Intra-operative Variation in Size of Brain Tumors After Craniotomy

Study Overview
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Brief Summary
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We planned to evaluate the change in tumor dimensions of intraaxial parenchymal tumors after craniotomy by comparing the tumor size on intraoperative ultrasonography (IOUSG) with pre-operative CECT and CEMRI brain.

Detailed Description
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Background: No previous study to determine the intraoperative changes in the tumor dimensions had been undertaken previously. Objectives: We planned to evaluate the change in tumor dimensions of intraaxial parenchymal tumors after craniotomy by comparing the tumor size on intraoperative ultrasonography (IOUSG) with pre-operative CECT and CEMRI brain. Study Design: This was a prospective observational study. Participants: Patients aged 15-65 years undergoing surgery at SKIMS for intraaxial parenchymal intracranial tumors were included. Methods: Standard pre-operative CECT and CEMRI brain were done to measure tumor dimensions and compared with IOUSG.

Official Title
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Intra-operative Variation in Size of Brain Tumors After Craniotomy - Observational Comparative Imaging Study

Conditions
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Brain Tumor, Primary

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients above the age of 15 years conferring to Grade I and II of American Society of Anesthesiologist (ASA) physical status classification system, undergoing elective craniotomy with intracranial tumor excision were included in this study. Patients with or without any neuro-deficit were also included. Only those patients in whom all the tumor dimensions could be defined with precision on pre-operative CECT, CEMRI and IOUSG were included in the final analysis. Exclusion Criteria: Patients' in whom there are multiple intracranial tumors (e.g. metastasis), deep seated tumors, inability to use IOUSG and in whom exact tumor dimensions cannot be defined either on pre-operative CECT/CEMRI or on IOUSG were excluded.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Patient's in whom there is increase in tumor size after craniotomy | |
| 2<br>Patient's in whom there was either no increase in tumor size or decrease in tumor size after craniotomy | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tumor dimension change | Change in tumor dimension, surface area and volume when comparing intraoperative ultrasound with pre-operative CEMRI and CECT brain | March 2018 to November 2019 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tumor distance from dural surface | Change in the distance of tumor from dural surface as measured on intraoperative ultrasound when comparing it with pre-operative CEMRI and CECT brain | March 2018 to November 2019 | 
| Relationship of tumor size change with other characteristics | Relationship of tumor size change with tumor consistency, tumor characteristics, histopathology, tumor location | March 2018 to November 2019 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parenchymal brain tumors, Intraaxial brain tumors, Gliomas, Glioblastoma multiforme, Low grade glioma, High grade glioma, Intraoperative Ultrasound (IOUS), Tumor Surfacing, Tumor expansion, Contrast enhanced magnetic resonance imaging (CEMRI) brain, Contrast enhanced computed tomography (CECT) brain