5-ALA-assisted stereotactic brain tumor biopsy improve diagnostic yield

Shofty, Ben; Richetta, Carla; Haim, Oz; Kashanian, Alon; Gurevich, Alexey; Grossman, Rachel

doi:10.1016/j.ejso.2019.07.001

Cited by 13 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is a tool of utmost importance for the diagnosis of intracranial lesions, particularly those with a difficult approach or located in eloquent areas, ensuring great accuracy and, therefore, adequate treatment. [22,34,37,51,52] Table 1: Summary of the patients submitted to stereotactic biopsy considering the diagnosis, site of the lesion, and the presence or absence of pneumocephalus and/or petechial hemorrhage. e accuracy rate in the present study was 96.6%, which is within the range reported by other authors (87.6-100%).…”

Section: Discussionmentioning

confidence: 99%

“…e accuracy rate in the present study was 96.6%, which is within the range reported by other authors (87.6-100%). [2,12,16,21,22,23,27,34,52,51,53] is result may be related to the relatively great number of samples (n = 12) collected during the procedure, contrarily to others who usually harvest four samples or less. [3,4,7,[10][11][12][13]18,[20][21][22][23][24]27] On the other hand, the collection of a greater number of samples may theoretically increase the chance of bleeding complications.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors have reported a bleeding rate of 0-19%. [2,37,49,51,52,53] e gold standard to determine the accuracy of the stereotactic biopsy is frozen section, as it allows prompt diagnosis and verification if the biopsy was performed at the intended site. [22,34,37,51,52] However, as aforementioned, its use has been reported only in 13 out of 57 studies on stereotactic biopsy in humans.…”

Section: Discussionmentioning

confidence: 99%

“…the use of frozen section. [2,6,12,28,32,[34][35][36]51,52,54,55,57] In cases of cystic lesions, such as brain abscesses, the mere aspiration of pus is enough to confirm appropriate targeting, making pathology consultation unnecessary.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Vilela‐Filho¹,

Porfírio²,

Goulart³

2022

Surgical Neurology International

View full text Add to dashboard Cite

Background: Confirmation of whether a stereotactic biopsy was performed in the correct site is usually dependent on the frozen section or on novel tumor-specific markers that are not widely available. Immediate postoperative computed tomography (CT) or magnetic resonance (MR) is routinely performed in our service after biopsy. In this retrospective study, we have carefully analyzed these images in an attempt to determine the presence of markers that indicate appropriate targeting. Methods: Medical records and neuroimages of patients who underwent stereotactic biopsy of intracranial lesions were reviewed. The following variables were assessed: age, sex, anatomopathology, lesion site, complications, diagnostic accuracy, and the presence of image markers. Results: Twenty-nine patients were included in this case series. About 96.6% of the biopsies were accurate according to the permanent section. Of the 86.2% of patients with intralesional pneumocephalus on the postoperative images, 51.7% additionally presented petechial hemorrhage. In 13.8% of the cases, no image markers were identified. Conclusion: This is the first report of intralesional pneumocephalus and petechial hemorrhage as indicators of appropriate targeting in stereotactic biopsy. In the majority of the cases, an immediate postoperative head CT, which is widely available, can estimate how adequate the targeting is. To use intralesional pneumocephalus/ petechial hemorrhages as not only postoperative but also as intraoperative markers of appropriate targeting, it is advised that the surgical wound should be temporarily closed and dressed after the biopsy so that the patient can undergo a CT/MR scan and be checked for the presence of theses markers before removing the stereotactic frame.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Vilela‐Filho¹,

Porfírio²,

Goulart³

2022

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…5-ALA-Fluorescence in PCNSL is described in 79–83% with a high positive predictive value for diagnostic tissue ( 47 , 49 ). Furthermore, positive 5-ALA fluorescence can help shorten surgical duration ( 50 ). Open surgery was historically without significance in PCNSL patients due to worse outcomes in older studies ( 51 – 53 ).…”

Section: Surgical Workupmentioning

confidence: 99%

An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients

et al. 2022

View full text Add to dashboard Cite

Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients.

show abstract

Laser interstitial thermal therapy (LITT) for pediatric low-grade glioma—case presentations and lessons learned

Strauss,

Gabay,

Roth

2024

Childs Nerv Syst

View full text Add to dashboard Cite

Background The surgical treatment of brain tumors has developed over time, offering customized strategies for patients and their specific lesions. One of the most recent advances in pediatric neuro-oncological surgery is laser interstitial thermal therapy (LITT). However, its effectiveness and indications are still being evaluated. The aim of this work is to review the current literature on LITT for pediatric low-grade gliomas (pLGG) and evaluate our initial results in this context. Methods We retrospectively reviewed our pediatric neurosurgery database for patients who received LITT treatment between November 2019 and December 2023. We collected data on the indications for LITT, technical issues during the procedure, and clinical and radiological follow-up. Results Three patients underwent 5 LITT procedures for pLGG. The lesion was thalamo-peduncular in one patient, cingulate in one, and deep parietal in one patient. Two patients had a previous open resection done and were diagnosed with pLGG. One patient underwent a stereotaxic biopsy during the LITT procedure that was non-diagnostic. The same patient underwent a later open resection of the tumor in the cingulate gyrus. There were no surgical complications and all patients were discharged home on the first post-operative day. The follow-up period was between 20 and 40 months. Radiological follow-up showed a progressive reduction of the tumor in patients with LGG. Conclusion Laser interstitial thermal therapy is a minimally invasive treatment that shows promise in treating deep-seated pLGG in children. The treatment has demonstrated a reduction in tumor volume, and the positive results continue over time. LITT can be used as an alternative treatment for tumors located in areas that are difficult to access surgically or in cases where other standard treatment options have failed.

show abstract

5-ALA-assisted stereotactic brain tumor biopsy improve diagnostic yield

Cited by 13 publications

References 21 publications

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients

Laser interstitial thermal therapy (LITT) for pediatric low-grade glioma—case presentations and lessons learned

Contact Info

Product

Resources

About