Navigated intraoperative ultrasound in pediatric brain tumors.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY Child's Nervous System Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI:10.1007/s00381-024-06492-8

Kevin Klein Gunnewiek, Kirsten M van Baarsen, Evie H M Graus, Wyger M Brink, Maarten H Lequin, Eelco W Hoving

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Abstract

Purpose: The aim of this study was to evaluate the diagnostic value and accuracy of navigated intraoperative ultrasound (iUS) in pediatric oncological neurosurgery as compared to intraoperative magnetic resonance imaging (iMRI).

Methods: A total of 24 pediatric patients undergoing tumor debulking surgery with iUS, iMRI, and neuronavigation were included in this study. Prospective acquisition of iUS images was done at two time points during the surgical procedure: (1) before resection for tumor visualization and (2) after resection for residual tumor assessment. Dice similarity coefficients (DSC), Hausdorff distances 95th percentiles (HD95) and volume differences, sensitivity, and specificity were calculated for iUS segmentations as compared to iMRI.

Results: A high correlation (R = 0.99) was found for volume estimation as measured on iUS and iMRI before resection. A good spatial accuracy was demonstrated with a median DSC of 0.72 (IQR 0.14) and a median HD95 percentile of 4.98 mm (IQR 2.22 mm). The assessment after resection demonstrated a sensitivity of 100% and a specificity of 84.6% for residual tumor detection with navigated iUS. A moderate accuracy was observed with a median DSC of 0.58 (IQR 0.27) and a median HD95 of 5.84 mm (IQR 4.04 mm) for residual tumor volumes.

Conclusion: We found that iUS measurements of tumor volume before resection correlate well with those obtained from preoperative MRI. The accuracy of residual tumor detection was reliable as compared to iMRI, indicating the suitability of iUS for directing the surgeon's attention to areas suspect for residual tumor. Therefore, iUS is considered as a valuable addition to the neurosurgical armamentarium.

Trial registration number and date: PMCLAB2023.476, February 12th 2024.

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小儿脑肿瘤术中超声导航。

目的：本研究旨在评估与术中磁共振成像（iMRI）相比，导航术中超声（iUS）在小儿肿瘤神经外科手术中的诊断价值和准确性：本研究共纳入了24名接受肿瘤剥除手术的儿科患者，他们分别接受了iUS、iMRI和神经导航。iUS图像的前瞻性采集在手术过程中的两个时间点进行：(1)切除前，用于肿瘤显像；(2)切除后，用于残余肿瘤评估。与 iMRI 相比，计算了 iUS 分段的骰子相似系数（DSC）、豪斯多夫距离第 95 百分位数（HD95）和体积差异、灵敏度和特异性：结果发现，切除术前 iUS 和 iMRI 测量的容积估计值具有很高的相关性（R = 0.99）。中位 DSC 为 0.72（IQR 为 0.14），中位 HD95 百分位数为 4.98 毫米（IQR 为 2.22 毫米），显示出良好的空间准确性。切除术后的评估显示，使用导航 iUS 检测残余肿瘤的灵敏度为 100%，特异度为 84.6%。残留肿瘤体积的中位DSC为0.58（IQR为0.27），中位HD95为5.84毫米（IQR为4.04毫米）：我们发现，切除术前 iUS 测量的肿瘤体积与术前 MRI 测量的肿瘤体积有很好的相关性。与 iMRI 相比，残留肿瘤检测的准确性更可靠，这表明 iUS 适合引导外科医生关注可疑的残留肿瘤区域。因此，iUS 被认为是神经外科武器库中的重要补充。试验注册号和日期：PMCLAB2023.476，2024 年 2 月 12 日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.