Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review

Authors

Muhammad Shakir, Aga Khan UniversityFollow
Ahmed Altaf, Aga Khan University
Hawra Hussain, Aga Khan UniversityFollow
Syed Muhammad Aqeel Abidi, Aga Khan UniversityFollow
Zoey Petitt, Duke University School of Medicine, United States
Mahnoor Tariq, Aga Khan University
Ahmed Gilani, Aga Khan University
Syed Ather Enam, Aga Khan UniversityFollow

Document Type

Review Article

Department

Pathology and Microbiology; Pathology and Laboratory Medicine; Neurosurgery

Abstract

Background: Immediate intraoperative histopathological examination of tumor tissue is indispensable for a neurosurgeon to track surgical resection. A brain smear is a simple, rapid, and cost-effective technique, particularly important in the diagnosis of brain tumors. The study aims to determine the effectiveness of intraoperative brain smear in the diagnosis of brain tumors in low- and middle-income countries (LMICs), while also evaluating its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.
Methods: A comprehensive search of the literature was conducted using PubMed, Scopus, and Google Scholar. The retrieved articles were independently screened by two reviewers. The data was extracted, processed, and organized using Microsoft Excel.
Results: A total of 59 out of 553 articles screened were included in the final analysis. The sensitivity and specificity of the intraoperative smear of brain tumors were found to be over 90% in most studies. The PPV was consistently above 90% in 11 studies, reaching 100% in one study and the NPV varied, ranging from 63% to 100%, and the accuracy was found to be >80% in most studies. One recurrent theme in the majority of the included studies was that an intraoperative brain smear is a cost-effective, quick, accessible, and accurate method of diagnosing brain tumors, requiring minimal training and infrastructure.
Conclusion: Intraoperative brain smear is a simple, rapid, cost-effective, and highly sensitive diagnostic modality for brain tumors. It can be a viable and accessible alternative to more traditional methods such as frozen sections and can be incorporated into neurosurgical practice in LMICs as a reliable and efficient diagnostic tool.

Comments

Issue and pagination are not provided by the author/publisher.

Publication (Name of Journal)

Surgical Neurology International

DOI

doi.org/10.25259/SNI_491_2023

Recommended Citation

Shakir, M., Altaf, A., Hussain, H., Abidi, S. A., Petitt, Z., Tariq, M., Gilani, A., Enam, S. A. (2023). Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review. Surgical Neurology International, 14, 325.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/357

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