An International Course on Intraoperative Ultrasound in Neurosurgery: Evaluation of a Multi-center, Hands-on Courses in Promoting Familiarity and Use of Intraoperative Ultrasound in Neurosurgery.

Abstract

Background and objectives: Intraoperative ultrasound (ioUS) is a real-time imaging tool with the potential to improve neurosurgical outcomes; however, its adoption is hindered by the need for specialized training. Structured educational programs have been successful in improving proficiency and promoting their utility. This study evaluated the impact of an international ioUS training course on participants' familiarity, comfort, and ability to apply ioUS in routine neurosurgical procedures.

Methods: Twenty-one ioUS courses were held across 12 countries (brainultrasound.org), featuring lectures, simulations, and hands-on training sessions. The curriculum covered ultrasound physics, artifacts, tumor characterization, 3D navigated ultrasound, and ioUS-guided procedures. Pre- and post-course surveys were administered at four courses-Cape Town (12/2023), Edinburgh (01/2024), Barcelona (04/2024), and Porto (05/2024)-to assess changes in knowledge and comfort.

Results: Sixty-seven neurosurgeons and residents participated (19 in Cape Town, 20 in Edinburgh, 16 in Barcelona, and 12 in Porto), with a 100% survey response rate. The median scores improved for familiarity with ioUS (4-8), comfort with its functionality (4-7), probe selection (4-8), image acquisition (4-8), and interpretation (4-8). Comfort in ioUS-guided procedures improved for ventricular catheter insertion (3-7), endoscopy (3-6), tumor resection (4-7), and Chiari I decompression (3-6). Participants reported a median likelihood of 9 (out of 10) for using ioUS in future practice.

Conclusions: The course significantly improved the participants' confidence and skills in performing ioUS. Structured training effectively bridges knowledge gaps and supports the broader adoption of ioUS in neurosurgical practice.