Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

OBJECTIVE Intraoperative imaging is increasingly being used for resection control in diffuse gliomas, which the extent of (EOR) important. ultrasound (iUS) has emerged as a highly effective tool this context. Navigated (NUS) combines benefits real-time with navigation guidance. In study, authors investigated use NUS an intraoperative adjunct gliomas. METHODS The retrospectively analyzed 210 glioma patients who underwent surgery using at their center. analysis included decision-making, diagnostic accuracy, and operative outcomes, particularly EOR related factors influencing this. RESULTS US-defined gross-total (GTR) was achieved 57.6% patients. Intermediate scans were evaluable 115 instances. These prompted change decision 42.5% cases (the majority further unanticipated residual tumor). Eventual MRI-defined GTR rates similar (58.6%), although concordance between US MRI 81% (170/210 cases). There 21 false positives 19 negatives NUS, resulting sensitivity 78%, specificity 83%, positive predictive value 77%, negative 84%. A large proportion (13/19 patients, 68%) false-negative results eventually had near-total resections. Tumor resectability, delineation, enhancement pattern, eloquent location, image resolution significantly influenced rate, though only resectability location significant on multivariate analysis. CONCLUSIONS useful detecting tumor residues positively course resection, leading to higher rates. Nevertheless, determined by innate its relationship reinforcing need combine iUS functional mapping techniques optimize