Navigating the challenges: ultrasound innovations in brain glioma surgery

TL;DR

This paper reviews how ultrasound innovations can improve brain glioma surgery by enabling safer and more precise tumor removal.

Contribution

The paper presents an overview of recent and emerging ultrasound technologies for intraoperative glioma surgery.

Findings

IOUS provides real-time imaging that adapts to brain shift during surgery.

Emerging technologies like functional ultrasound and AI-assisted interpretation improve tumor delineation and functional preservation.

Abstract

Achieving maximal safe resection during glioma surgery while preserving neurological function remains a significant challenge. Intraoperative ultrasound (IOUS) offers real-time imaging that dynamically adapts to brain shift and surgical progression. This review highlights recent advances in IOUS, including established modalities such as contrast-enhanced and 3D ultrasound, and emerging innovations such as functional ultrasound (FUS), 4D volumetric imaging, artificial intelligence (AI)-assisted interpretation, and ultrasound-sensitive nanobubbles. These technologies aim to improve the identification of residual tumor, delineate infiltrative margins, and enable functional preservation. Integration with neuronavigation systems enhances accuracy, while new theranostic strategies suggest a future role for ultrasound in intraoperative therapy. Collectively, these developments position IOUS as a central component in the evolution of precision glioma surgery.

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