Khalid Abdelaziz,Stuart Smith,Ahmed Aly,Mahmoud Ragab,Radwan Noubi,Simon Howarth,
Extent of Glioma Resection on Intraoperative Ultrasound Correlates Well with Postoperative MRI Results
Journal of Surgical Oncology
2019
2674-3000
http://dx.doi.org/10.31487/j.JSO.2019.04.01
https://www.sciencerepository.org/extent-of-glioma-resection-on-intraoperative-ultrasound-correlates-well-with-postoperative-mri-results_JSO-2019-4-101 
Abstract: Background: Maximal surgical resection is thought to confer survival benefit for both high- and low-grade
gliomas. Intraoperative imaging assists with achieving maximal surgical resection. Different intraoperative
imaging modalities have been implemented, but intra-operative MRI has a high cost that may limit its uptake
in resource scarce healthcare systems.
Objectives: This study aims to evaluate intraoperative ultrasound as a surrogate for intra and post-operative
MRI for assessing the extent of resection of glioma.
Methods: A partially prospective comparative study, which compares a prospective cohort group with a
historical control group. We evaluated 74 glioma patients, who all underwent surgery in a regional UK
Neurosurgical centre between October 2013 and October 2017. The study population was divided into 2
groups based on the use of ultrasound to guide the resection. We compared the size of the lesion prior and
after excision to evaluate the extent of resection and undertook comparison with post-operative MRI.
Results: The mean extent of resection on the ultrasound images was 96.1 % and 97.7 % on the postoperative
MR. Using Spearman’s correlation; extent of resection on the ultrasound images was strongly correlated
with the extent of resection on the postoperative MR images (P=value <0.001). The use of intraoperative
ultrasound was associated with a significant increase in the number of patients in whom 95% or greater
extent of resection was achieved (Fisher’s exact test P= value 0.033).
Conclusion: Intra-operative ultrasonography could provide a reliable and cheaper alternative to
intraoperative MRI to improve the extent of resection in glioma surgeryKeywords: Gliomas, intraoperative ultrasound, postoperative MR, surgical resection