Ultrasound-Guided Transcortical Technique for Deep Brain Tumor Access

This study investigates a novel ultrasound-assisted transcortical approach for accessing and resecting deep-seated brain tumors, providing detailed methodology and insights into the procedure’s accuracy, efficacy, and safety. Traditionally, surgery for tumors located deep in the brain can be challenging due to the complexity of accessing the target area without affecting surrounding structures. By combining conventional neuronavigation systems with intraoperative ultrasound (IOUS), this technique facilitates real-time visualization, which aids in navigating through the brain’s white matter towards the tumor. For the study, a standard ventricular catheter was placed using the Medtronic S8 Neuronavigation System to plan and guide the craniotomy site, followed by an ultrasound device (Arietta 850, Hitachi-Aloka Medical) to guide the catheter directly to the tumor site. Of the ten patients who participated, nine successfully underwent catheter placement via this method without any need for reorientation or major difficulties. Only one patient required conversion to an anterior approach, and two experienced mild adverse events that resolved without complication. The results indicate that this ultrasound-assisted transcortical approach is accurate, minimally invasive, and can be completed without extensive additional resources, making it a promising option for difficult cases where direct access to deep-seated tumors is essential. Improved IOUS imaging provides higher control and precision in tumor resection, enhancing the ability to perform targeted and safe interventions. Future studies may help refine and expand the use of this approach, offering a potentially safer alternative for patients requiring delicate intracranial tumor surgeries.