Intraoperative MRI versus intraoperative ultrasound was used in the surgery of childhood brain tumors

Carlo Giussani et al.
, Department of Neurosurgery, University Hospital Bicoca, Milan, Italy, conducted a systematic literature review and meta-analysis to write about the differences between the cost and efficacy of intraoperative MRI and iOUS to assess tumor residuals, and the results were published in the August 2022 issue of the journal
Childs Nerv Syst.

——Excerpt from the article chapter

【Ref: Giussani C, et al.
Childs Nerv Syst.
2022 Aug; 38(8):1445-1454.
doi: 10.
1007/s00381-022-05545-0.
Epub 2022 May 5.
】

Research background

The resection range (EOR) of a pediatric central nervous system tumor is related to the prognosis of the child, and total resection (GTR) tumor within the maximum safety range is the key
to achieving good results.

At present, imaging techniques such as intraoperative ultrasound (iOUS) and intraoperative MRI have been developed to detect any residual tumor, but the cost is different
.

Carlo Giussani et al.
, Department of Neurosurgery, University Hospital Bicoca, Milan, Italy, conducted a systematic literature review and meta-analysis to write about the differences between the cost and efficacy of intraoperative MRI and iOUS to assess tumor residuals, and the results were published in the August 2022 issue of the journal
Childs Nerv Syst.

Research Methods

Based on the guidelines for Priority Report Entries (PRISMA) for systematic reviews and meta-analyses, the investigators searched the existing literature in the PubMed database until December 31, 2021, with the keywords "intraoperative ultrasound and childhood brain tumors", "iOUS and childhood brain tumors", "intraoperative magnetic resonance and childhood brain tumors", and "intraoperative MRI and childhood brain tumors"
.

A total of 300 relevant articles were searched, and 23 were finally included by reading the literature and abstracts and reviewing the content of the literature article by article
.

Of the 929 children with brain tumors using intraoperative MRI imaging, 349 (38%) underwent additional supplemental resection
after iMRI scanning.

Of the 794 patients (of whom data were missing) who underwent GTR measurements, 552 (70%) of the children achieved GTR
.

In 379 children who used iOUS to evaluate for postoperative residual brain tumors, 291 (77%) achieved GTR, and 256 (68%) were confirmed in postoperative MRI
.

Conclusion of the study

Finally, the authors note that this literature meta-analysis shows that for most childhood brain tumors, iOUS is comparable to iMRI in estimating tumor EOR, so expensive equipment does not mean better
results.