The new ultrasound technique, called shear wave elastography, could be used during brain surgery to detect residual cancerous tissue, allowing surgeons to remove as much as possible.
Researchers believe that the new type of scan, which is much faster to carry out and more affordable than 'gold standard' MRI scans, has the potential to reduce a patient's risk of relapse by cutting the chances that a tumour will grow back. A multi-institutional team led by The Institute of Cancer Research, London, and the National Hospital for Neurology and Neurosurgery, London, compared three different techniques to detect tumour tissue during surgery - shear wave scans, a standard 2D ultrasound, and a surgeon's opinion - in 26 patients.
A type of ultrasound scan can detect cancer tissue left behind after a brain tumour is removed more sensitively than surgeons, and could improve the outcome from operations, a new study suggests.
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The research was conducted in collaboration with clinicians from The Royal London Hospital and University Hospital Southampton. Researchers performed shear wave scans and 2D ultrasounds during the operation - before, during and after tumour removal. The researchers also asked surgeons to identify potentially cancerous tissue before providing them with scan findings. The team then compared all techniques with gold-standard MRI scans after surgery.
The study is published in the journal Frontiers in Oncology and was funded by the Royal Free Charity and the Engineering and Physical Sciences Research Council, part of UKRI. It found that shear wave elastography was more sensitive in detecting residual tumour tissue than a standard ultrasound or the surgeon alone.
Patient outcomes from brain tumour surgery are known to be better when as much of the tumour as possible is removed. In order to make sure that none of the resectable tumour is left behind, neurosurgeons use tools to guide them during surgery.
Shear wave scans were shown to be as good as post-surgery MRIs at detecting tumour tissue that had been left behind - making them a cheaper, faster and more feasible alternative. The study is the first to demonstrate the potential of shear wave elastography as a neurosurgical tool to confirm during surgery the completeness of tumour removal - although the benefits of the technique will now need to be confirmed in larger studies before it can be recommended as standard practice.
Study leader Professor Jeffrey Bamber, Professor in Physics Applied to Medicine at The Institute of Cancer Research, London, said: "Ensuring all of a brain tumour is removed without damaging healthy tissue is a major challenge in brain surgery. Using this new type of scan, surgeons could greatly increase confidence that no cancerous tissue is going to be left behind after surgery.
"Shear wave scanning can quickly and affordably map the stiffness of brain and tumour tissue in patients during surgery. Tumour tissue tends to have a different stiffness from that of surrounding healthy brain tissue and can be located and removed.
Professor Kevin Harrington, Head of the Division of Radiotherapy and Imaging at The Institute of Cancer Research, London, said: "Imaging plays a crucial role in many aspects of cancer treatment, in providing valuable information about tumours and ensuring doctors don't have to make decisions blind. This new study has shown for the first time that a particular type of ultrasound scan could provide real-time guidance to brain surgeons during operations as they choose which tissue to remove. It's an exciting area of research which has the potential to improve outcomes for patients by ensuring surgeons take out the entire tumour while minimising damage to the healthy brain."
Mr Neil Dorward, Consultant Neurosurgeon and co-researcher at the National Hospital for Neurology and Neurosurgery said: "This technique provides a very practical means of detecting areas of potentially removable tumour that are not readily visible to the operating surgeon. This has the potential to substantially improve the outcome of such operations."
MEDICA-tradefair.com; Source: Institute of Cancer Research