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Navigated 3D–ultrasound versus conventional neuronavigation during awake resections of eloquent low-grade gliomas: a comparative study at a single institution

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

The data showing usefulness of navigated 3D–ultrasound (3DUS) during awake resections of eloquent gliomas are sparse. Results of surgeries performed using 3DUS were never compared to procedures guided by standard neuronavigation. The aim of this work is to assess the effectiveness of 3DUS during awake resections of eloquent low-grade gliomas (LGGs) by comparing surgical results of two series of patients operated on using conventional neuronavigation and using 3DUS. To our knowledge, a similar study is lacking in the literature.

Methods

During a 4-year period (September 2006 to August 2010) 21 awake resections of LGGs guided by neuronavigation (series 1, S1) were consecutively performed in Department of Neurosurgery in Bratislava. During another 4-year period (August 2010 to July 2014) 28 awake resections of LGGs guided by 3DUS (series 2, S2) were consecutively conducted. In both patients series, the eloquent cortical and subcortical structures were intraoperatively detected by direct electrical stimulation. Extent of tumor resection (EOR) and functional outcome in both series were compared.

Results

EOR was significantly greater (p = 0.022) in S2 (median = 93.25%; mean = 86.79%), as compared to S1 (median 87.1%; mean = 75.85%). One permanent minor deficit in S1 and 2 minor deficits in S2 occurred, the difference was not significant (p = 0.999).

Conclusions

Our work represents the first study comparing results of surgeries guided by 3DUS versus conventional navigation. The extent of awake resections of eloquent LGG guided by 3DUS was greater comparing to awake resections guided by standard neuronavigation; use of 3DUS had no impact on the number of new permanent deficits.

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Acknowledgements

The authors thank Atle Kleven, former CEO at SonoWand, for very important comments and suggestions during the writing of this paper.

Funding

Scientific Grant Agency of the Ministry of Education of the Slovak Republic and the Slovak Academy of Sciences (VEGA) provided financial support in the form of grant (number 1/0959/16). The sponsor had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Neurosurgery, Comenius University, Faculty of Medicine, University Hospital Bratislava, Limbová 5, 833 05, Bratislava, Slovakia

    Andrej Šteňo, Ľubica Petričková, Jozef Šurkala & Juraj Šteňo

  2. Department of Anaesthesiology, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia

    Vladimír Hollý & Peter Mendel

  3. Speech and language therapy clinic, University Hospital Bratislava, Bratislava, Slovakia

    Veronika Šteňová

  4. II. Department of Neurology, Comenius University, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia

    Gabriela Timárová

  5. Dr. Magnet s.r.o, Bratislava, Slovakia

    Michaela Jezberová & Víťazoslav Belan

  6. Department of Pathology, Slovak Medical University, Bratislava, Slovakia

    Boris Rychlý

  7. Cytopathos s.r.o, Bratislava, Slovakia

    Boris Rychlý

Authors
  1. Andrej Šteňo
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  2. Vladimír Hollý
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  3. Peter Mendel
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  4. Veronika Šteňová
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  5. Ľubica Petričková
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  6. Gabriela Timárová
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  7. Michaela Jezberová
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  8. Víťazoslav Belan
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  10. Jozef Šurkala
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  11. Juraj Šteňo
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Corresponding author

Correspondence to Andrej Šteňo.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Šteňo, A., Hollý, V., Mendel, P. et al. Navigated 3D–ultrasound versus conventional neuronavigation during awake resections of eloquent low-grade gliomas: a comparative study at a single institution. Acta Neurochir 160, 331–342 (2018). https://doi.org/10.1007/s00701-017-3377-8

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  • DOI: https://doi.org/10.1007/s00701-017-3377-8

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