Intraoperative imaging in the neurosurgery operating theatre: A review of the most commonly used techniques for brain tumour surgery
Por:
Solis, ST, Schmidt, CD, Sanchez, JG, Portales, IF, de Pedro, MD, Berrocal, VR, Valle, RD
Publicada:
1 jul 2020
Resumen:
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 Espanola de Neurocirugia (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. (C) 2019 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Solis, ST:
Clin Univ Navarra, Dept Neurocirugia, Pamplona, Spain
Schmidt, CD:
Hosp San Pau & Creu, Dept Neurocirugia, Barcelona, Spain
Sanchez, JG:
Hosp Clin Barcelona, Dept Neurocirugia, Barcelona, Spain
Portales, IF:
Hosp Infanta Cristina, Dept Neurocirugia, Badajoz, Spain
de Pedro, MD:
Hosp Ramon & Cajal, Dept Neurocirugia, Madrid, Spain
Berrocal, VR:
Hosp Ramon & Cajal, Dept Neurocirugia, Madrid, Spain
Valle, RD:
Clin Univ Navarra, Dept Neurocirugia, Pamplona, Spain
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