Assessing the completeness of brain tumor resection using intraoperative ultrasound

Abstract

One of the key tasks in brain tumor neurosurgery is achieving maximum radical resection, which directly impacts patient prognosis. Traditional methods of intraoperative control have limitations, making the implementation of modern imaging technologies, such as intraoperative ultrasound (IOUS), highly relevant.

Objective. To study the capabilities of intraoperative ultrasound in benign and malignant gliomas using modern techniques.

Materials and methods. A prospective study included 58 patients operated on between January 2023 and September 2024. All patients underwent repeat IOUS in B-mode and with contrast enhancement after the main tumor volume was removed to detect residual tumor tissue.

Results. Repeat intraoperative ultrasound scanning allowed identification of residual tumor foci with a minimal size of up to 4 mm in 7 (12.07 %) of 58 patients, leading to renewed resection and achievement of total or subtotal cytoreduction in 100 % of cases. The method provided visualization of tumor boundaries, differentiation from perifocal edema and critical anatomical structures, and also enabled monitoring for the development of intraoperative complications.

Conclusion. Intraoperative ultrasound is a highly informative, cost-effective, and safe method that increases the radicality of neurosurgical interventions through precise intraoperative control and can be recommended for widespread implementation in clinical practice.