Intraoperative imaging in the neurosurgery operating theatre: A review of the most commonly used techniques for brain tumour surgery.

Intraoperative imaging in the neurosurgery operating theatre: A review of the most commonly used techniques for brain tumour surgery.:

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Intraoperative imaging in the neurosurgery operating theatre: A review of the most commonly used techniques for brain tumour surgery.

Neurocirugia (Astur). 2019 Dec 10;:

Authors: Tejada Solís S, de Quintana Schmidt C, Gonzalez Sánchez J, Fernández Portales I, Del Álamo de Pedro M, Rodríguez Berrocal V, Díez Valle R, Grupo de trabajo de la SENEC

Abstract

INTRODUCTION: New intraoperative imaging techniques, which aim to improve tumour resection, have been implemented in recent years in brain tumour surgery, although they lead to an increase in resources. In order to carry out an update on this topic, this manuscript has been drafted by a group from the Sociedad Española de Neurocirugía (Spanish Society of Neurosurgery).

MATERIAL AND METHODS: Experts in the use of each one of the most-used intraoperative techniques in brain tumour surgery were presented with a description of the technique and a brief review of the literature. Indications for use, their advantages and disadvantages based on clinical experience and on what is published in the literature will be described.

RESULTS: The most robust intraoperative imaging technique appears to be low- and high-field magnetic resonance imaging, but this is the technique which results in the greatest expenditure. Intraoperative ultrasound navigation is portable and less expensive, but it provides poorer differentiation of high-grade tumours and is observer-dependent. The most-used fluorescence techniques are 5-aminolevulinic acid for high-grade gliomas and fluorescein, useful in lesions which rupture the blood-brain barrier. Last of all, intraoperative CT is more versatile in the neurosurgery operating theatre, but it has fewer indications in neuro-oncology surgery.

CONCLUSIONS: Intraoperative imaging techniques are used with increasingly greater frequency in brain tumour surgery, and the neurosurgeon should assess their possible use depending on their resources and the needs of each patient.

PMID: 31836283 [PubMed - as supplied by publisher]