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Acta Neurochirurgica

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01-11-2010 | Clinical Article

Ultrasound-guided operations in unselected high-grade gliomas—overall results, impact of image quality and patient selection

Authors: Ole Solheim, Tormod Selbekk, Asgeir Store Jakola, Geirmund Unsgård

Published in: Acta Neurochirurgica | Issue 11/2010

Abstract

Background

A number of tools, including intraoperative ultrasound, are reported to facilitate surgical resection of high-grade gliomas. However, results from selected surgical series do not necessarily reflect the effectiveness in common neurosurgical practice. Delineation of seemingly similar brain tumours vary in different ultrasound-guided operations, perhaps limiting usefulness in certain patients.

Methods

We explore and describe the results associated with use of the SonoWand system with intraoperative ultrasound in a population-based, unselected, high-grade glioma series. Surgeons filled out questionnaires about presumed extent of resection, use of ultrasound and ultrasound image quality just after surgery. We evaluate the impact of ultrasound image quality. We also explore the importance of patient selection for surgical results.

Results

Of 156 consecutive malignant glioma operations, 142 (91%) were resections whilst 14 (9%) were only biopsies. We achieved gross total resection (GTR) in 37% of all high-grade glioma resections, whilst worsening of functional status was seen in 13%. The risk of getting worse was significantly higher in reoperations, resections in eloquent locations, resections in cases with poor ultrasound image quality, resection when surgeons’ resection grade estimates were inaccurate and in cases with surgery-related complications. Aiming for GTR, unifocality of lesion, non-eloquent location and medium or good ultrasound image quality were identified as independent factors associated with achieving GTR.

Conclusion

We report good overall results, both in terms of resection grades and functional outcome in consecutive malignant glioma resections, in which intraoperative ultrasound was used in 95%. We observed a seeming dose–response relationship between ultrasound image quality and clinical and radiological results. This may suggest that better ultrasound facilitates better surgery. The study also clearly demonstrates that, in terms of surgical results, the selection of patients seems to be much more important than the selection of surgical tools.

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Title: Ultrasound-guided operations in unselected high-grade gliomas—overall results, impact of image quality and patient selection
Authors: Ole Solheim
Tormod Selbekk
Asgeir Store Jakola
Geirmund Unsgård
Publication date: 01-11-2010
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-010-0731-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ultrasound-guided operations in unselected high-grade gliomas—overall results, impact of image quality and patient selection

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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