Animal study assessing safety of an acoustic coupling fluid that holds the potential to avoid surgically induced artifacts in 3D ultrasound guided operations

BMC Medical Imaging

Geirmund Unsgård⁵  Petter Aadahl⁴  Lisa M Sagberg⁵  Sverre H Torp³  Ole Solheim⁵  Ralf-Peter Michler¹  Tormod Selbekk²  Arve Jørgensen⁴  Asgeir S Jakola⁵ 

[1] Department of Neurology and Clinical Neurophysiology, St.Olavs University Hospital, Trondheim, Norway;Department of Medical Technology, SINTEF, Trondheim, Norway;Department of Pathology and Medical Genetics, St.Olavs University Hospital, Trondheim, Norway;Department of Diagnostic Imaging, St.Olavs University Hospital, Trondheim, Norway;National Competence Centre for Ultrasound and Image-guided Therapy, Trondheim, Norway

关键词: Ultrasound;    Intraoperative imaging;    Brain tumor;    Brain imaging;   

Others  :  797808
DOI  :  10.1186/1471-2342-14-11

 received in 2013-12-01, accepted in 2014-03-19,  发布年份 2014

【 摘 要 】

Background

Use of ultrasound in brain tumor surgery is common. The difference in attenuation between brain and isotonic saline may cause artifacts that degrade the ultrasound images, potentially affecting resection grades and safety. Our research group has developed an acoustic coupling fluid that attenuates ultrasound energy like the normal brain. We aimed to test in animals if the newly developed acoustic coupling fluid may have harmful effects.

Methods

Eight rats were included for intraparenchymal injection into the brain, and if no adverse reactions were detected, 6 pigs were to be included with injection of the coupling fluid into the subarachnoid space. Animal behavior, EEG registrations, histopathology and immunohistochemistry were used in assessment.

Results

In total, 14 animals were included, 8 rats and 6 pigs. We did not detect any clinical adverse effects, seizure activity on EEG or histopathological signs of tissue damage.

Conclusion

The novel acoustic coupling fluid intended for brain tumor surgery appears safe in rats and pigs under the tested circumstances.

【 授权许可】

   
2014 Jakola et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Stummer W, Reulen H-J, Meinel T, Pichlmeier U, Schumacher W, Tonn J-C, Rohde V, Oppel F, Turowski B, Woiciechowsky C, Franz K, Pietsch T, ALA-Glioma Study Group: Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery 2008, 62(3):564-576.
• [2]Jakola AS, Myrmel KS, Kloster R, Torp SH, Lindal S, Unsgard G, Solheim O: Comparison of a strategy favoring early surgical resection vs a strategy favoring watchful waiting in low-grade gliomas. JAMA 2012, 308(18):1881-1888.
• [3]Stummer W, Tonn C Jr, Mehdorn HM, Nestler U, Franz K, Goetz C, Bink A, Pichlmeier U: Counterbalancing risks and gains from extended resections in malignant glioma surgery: a supplemental analysis from the randomized 5-aminolevulinic acid glioma resection study. J Neurosurg 2010, 114(3):613-623.
• [4]Senft C, Bink A, Franz K, Vatter H, Gasser T, Seifert V: Intraoperative MRI guidance and extent of resection in glioma surgery: a randomised, controlled trial. Lancet Oncol 2011, 12(11):997-1003.
• [5]Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen H-J: Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006, 7(5):392-401.
• [6]Unsgaard G, Rygh OM, Selbekk T, Müller TB, Kolstad F, Lindseth F, Hernes TAN: Intra-operative 3D ultrasound in neurosurgery. Acta Neurochir 2006, 148(3):235-253.
• [7]Szelényi A, Bello L, Duffau H, Fava E, Feigl GC, Galanda M, Neuloh G, Signorelli F, Sala F: Intraoperative electrical stimulation in awake craniotomy: methodological aspects of current practice. Neurosurg Focus 2010, 28(2):E7.
• [8]Saether CA, Torsteinsen M, Torp SH, Sundstrom S, Unsgard G, Solheim O: Did survival improve after the implementation of intraoperative neuronavigation and 3D ultrasound in glioblastoma surgery? A retrospective analysis of 192 primary operations. J Neurol Surg A Cent Eur Neurosurg 2012, 73(2):73-78.
• [9]Solheim O, Selbekk T, Jakola AS, Unsgård G: Ultrasound-guided operations in unselected high-grade gliomas—overall results, impact of image quality and patient selection. Acta Neurochir 2010, 152(11):1873-1886.
• [10]Rygh O, Selbekk T, Torp S, Lydersen S, Hernes T, Unsgaard G: Comparison of navigated 3D ultrasound findings with histopathology in subsequent phases of glioblastoma resection. Acta Neurochir 2008, 150(10):1033-1042.
• [11]Gerganov VM, Samii A, Giordano M, Samii M, Fahlbusch R: Two-dimensional high-end ultrasound imaging compared to intraoperative MRI during resection of low-grade gliomas. J Clin Neurosci 2011, 18(5):669-673.
• [12]Selbekk T, Jakola AS, Solheim O, Johansen TF, Lindseth F, Reinertsen I, Unsgard G: Ultrasound imaging in neurosurgery: approaches to minimize surgically induced image artefacts for improved resection control. Acta Neurochir (Wien) 2013, 155(6):973-980.
• [13]Hafting T, Fyhn M, Bonnevie T, Moser MB, Moser EI: Hippocampus-independent phase precession in entorhinal grid cells. Nature 2008, 453(7199):1248-1252.
• [14]Morgan CJ, Pyne-Geithman GJ, Jauch EC, Shukla R, Wagner KR, Clark JF, Zuccarello M: Bilirubin as a cerebrospinal fluid marker of sentinel subarachnoid hemorrhage: a preliminary report in pigs. J Neurosurg 2004, 101(6):1026-1029.
• [15]Wideroe M, Olsen O, Pedersen TB, Goa PE, Kavelaars A, Heijnen C, Skranes J, Brubakk AM, Brekken C: Manganese-enhanced magnetic resonance imaging of hypoxic-ischemic brain injury in the neonatal rat. Neuroimage 2009, 45(3):880-890.
• [16]Smith JS, Chang EF, Lamborn KR, Chang SM, Prados MD, Cha S, Tihan T, VandenBerg S, McDermott MW, Berger MS: Role of Extent of Resection in the Long-Term Outcome of Low-Grade Hemispheric Gliomas. J Clin Oncol 2008, 26(8):1338-1345.