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REVIEW article

Front. Neurol.

Sec. Neuro-Oncology and Neurosurgical Oncology

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1553018

This article is part of the Research TopicImproving neurosurgical precision: leveraging technology for enhanced visualization and navigation of complex neuroanatomyView all 9 articles

Navigating the Challenges: Ultrasound Innovations in Brain Glioma Surgery

Provisionally accepted
Shayan SadrinasabShayan Sadrinasab1Armin AminiyanArmin Aminiyan2Sadaf SaketSadaf Saket3Fatemeh KhosraviFatemeh Khosravi4Nadia PourmohammadiNadia Pourmohammadi5Masoud Saadat FakhrMasoud Saadat Fakhr6*
  • 1Shahid Beheshti University, Tehran, Tehran, Iran
  • 2Islamic Azad University System, Tehran, Tehran, Iran
  • 3Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran
  • 4Islamic Azad University, Ramsar Branch, Iran
  • 5Shahroud University of Medical Sciences, Shahrood, Semnan, Iran
  • 6Faculty of Medicine, Tehran Medical Sciences School Branch, Islamic Azad University, Tehran, Iran, Tehran, Iran

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Achieving maximal safe resection during glioma surgery while preserving neurological function remains a significant challenge. Intraoperative ultrasound (IOUS) offers real-time imaging that dynamically adapts to brain shift and surgical progression. This review highlights recent advances in IOUS, including established modalities such as contrast-enhanced and 3D ultrasound, and emerging innovations such as functional ultrasound (FUS), 4D volumetric imaging, artificial intelligence (AI)-assisted interpretation, and ultrasound-sensitive nanobubbles. These technologies aim to improve the identification of residual tumor, delineate infiltrative margins, and enable functional preservation. Integration with neuronavigation systems enhances accuracy, while new theranostic strategies suggest a future role for ultrasound in intraoperative therapy.Collectively, these developments position IOUS as a central component in the evolution of precision glioma surgery.

Keywords: Glioma surgery, intraoperative ultrasound, navigable ultrasound systems, Brain tumor resection, functional ultrasound

Received: 29 Dec 2024; Accepted: 11 Sep 2025.

Copyright: © 2025 Sadrinasab, Aminiyan, Saket, Khosravi, Pourmohammadi and Saadat Fakhr. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Masoud Saadat Fakhr, Faculty of Medicine, Tehran Medical Sciences School Branch, Islamic Azad University, Tehran, Iran, Tehran, Iran

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material