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J Pediatr Neurosci. 2017 Jan-Mar;12(1):19-23. doi: 10.4103/jpn.JPN_141_16.

Resection of Pediatric Brain Tumors: Intraoperative Ultrasound Revisited.

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1
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.

Abstract

BACKGROUND:

Extent of resection is a very important prognostic marker in most pediatric brain tumors. Intraoperative imaging facilitates resection control. Intraoperative ultrasound (IOUS) is a cost-effective alternative to intraoperative magnetic resonance, but scant literature addresses its utility in this context.

METHODS:

We retrospectively reviewed all pediatric brain tumors operated at our center using navigated three-dimensional ultrasound (US). The utility of the US in resection control was recorded and extent of resection evaluated.

RESULTS:

IOUS was used in 20 cases (3 for frameless biopsy and 17 for tumor resection control). It was 100% accurate in localizing all tumors and yielded 100% diagnosis in the biopsy cases. Technical limitations precluded its use in 2 of the 17 cases of tumor resection. In the remaining 15, it correctly predicted the residual tumor status in 13 cases (87%). A gross total resection was achieved overall in 12 cases (80%) with postoperative morbidity in only one case.

CONCLUSIONS:

IOUS is a useful tool to localize intracranial tumors and guide the resection reliably. Widespread use can improve its applicability and make it an effective intraoperative imaging tool in pediatric brain tumors.

KEYWORDS:

Intraoperative imaging; intraoperative ultrasound; pediatric brain tumors; utility

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