PMID- 30560090
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 8
DP  - 2018
TI  - Advanced Ultrasound Imaging in Glioma Surgery: Beyond Gray-Scale B-mode.
PG  - 576
LID - 10.3389/fonc.2018.00576 [doi]
LID - 576
AB  - Introduction: Glioma surgery is aimed at obtaining maximal safe tumor resection 
      while preserving or improving patient's neurological status. For this reason, 
      there is growing interest for intra-operative imaging in neuro-oncological 
      surgery. Intra-operative ultrasound (ioUS) provides the surgeon with real-time, 
      anatomical and functional information. Despite this, in neurosurgery ioUS mainly 
      relies only on gray-scale brightness mode (B-mode). Many other ultrasound imaging 
      modalities, such as Fusion Imaging with pre-operative acquired magnetic resonance 
      imaging (MRI), Doppler modes, Contrast Enhanced Ultrasound (CEUS), and 
      elastosonography have been developed and have been extensively used in other 
      organs. Although these modalities offer valuable real-time intra-operative 
      information, so far their usage during neurosurgical procedures is still limited. 
      Purpose: To present an US-based multimodal approach for image-guidance in glioma 
      surgery, highlighting the different features of advanced US modalities: fusion 
      imaging with pre-operative acquired MRI for Virtual Navigation, B-mode, Doppler 
      (power-, color-, spectral-), CEUS, and elastosonography. Methods: We describe, in 
      a step-by-step fashion, the applications of the most relevant advanced US 
      modalities during different stages of surgery and their implications for surgical 
      decision-making. Each US modality is illustrated from a technical standpoint and 
      its application during glioma surgery is discussed. Results: B-mode offers 
      dynamic morphological information, which can be further implemented with fusion 
      imaging to improve image understanding and orientation. Doppler imaging permits 
      to evaluate anatomy and function of the vascular tree. CEUS allows to perform a 
      real-time angiosonography, providing valuable information in regards of 
      parenchyma and tumor vascularization and perfusion. This facilitates tumor 
      detection and surgical strategy, also allowing to characterize tumor grade and to 
      identify residual tumor. Elastosonography is a promising tool able to better 
      define tumor margins, parenchymal infiltration, tumor consistency and permitting 
      differentiation of high grade and low grade lesions. Conclusions: Multimodal ioUS 
      represents a valuable tool for glioma surgery being highly informative, rapid, 
      repeatable, and real-time. It is able to differentiate low grade from high grade 
      tumors and to provide the surgeon with relevant information for surgical 
      decision-making. ioUS could be integrated with other intra-operative imaging and 
      functional approaches in a synergistic manner to offer the best image guidance 
      for each patient.
FAU - Del Bene, Massimiliano
AU  - Del Bene M
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
AD  - Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 
      Milan, Italy.
FAU - Perin, Alessandro
AU  - Perin A
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Casali, Cecilia
AU  - Casali C
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Legnani, Federico
AU  - Legnani F
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Saladino, Andrea
AU  - Saladino A
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Mattei, Luca
AU  - Mattei L
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Vetrano, Ignazio Gaspare
AU  - Vetrano IG
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - Saini, Marco
AU  - Saini M
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
FAU - DiMeco, Francesco
AU  - DiMeco F
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
AD  - Department of Pathophysiology and Transplantation, University of Milan, Milan, 
      Italy.
AD  - Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, 
      United States.
FAU - Prada, Francesco
AU  - Prada F
AD  - Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 
      Milan, Italy.
AD  - Department of Neurological Surgery, University of Virginia, Charlottesville, VA, 
      United States.
AD  - Focused Ultrasound Foundation, Charlottesville, VA, United States.
LA  - eng
PT  - Journal Article
DEP - 20181203
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC6287020
OTO - NOTNLM
OT  - B-mode
OT  - Doppler
OT  - Glioma
OT  - contrast enhanced ultrasound
OT  - elastography
OT  - fusion imaging
OT  - intra-operative ultrasound
OT  - navigated ultrasound
EDAT- 2018/12/19 06:00
MHDA- 2018/12/19 06:01
PMCR- 2018/01/01
CRDT- 2018/12/19 06:00
PHST- 2018/09/15 00:00 [received]
PHST- 2018/11/16 00:00 [accepted]
PHST- 2018/12/19 06:00 [entrez]
PHST- 2018/12/19 06:00 [pubmed]
PHST- 2018/12/19 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2018.00576 [doi]
PST - epublish
SO  - Front Oncol. 2018 Dec 3;8:576. doi: 10.3389/fonc.2018.00576. eCollection 2018.