• World Neurosurg · Feb 2023

    Review

    Ultrasound Elastography in Neurosurgery: Current Applications and Future Perspectives.

    • Abdulrahman Albakr, David Ben-Israel, Runze Yang, Alexander Kruger, Wajda Alhothali, Abdullah Al Towim, Sanju Lama, Abdulrazag Ajlan, Jay Riva-Cambrin, Francesco Prada, Amro Al-Habib, and Garnette R Sutherland.
    • Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Division of Neurosurgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia; Project neuroArm, Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
    • World Neurosurg. 2023 Feb 1; 170: 195205.e1195-205.e1.

    BackgroundSimilar to clinical palpation, Ultrasound elastography (USE) helps distinguish between tissues by providing information on their elasticity. While it has been widely explored and has been applied to many body organs, USE has not been studied as extensively for application in neurosurgery. The current systematic review was performed to identify articles related to the use of interoperative USE in neurosurgery.MethodsSearch included MEDLINE(R) database. Only original peer-reviewed full-text articles were included. No language or publication year restrictions were imposed. Two independent reviewers assessed the search results for relevance. The identified articles were screened by title, abstract, and full-text review.ResultsSeventeen articles were included in the qualitative analysis and 13 articles were related to oncology, epilepsy (n = 3), and spine (n = 1). In oncology, USE was found useful in defining tumor stiffness, aiding surgical planning, detecting residual tumors, discriminating between tumor and brain tissue, and differentiating between different tumors. In epilepsy, USE could improve the detection of epileptogenic foci, thereby enhancing the prospect of complete and safe resection. The application in spinal surgery was limited to demonstrating that a compressed spinal cord is stiffer than the decompressed one.ConclusionsUSE was found to be a safe, quick, portable, and economic tool that was a useful intraoperative adjunct to provide information corresponding to a variety of neurosurgical diseases, at different stages of surgery. This review describes the current intraoperative neurosurgical applications of USE, the concept of elasticity, and different USE modalities as well as the technical challenges, limitations, and possible future implications.Copyright © 2022 Elsevier Inc. All rights reserved.

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