Intraoperative Ultrasound in Neurosurgical Oncology: A National Survey of French Practices, Benefits, and Limitations.

OBJECTIVE: To evaluate the patterns of use, perceived benefits, limitations, and needs related to intraoperative ultrasound (IOUS) in neurosurgical oncology practice in France. METHODS: A structured 24-item questionnaire was distributed to members of the French Neurosurgical Society (Club de Neuro-Oncologie - Société Française de Neurochirurgie). The survey explored demographics, IOUS usage patterns in cranial and spine tumor surgery, perceived utility, limitations, integration with neuronavigation, training, and interest in future research. RESULTS: 108 neurosurgeons, predominantly from high-volume academic centers, completed the survey. IOUS was widely used for gliomas, metastases, and intramedullary tumors, primarily for lesion localization and residual tumor assessment. It was often combined with MRI-based neuronavigation. The highest perceived benefits were for tumor boundary delineation (mean 3.64 ± 1.02) and improved resection quality (mean 3.26 ± 1.08), while vascular assessment was rated lower (mean 2.02 ± 1.07). Main limitations included insufficient image quality (52.8%) and technical constraints (30.6%). Despite limited formal training (96.3%), most respondents expressed interest in dedicated IOUS training (85.2%) and multicenter studies (90.7%). CONCLUSION: IOUS is widely adopted in neurosurgical oncology and perceived as useful for improving tumor resection. Its benefits vary with surgical experience, and current limitations are primarily technical and educational. Future advancements and structured training may enhance its utility.