimately, improved patient survival and quality of life.

The data collected from this retrospective analysis could also provide valuable insights for future prospective studies and could contribute to the development of guidelines for the use of ioUS in neurosurgery.

Inclusion criteria

• Adult patients aged 18 years or older.
• Patients diagnosed with gliomas, confirmed by a pathologist.
• Patients who are scheduled to undergo craniotomy for tumor resection.
• Patients who are willing and able to give informed consent for participation in the trial.
• Patients who are capable of undergoing both intraoperative ultrasound and postoperative MRI.

Exclusion criteria

• Patients under the age of 18.
• Patients with non-glioma brain tumors.
• Patients who underwent stereotactic biopsies.
• Patients who are unable to provide informed consent due to cognitive impairment, language barriers, or any other reason.
• Patients with contraindications for MRI such as certain types of implanted medical devices, severe claustrophobia, or allergies to contrast material.
• Pregnant or breastfeeding women.