Highlights
- •32 studies with 990 patients identified reporting elastography for neurosurgery.
- •Elastography can determine lesion stiffness and assist with diagnostic workup.
- •Quantitative measurements can help differentiate lesions pre-operatively.
- •Ultrasound elastography can provide real-time data to improve tumor resection.
- •Microscopic abnormalities and residual lesions can be identified on elastography.
Abstract
Elastography is an imaging technology capable of measuring tissue stiffness and consistency.
The technology has achieved widespread use in the workup and management of diseases
of the liver, breast, thyroid, and prostate. Although elastography is increasingly
being applied in neurosurgery, it has not yet achieved widespread adoption and many
clinicians remain unfamiliar with the technology. Therefore, we sought to summarize
the range of applications and elastography modalities available for neurosurgery,
report its effectiveness in comparison with conventional imaging methods, and offer
recommendations. All full-text English-language manuscripts on the use of elastography
for neurosurgical procedures were screened using the PubMed/MEDLINE, Embase, Cochrane
Library, Scopus, and Web of Science databases. Thirty-two studies were included with
990 patients, including 21 studies on intracranial tumors, 5 on hydrocephalus, 4 on
epilepsy, 1 on spinal cord compression, and 1 on adolescent scoliosis. Twenty studies
used ultrasound elastography (USE) whereas 12 used magnetic resonance elastography
(MRE). MRE studies were mostly used in the preoperative setting for assessment of
lesion stiffness, tumor–brain adherence, diagnostic workup, and operative planning.
USE studies were performed intraoperatively to guide resection of lesions, determine
residual microscopic abnormalities, assess the tumor–brain interface, and study mechanical
properties of tumors. Elastography can assist with resection of brain tissue, detection
of microscopic lesions, and workup of hydrocephalus, among other applications under
investigation. Its sensitivity often exceeds that of conventional MRI and ultrasound
for identifying abnormal tissue and lesion margins.
Keywords
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Article info
Publication history
Accepted:
July 20,
2022
Received:
July 6,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
