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Resection of pediatric intracerebral tumors with the aid of intraoperative real-time 3-D ultrasound

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Abstract

Purpose

Intraoperative ultrasound (IOUS) has become a useful tool employed daily in neurosurgical procedures. In pediatric patients, IOUS offers a radiation-free and safe imaging method. This study aimed to evaluate the use of a new real-time 3-D IOUS technique (RT-3-D IOUS) in our pediatric patient cohort.

Material and methods

Over 24 months, RT-3-D IOUS was performed in 22 pediatric patients (8 girls and 14 boys) with various brain tumors. These lesions were localized by a standard navigation system followed by analyses before, intermittently during, and after neurosurgical resection using the iU22 ultrasound system (Philips, Bothell, USA) connected to the RT-3-D probe (X7-2).

Results

In all 22 patients, real-time 3-D ultrasound images of the lesions could be obtained during neurosurgical resection. Based on this imaging method, rapid orientation in the surgical field and the approach for the resection could be planned for all patients. In 18 patients (82%), RT-3-D IOUS revealed a gross total resection with a favorable neurological outcome.

Conclusion

RT-3-D IOUS provides the surgeon with advanced orientation at the tumor site via immediate live two-plane imaging. However, navigation systems have yet to be combined with RT-3-D IOUS. This combination would further improve intraoperative localization.

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Disclosure

The real-time 3-D US transducer has been provided by the company Philips for research purposes. This is not the case for the US system IU22, which was bought by the department. No further financial collaborations, consulting contracts, or conflicts of interest exist.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Zurich, Frauenklinikstr.10, 8091, Zurich, Switzerland

    Nils H. Ulrich, Jan-Karl Burkhardt, Carlo Serra, René-Ludwig Bernays & Oliver Bozinov

  2. Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA

    Jan-Karl Burkhardt

Authors
  1. Nils H. Ulrich
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  2. Jan-Karl Burkhardt
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  3. Carlo Serra
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  4. René-Ludwig Bernays
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  5. Oliver Bozinov
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Correspondence to Nils H. Ulrich.

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Ulrich, N.H., Burkhardt, JK., Serra, C. et al. Resection of pediatric intracerebral tumors with the aid of intraoperative real-time 3-D ultrasound. Childs Nerv Syst 28, 101–109 (2012). https://doi.org/10.1007/s00381-011-1571-1

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  • DOI: https://doi.org/10.1007/s00381-011-1571-1

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