Enhancement of intra-operative ultrasound in brain tumour surgery
Research type
Research Study
Full title
Enhancement of intra-operative ultrasound in brain tumour surgery with the use of microbubbles as a contrast agent, shear wave elastography, and advanced image processing.
IRAS ID
179386
Contact name
Dipankar Nandi
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 2 months, 25 days
Research summary
Prognosis in patients with high grade brain tumours remains poor. However, near total removal of as much malignant tissue as possible, has been shown to have a positive impact on progression free survival and mortality in both high and low grade tumours. The capability to achieve this, in particular in areas near eloquent brain (those parts of the brain which control the senses, speech and motor function), has led to an increase in the popularity of intraoperative imaging. This attempts to eliminate the error produced by brain shift, due to loss of cerebrospinal fluid (the fluid which circulates in and around the brain), or tumour resection/removal, an inherent problem in navigation systems based on preoperative imaging. Intraoperative Magnetic Resonance Imaging (MRI) offers superior image quality; however, it involves several logistical hurdles and is prohibitively expensive for many neurosurgical centres. By comparison, intraoperative three-dimensional ultrasound is user-friendly and cost effective, permitting multiple image acquisitions, and minimally increased operative time. It allows precise visualisation of vital structures and eloquent regions, progression of tumour resection, and management of immediate complications such as a haematoma. Intraoperative ultrasound is routinely used in tumour resection surgery at Charing Cross Hospital, as it is in many centres worldwide. Ultrasound is, however, user dependent with an operator learning curve. Currently, real-time ultrasound image analysis of intrinsic brain tumours remains an under-developed field. This has restricted its scope and practical application in routine brain tumour surgery.
The current project is a prospective randomized double-blinded study which compares the recently introduced techniques of intraoperative contrast enhanced ultrasonography and shear wave elastography with standard ultrasound. It aims to evaluate the benefits of these intraoperative techniques, which impact minimally on operative time and theatre logistics, to the extent of tumour resection and hence, progression free survival and mortality.REC name
London - South East Research Ethics Committee
REC reference
15/LO/1856
Date of REC Opinion
23 Dec 2015
REC opinion
Further Information Favourable Opinion