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Master Thesis

Development of a clinical protocol for intraoperative ultrasound acquisition with ShearWave elastography during brain tumor resections

Abstract : Background: The brain-shift impairs the optimal brain tumor resection despite the neuronavigation. Intraoperative ultrasonography can avoid the brain-shift and improve the guided resection. We already presented a constraint-based biomechanical simulation method to compensate for brain-shift, using intraoperative ultrasound acquisition. ShearWave elastography (SWE), a new ultrasound modality, can reliably quantify and discriminate the tumor stiffness and the healthy brain parenchyma. We developed and proposed a reliable and reproducible clinical protocol for intraoperative ultrasound acquisition with SWE. Methods: We used the Aixplorer ultrasound scanner and tested 4 different probes during brain tumor resections. We made a clinical retrospective analysis of gross total resections (GTR), progression-free survival (PFS) and overall survival (OS). Results: We made 20 tumor resections guided by intraoperative ultrasonography with SWE from 10/2018 to 02/2020. We retained two linear probes (SL10-2 and SLH20-6 "hockey stick"), changed the sterile drape, established a draping protocol, and the positioning of the ultrasound scanner into the operative room. The acquisitions will be made in pre-resection after the opening of the dura mater, in intra-resection and in post-resection, with acquisition B mode (40mm depth), then doppler, then SWE (windowing from 0 to 30 kPa), for each probe. 80% of patients operated with this protocol had a GTR and tend to have a better PFS, and OS, even if it did not reach significance. Conclusion: We will validate our protocol in a future prospective clinical study to confirm the clinical contribution of SWE in tumor resection.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02938196
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Submitted on : Monday, September 14, 2020 - 6:12:50 PM
Last modification on : Wednesday, September 16, 2020 - 3:12:59 AM

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  • HAL Id : dumas-02938196, version 1

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Florian Le Lann. Development of a clinical protocol for intraoperative ultrasound acquisition with ShearWave elastography during brain tumor resections. Human health and pathology. 2020. ⟨dumas-02938196⟩

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