Open Access Open Badges Research article

Comparison of contrast in brightness mode and strain ultrasonography of glial brain tumours

Tormod Selbekk12*, Reidar Brekken12, Marit Indergaard2, Ole Solheim23 and Geirmund Unsgård23

Author Affiliations

1 Department of Medical Technology, SINTEF, Olav Kyrres gate 9, Trondheim, Norway

2 Faculty of Medicine, Norwegian University of Science and Technology, Olav Kyrres gate 9, Trondheim, Norway

3 Department of Neurosurgery, St. Olav University Hospital, Olav Kyrres gate 9, Trondheim, Norway

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BMC Medical Imaging 2012, 12:11  doi:10.1186/1471-2342-12-11

Published: 23 May 2012



Image contrast between normal tissue and brain tumours may sometimes appear to be low in intraoperative ultrasound. Ultrasound imaging of strain is an image modality that has been recently explored for intraoperative imaging of the brain. This study aims to investigate differences in image contrast between ultrasound brightness mode (B-mode) images and ultrasound strain magnitude images of brain tumours.


Ultrasound radiofrequency (RF) data was acquired during surgery in 15 patients with glial tumours. The data were subsequently processed to provide strain magnitude images. The contrast in the B-mode images and the strain images was determined in assumed normal brain tissue and tumour tissue at selected regions of interest (ROI). Three measurements of contrast were done in the ultrasound data for each patient. The B-mode and strain contrasts measurements were compared using the paired samples t- test.


The statistical analysis of a total of 45 measurements shows that the contrasts in the strain magnitude images are significantly higher than in the conventional ultrasound B-mode images (P < 0.0001).


The results indicate that ultrasound strain imaging provides better discrimination between normal brain tissue and glial tumour tissue than conventional ultrasound B-mode imaging. Ultrasound imaging of tissue strain therefore holds the potential of becoming a valuable adjunct to conventional intraoperative ultrasound imaging in brain tumour surgery.

Ultrasound; Elastography; Elastogram; Strain; Brain; Neurosurgery; Brain tumours; Image contrast