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01-10-2020 | Glioma | Review

Reliability of intraoperative ultrasound in detecting tumor residual after brain diffuse glioma surgery: a systematic review and meta-analysis

Authors: Gianluca Trevisi, Paolo Barbone, Giorgio Treglia, Maria Vittoria Mattoli, Annunziato Mangiola

Published in: Neurosurgical Review | Issue 5/2020

Abstract

Intraoperative ultrasonography (iUS) is considered an accurate, safe, and cost-effective tool to estimate the extent of resection of both high-grade (HGG) and low-grade (DLGG) diffuse gliomas (DGs). However, it is currently missing an evidence-based assessment of iUS diagnostic accuracy in DGs surgery. The objective of review is to perform a systematic review and meta-analysis of the diagnostic performance of iUS in detecting tumor residue after DGs resection. A comprehensive literature search for studies published through October 2018 was performed according to PRISMA-DTA and STARD 2015 guidelines, using the following algorithm: (“ultrasound” OR “ultrasonography” OR “ultra-so*” OR “echo*” OR “eco*”) AND (“brain” OR “nervous”) AND (“tumor” OR “tumour” OR “lesion” OR “mass” OR “glio*” OR “GBM”) AND (“surgery” OR “surgical” OR “microsurg*” OR “neurosurg*”). Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), and diagnostic odds ratio (DOR) of iUS in DGs were calculated. A subgroup analysis for HGGs and DLGGs was also conducted. Thirteen studies were included in the systematic review (665 DGs). Ten articles (409 DGs) were selected for the meta-analysis with the following results: sensitivity 72.2%, specificity 93.5%, LR− 0.29, LR+ 3, and DOR 9.67. Heterogeneity among studies was non-significant. Subgroup analysis demonstrates a better diagnostic performance of iUS for DLGGs compared with HGGs. iUS is an effective technique in assessing DGs resection. No significant differences are seen regarding iUS modality and transducer characteristics. Its diagnostic performance is higher in DLGGs than HGGs and could be worsened by previous treatments, surgical artifacts, and small tumor residue volumes.

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Title: Reliability of intraoperative ultrasound in detecting tumor residual after brain diffuse glioma surgery: a systematic review and meta-analysis
Authors: Gianluca Trevisi
Paolo Barbone
Giorgio Treglia
Maria Vittoria Mattoli
Annunziato Mangiola
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Glioma
Ultrasound
Glioma
Ultrasound
Glioma
Published in: Neurosurgical Review / Issue 5/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-019-01160-x

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Reliability of intraoperative ultrasound in detecting tumor residual after brain diffuse glioma surgery: a systematic review and meta-analysis

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