Intraoperative Cerebral Glioma Characterization with Contrast Enhanced Ultrasound

نویسندگان

  • Francesco Prada
  • Luca Mattei
  • Massimiliano Del Bene
  • Luca Aiani
  • Marco Saini
  • Cecilia Casali
  • Assunta Filippini
  • Federico Giuseppe Legnani
  • Alessandro Perin
  • Andrea Saladino
  • Ignazio Gaspare Vetrano
  • Luigi Solbiati
  • Alberto Martegani
  • Francesco DiMeco
چکیده

BACKGROUND Contrast enhanced ultrasound (CEUS) is a dynamic and continuous modality providing real-time view of vascularization and flow distribution patterns of different organs and tumors. Nevertheless its intraoperative use for brain tumors visualization has been performed few times, and a thorough characterization of cerebral glioma had never been performed before. AIM To perform the first characterization of cerebral glioma using CEUS and to possibly achieve an intraoperative differentiation of different gliomas. METHODS We performed CEUS in an off-label setting in 69 patients undergoing surgery for cerebral glioma. An intraoperative qualitative analysis was performed comparing iCEUS with B-mode imaging. A postprocedural semiquantitative analysis was then performed for each case, according to EFSUMB criteria. Results were related to histopathology. RESULTS We observed different CE patterns: LGG show a mild, dotted CE with diffuse appearance and slower, delayed arterial and venous phase. HGG have a high CE with a more nodular, nonhomogeneous appearance and fast perfusion patterns. CONCLUSION Our study characterizes for the first time human brain glioma with CEUS, providing further insight regarding these tumors' biology. CEUS is a fast, safe, dynamic, real-time, and economic tool that might be helpful during surgery in differentiating malignant and benign gliomas and refining surgical strategy.

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عنوان ژورنال:

دوره 2014  شماره 

صفحات  -

تاریخ انتشار 2014