SURG-39. EVALUATING THE EFFECTIVENESS OF NON-NAVIGATED 2D INTRAOPERATIVE ULTRASOUND IN GLIOMA SURGERY: RECONSIDERING THE PUSH FOR MORE COMPLEX INTRAOPERATIVE IMAGING

Abstract

Abstract INTRODUCTION In the swiftly evolving domain of neurosurgical technology, conventional methodologies like the non-navigated two-dimensional intraoperative ultrasound (nn-2D-IOUS) might be at risk of being overlooked. This research investigates the clinical effectiveness and surgical significance of nn-2D-IOUS, particularly for glioma removal procedures. METHODS This retrospective research, conducted at a single healthcare institution, reviewed 99 unselected patients diagnosed with both high and low-grade gliomas. The main objective was to examine the competency of nn-2D-IOUS in delivering satisfactory image quality, recognizing leftover tumor tissue, and its impact on the extent of tumor removal. Early postoperative MRI data were used as a reliable comparison measure to verify these findings. RESULTS nn-2D-IOUS exhibited notable efficiency, generating superior image quality in nearly 79% of analyzed cases. It showcased a sensitivity of 68% and a remarkable specificity of 100%, thus affirming its instrumental role in intraoperative tumor identification. In scenarios where complete tumor excision was intended, a resection surpassing 95% of the original tumor volume was accomplished in 86% of patients. Moreover, when the nn-2D-IOUS didn't detect residual tumor, the average volume of overlooked tumor tissue was significantly small, approximately 0.27 cm³. CONCLUSION Our research presents persuasive evidence emphasizing the critical role and effectiveness of nn-2D-IOUS in glioma surgeries. The findings underline the potential of leveraging cost-efficient, traditional technologies like nn-2D-IOUS to attain superior surgical results, even when compared to more sophisticated alternatives. This understanding has profound implications, especially for resource-limited environments, underscoring the need to maximize the usage of available tools to enhance patient care in a practical, economical manner.