• Contrast-enhanced MRI Versus Contrast-enhanced Ultrasound: A Comparison in Glioblastoma Surgery Using Intra-operative Fusion Imaging

    Final Number:
    1602

    Authors:
    Francesco Prada MD; Valerio Vitale; Massimiliano Del Bene; Carlo Boffano; Luca Maria Sconfienza; Valentina Pinzi; Giovanni Mauri; Luigi Solbiati; Georgios Sakas; Velizar Kolev; Ludovico D'incerti; Francesco DiMeco MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: To compare glioblastoma multiforme (GBM) contrast enhancement (location, morphology, margins, dimensions, and pattern) obtained with intra-operative contrast enhanced ultrasound (CEUS) to the images obtained with pre-operative Gd-enhanced T1 MRI, using real-time fusion imaging.

    Methods: To compare glioblastoma multiforme (GBM) contrast enhancement (location, morphology, margins, dimensions, and pattern) obtained with intra-operative contrast enhanced ultrasound (CEUS) to the images obtained with pre-operative Gd-enhanced T1 MRI, using real-time fusion imaging.

    Results: Fusion imaging for virtual navigation allowed to match the real-time CEUS scans to correspondent co-planar pre-operative Gd-enhanced T1 MRI image in all cases with a positional discrepancy less than 2mm. Contrast enhancement of Gd-enhanced T1 MRI and CEUS was superimposable in all cases for location, margins, dimensions, and morphology. The qualitative analysis of contrast enhancement pattern demonstrated a similar distribution in CEUS and in Gd-enhanced T1 MRI in 9 patients: 7 lesions showed peripheral inhomogeneous ring enhancement and 2 lesions a prevalent nodular pattern. In one patient contrast enhancement pattern was different between the two modalities: CEUS showed enhancement of the entire bulk of the tumor while Gd-enhanced T1 MRI, demonstrated peripheral contrast enhancement.

    Conclusions: Glioblastoma contrast enhancement with CEUS is superimposable to that provided by pre-operative Gd-enhanced T1 MRI in regards of location, margins, morphology, and dimensions, with similar enhancement pattern in the majority of cases, thus is of potential use in surgical management of GBM.

    Patient Care: The information obtained with CEUS is of potential utility in surgical management of GBM.

    Learning Objectives: Intra-operative CEUS during GBM surgery allows obtaining similar information regarding location, morphology, margins and dimensions to that achieved with pre-operative Gd-enhanced T1 MRI and can be used as an intra-operative guidance in GBMs removal.

    References:

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