Diagnostic ability of intraoperative ultrasound for identifying tumor residual in glioma surgery operation

Guangying Zhang, Zhanzhan Li, Daolin Si and Liangfang Shen _

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Oncotarget. 2017; 8:73105-73114. https://doi.org/10.18632/oncotarget.20394

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Guangying Zhang1, Zhanzhan Li1, Daolin Si2 and Liangfang Shen1

1Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China

2Department of Pediatric Neurology, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China

Correspondence to:

Liangfang Shen, email: [email protected]

Keywords: intraoperative ultrasound, glioma residual, diagnostic test, meta-analysis

Received: June 28, 2017     Accepted: August 09, 2017     Published: August 22, 2017


Achieving total glioma resection represents a major challenge to neurosurgeons with no distinct margin between tumor and surrounding brain tissue. Many imaging methods are employed in surgery visualization and resection control. We performed this meta-analysis to assess the diagnosis value of intraoperative ultrasound and judged whether ultrasound is a suitable tool in detecting glioma residual. The databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu were systematically searched to find out relevant studies and published up to May 5, 2017. A total of 14 studies involving 542 participants met the selection criteria and bivariate mixed effects models were used for analysis. The parameters and their corresponding 95% confidence interval (CI) were computed on Stata 12.0 software. The pooled sensitivity was 0.75 (95%CI: 0.62–0.84), specificity was 0.88 (95%CI: 0.79–0.94), positive likelihood ratios was 6.27 (95%CI: 3.76–10.47), negative likelihood ratios was 0.29 (95%CI: 0.20–0.42), diagnostic odds ratios was 21.83 (95%CI: 14.20–33.55) and area under the curve of summary receiver operator characteristic was 0.89. Stratified meta-analysis showed sensitivity and area under the curve in low-grade glioma were both higher than high-grade glioma. The Deek’s plot showed no significant publication bias (t = -1.03, P = 0.33). Intraoperative ultrasound has high overall diagnostic value to identify glioma remnants, especially in low-grade glioma, which shows a benefit for prognosis and life quality of patients. In general, Intraoperative ultrasound is an effective tool for maximizing the extent of glioma resection.

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