Comparative Study between Neuro-navigation and Intra-Operative Ultrasound in Excision of Intra-axial Brain Lesions

Abstract

The application of imaging during surgery can improve patient outcomes by accurate and thorough removal of lesions while having minimal impact on healthy tissue. Maximum safe resection has shown to improve outcome by extending survival and relieving tumor pressure. Multiple intraoperative aids have been introduced over the last two decades to help surgeons achieve maximum safe resection. In this study we compared the use of Neuronavigation to intraoperative ultrasound guidance in excision of intra-axial brain lesion. Patients and methods We conducted a cohort study comparing the use of neuronavigation to intraoperative ultrasound guidance in excision of intra-axial brain lesion. We included patients with intra-axial brain lesion is amenable to gross total resection. The primary outcome was extent of resection assessed using a non-volumetric technique. Other outcomes included the postoperative functional status and the rate of operative complications. Results There were 34 patients in the Neuronavigation group and 17 patients in the ultrasound group. The extent of resection was significantly better in the ultrasound group as the extent of tumor resection based on the GTR/NTR/STR method of assessment showed that the IOUS group had statistically significant higher chance of achieving GTR (29.4%) than the navigation group (8.8%). In the IOUS group near total and subtotal resection rates were 17% and 52% respectively. In neuronavigation group 11.8% and 79.4%.