How to Perform Intra-Operative Contrast-Enhanced Ultrasound of the Brain-A WFUMB Position Paper

Francesco Prada; Ignazio G Vetrano; Antonio G Gennari; Giovanni Mauri; Alberto Martegani; Luigi Solbiati; Luca Maria Sconfienza; Emilio Quaia; Kathryn N Kearns; M Yashar S Kalani; Min S Park; Francesco DiMeco; Christoph Dietrich

doi:10.1016/j.ultrasmedbio.2021.04.016

How to Perform Intra-Operative Contrast-Enhanced Ultrasound of the Brain-A WFUMB Position Paper

Ultrasound Med Biol. 2021 Aug;47(8):2006-2016. doi: 10.1016/j.ultrasmedbio.2021.04.016. Epub 2021 May 24.

Authors

Affiliations

¹ Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA; Focused Ultrasound Foundation, Charlottesville, VA, USA. Electronic address: [email protected].
² Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
³ Department of Neuropediatrics, MR Research Center, University Children's Hospital, Zurich, Switzerland.
⁴ Division of Interventional Radiology, European Institute of Oncology IRCCS, Milan, Italy.
⁵ Division of Radiology, Ospedale Valduce, Como, Italy.
⁶ Division of Radiology, Humanitas Research Hospital, Rozzano, Italy.
⁷ IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
⁸ Radiology Institute, Department of Medicine-DIMED, University of Padova, Padova, Italy.
⁹ Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, VA, USA.
¹⁰ University of Oklahoma School of Medicine, St. John's Neuroscience Institute, Tulsa, OK, USA.
¹¹ Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA.
¹² Department of Internal Medicine, Caritas Krankenhaus Bad Mergentheim, Bern, Switzerland.

PMID: 34045096
DOI: 10.1016/j.ultrasmedbio.2021.04.016

Abstract

Intra-operative ultrasound has become a relevant imaging modality in neurosurgical procedures. While B-mode, with its intrinsic limitations, is still considered the primary ultrasound modality, intra-operative contrast-enhanced ultrasound (ioCEUS) has more recently emerged as a powerful tool in neurosurgery. Though still not used on a large scale, ioCEUS has proven its utility in defining tumor boundaries, identifying lesion vascular supply and mapping neurovascular architecture. Here we propose a step-by-step procedure for performing ioCEUS analysis of the brain, highlighting its neurosurgical applications. Moreover, we provide practical advice on the use of ultrasound contrast agents and review technical ultrasound parameters influencing ioCEUS imaging.

Keywords: Brain tumors; CEUS; Central nervous system; Contrast-enhanced ultrasound; Intraoperative ultrasounds; Neurosurgery; Neurovascular diseases.

Publication types

Practice Guideline
Review

MeSH terms

Brain Neoplasms / diagnostic imaging*
Brain Neoplasms / surgery*
Contrast Media*
Humans
Intraoperative Period
Neurosurgical Procedures*
Ultrasonography / methods

Substances

Contrast Media