Department of Neurosurgery, University Hospital Río Hortega, Calle Dulzaina, 2, 47012, Valladolid, Spain.
J Neurooncol. 2024 May;167(3):387-396. doi: 10.1007/s11060-024-04614-5. Epub 2024 Feb 28.
In an era characterized by rapid progression in neurosurgical technologies, traditional tools such as the non-navigated two-dimensional intraoperative ultrasound (nn-2D-IOUS) risk being overshadowed. Against this backdrop, this study endeavors to provide a comprehensive assessment of the clinical efficacy and surgical relevance of nn-2D-IOUS, specifically in the context of glioma resections.
This retrospective study undertaken at a single center evaluated 99 consecutive, non-selected patients diagnosed with both high-grade and low-grade gliomas. The primary objective was to assess the proficiency of nn-2D-IOUS in generating satisfactory image quality, identifying residual tumor tissue, and its influence on the extent of resection. To validate these results, early postoperative MRI data served as the reference standard.
The nn-2D-IOUS exhibited a high level of effectiveness, successfully generating good quality images in 79% of the patients evaluated. With a sensitivity rate of 68% and a perfect specificity of 100%, nn-2D-IOUS unequivocally demonstrated its utility in intraoperative residual tumor detection. Notably, when total tumor removal was the surgical objective, a resection exceeding 95% of the initial tumor volume was achieved in 86% of patients. Additionally, patients in whom residual tumor was not detected by nn-2D-IOUS, the mean volume of undetected tumor tissue was remarkably minimal, averaging at 0.29 cm.
Our study supports nn-2D-IOUS's invaluable role in glioma surgery. The results highlight the utility of traditional technologies for enhanced surgical outcomes, even when compared to advanced alternatives. This is particularly relevant for resource-constrained settings and emphasizes optimizing existing tools for efficient patient care. NCT05873946 - 24/05/2023 - Retrospectively registered.
在神经外科技术快速发展的时代，传统工具（如非导航二维术中超声（nn-2D-IOUS））有被取代的风险。在此背景下，本研究旨在全面评估 nn-2D-IOUS 在神经外科手术中的临床疗效和相关性，特别是在脑胶质瘤切除术中的应用。
这项单中心回顾性研究评估了 99 例连续、未经选择的高级别和低级别脑胶质瘤患者。主要目的是评估 nn-2D-IOUS 在产生满意的图像质量、识别残留肿瘤组织方面的能力，以及对切除范围的影响。为了验证这些结果，早期术后 MRI 数据作为参考标准。
nn-2D-IOUS 具有较高的有效性，评估的患者中有 79%成功生成了高质量的图像。nn-2D-IOUS 在术中残留肿瘤检测方面具有 68%的敏感性和 100%的完美特异性。当总肿瘤切除是手术目标时，86%的患者实现了超过初始肿瘤体积 95%的切除。此外，在 nn-2D-IOUS 未检测到残留肿瘤的患者中，未检测到的肿瘤组织平均体积非常小，为 0.29cm。
我们的研究支持 nn-2D-IOUS 在脑胶质瘤手术中的重要作用。研究结果强调了传统技术在提高手术效果方面的实用性，即使与先进的替代技术相比也是如此。这对于资源有限的环境尤其重要，强调了优化现有工具以实现高效的患者护理的必要性。NCT05873946 - 24/05/2023 - 回顾性注册。
