Ultrasound elastography in neurooncology: Basic principles, applications, and illustrative cases

Abstract Intraoperative ultrasound as an adjunct for brain and spinal cord tumors has seen an uptick in interest over the last few decades owing to real-time imaging, ease of use, and refining of the technology involved. Ultrasound elastography is a relatively newer modality that estimates tissue stiffness, parenchyma–tumor interface, and possibly tissue histology. Paired with B-mode ultrasound, elastography has the potential to guide tumor resection better and intraoperative planning. In this study, we describe the fundamental principles and different types of elastography techniques. We summarize the current use and demonstrate the application of strain elastography in brain tumor resection using a few cases.