REVIEW article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
This article is part of the Research TopicImproving neurosurgical precision: leveraging technology for enhanced visualization and navigation of complex neuroanatomyView all 16 articles
Visualizing Spinal Tumors: A Review of Intraoperative Contrast Enhanced Ultrasound during Spinal Tumor Resections
Provisionally accepted
Kyle Porter Stegmann1*
Brian Fabian Saway2*
Liz Iglesias1Jackson Maradik1
Parker Dhillon1Stephen Kalhorn2- 1Medical University of South Carolina, Charleston, United States
- 2Department of Neurosurgery, Medical University of South Carolina, Charleston, United States
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Objective: Contrast-enhanced ultrasound (CEUS) is an imaging tool that has recently gained popularity for neurosurgical applications. By using microbubble contrast agents, CEUS improves the real-time visualization of vascular structures and tissue perfusion patterns in the brain and spinal cord. Visualizing tumor margins and vascular structures is an essential aspect of spinal cord tumor resections. However, current intraoperative methods are limited. CEUS offers a dynamic, noninvasive approach to delineate margins and vascular characteristics, potentially guiding more effective tumor resection. The objective of this review is to evaluate the current body of literature on the applications and advantages of CEUS for spinal cord tumor resections. Methods: PubMed, SCOPUS, and Cochrane databases were searched for studies pertaining to CEUS utilized during spinal tumor resections. Two authors extracted and independently reviewed the data to reduce bias. Tumor type, tumor location, and primary findings were summarized. Results: Eight studies with 76 subjects were analyzed. CEUS was used in the resection of 74 intradural intramedullary and 2 intradural extramedullary tumors, all of varying tumor types. CEUS proved to be a valuable intraoperative tool for visualizing tumor margins and illustrating perfusion characteristics of intramedullary spinal tumors in real-time. Conclusion: Current literature suggests that CEUS has the capability to provide real-time data for the visualization of tumor margins and perfusion patterns of spinal cord tumors. However, with only case reports and case series currently published, there is a need for future investigation into the clinical potentials of CEUS as an adjunct tool for guiding spinal cord tumor resections.
Keywords: contrast-enhanced ultrasound, intraoperativeimaging, Neuro-Oncology, spinal tumors, surgical resection
Received: 09 Nov 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Stegmann, Saway, Iglesias, Maradik, Dhillon and Kalhorn. 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:
Kyle Porter Stegmann
Brian Fabian Saway
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.