title: Resection of pediatric intracerebral tumors with the aid of intraoperative real-time 3-D ultrasound.
abstract: OBJECTIVE
  Intraoperative ultrasound (IOUS) has become a useful tool employed daily in neurosurgical procedures. In pediatric patients, IOUS offers a radiation-free and safe imaging method. This study aimed to evaluate the use of a new real-time 3-D IOUS technique (RT-3-D IOUS) in our pediatric patient cohort.
  
  
  METHODS
  Over 24 months, RT-3-D IOUS was performed in 22 pediatric patients (8 girls and 14 boys) with various brain tumors. These lesions were localized by a standard navigation system followed by analyses before, intermittently during, and after neurosurgical resection using the iU22 ultrasound system (Philips, Bothell, USA) connected to the RT-3-D probe (X7-2).
  
  
  RESULTS
  In all 22 patients, real-time 3-D ultrasound images of the lesions could be obtained during neurosurgical resection. Based on this imaging method, rapid orientation in the surgical field and the approach for the resection could be planned for all patients. In 18 patients (82%), RT-3-D IOUS revealed a gross total resection with a favorable neurological outcome.
  
  
  CONCLUSIONS
  RT-3-D IOUS provides the surgeon with advanced orientation at the tumor site via immediate live two-plane imaging. However, navigation systems have yet to be combined with RT-3-D IOUS. This combination would further improve intraoperative localization.
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, Frauenklinikstr.10, 8091 Zurich, Switzerland. nils.ulrich@usz.ch
authors.forename: Nils H
authors.initials: NH
authors.lastname: Ulrich
authors.forename: Jan-Karl
authors.initials: JK
authors.lastname: Burkhardt
authors.forename: Carlo
authors.initials: C
authors.lastname: Serra
authors.forename: René-Ludwig
authors.initials: RL
authors.lastname: Bernays
authors.forename: Oliver
authors.initials: O
authors.lastname: Bozinov
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007432:Intraoperative Period; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D038361:Neuronavigation / Q000379:methods*; D025321:Surgery, Computer-Assisted; D014463:Ultrasonography