imageFrom polymer coatings that light up guided needles for biopsy to the reality and potential of three-dimensional ultrasound, the modality’s capabilities in surgical procedures are brightening the imaging landscape for surgeons and patients alike. The range of surgical applications spans from brain, breast and abdominal to heart, spine and vascular, as surgeons and radiologists combine their expertise to deliver noninvasive, real-time imaging that can make a patient’s surgical experience more order than ordeal.

Real-time imaging assists the localization of tumors, as well as guiding the ablation of tumors. Ultrasound also is assisting in the placement of radioactive seeds in brachytherapy and other therapeutic procedures. With its diagnostic capabilities well recognized, ultrasound’s surgical applications are expanding into accepted and prevalent use.

“Probably one of the more common indications today is in the evaluation of the liver in patients who have colon cancer,” says Christopher Merritt, M.D., professor of radiology at the Jefferson Ultrasound Research and Education Institute (Philadelphia). A person who is found to have colon cancer and is scheduled for a resection of the tumor receives a CT scan and ultrasound exam as part of his or her preoperative workup.

“These are important studies in terms of identifying whether the disease has spread to the liver or other organs,” Merritt says. “In about 10 to 15 percent of cases, the ultrasound, CT or MR [scan] may not show evidence of tumor spread.” This may be discovered at the time of surgery just by inspecting the liver. Very often, particularly if the preoperative study shows only one or two lesions within the liver, the patient is a candidate for resection of those lesions, and ultrasound will be used intraoperatively to directly scan the liver.

Please refer to the September 2001 issue for the complete story. For information on article reprints, contact Martin St. Denis