Accuracy and diagnostic yield of stereotactic biopsy in the diagnosis of brain masses: Comparison of results of biopsy and resected surgical specimens

Abstract

The aim of this retrospective study was to investigate the diagnostic yield and accuracy of stereotactic biopsy in patients harboring brain mass. Stereotactic biopsy was performed in 130 patients between 1995 and 2000 in an educational and research hospital in Turkey. The results of histological analysis were compared to the resected specimens in 23 patients. The lesions were lobar in 62% of cases and deep-seated in 38% of cases. During the biopsy procedures, the pathologist was in the operating theatre and a very small fragment was used for cytological examination. No frozen section was used in any of the cases. Samples were diagnostic in 122 cases. The overall diagnostic yield of the procedure was 94%. A definitive histological diagnosis was not made in eight patients. The histological diagnoses of the two procedures were identical (complete agreement) in 16 cases. In three cases, the histological diagnoses between the two procedures were slightly different without impact on patient care (minor disagreement). The diagnosis of the stereotactic biopsy was completely changed after craniotomy in four cases (major disagreement). The accuracy of the histological diagnosis was 83%. There was only one major complication, which involved intracerebral hemorrhage. Despite the limited number of patients who underwent resection, our data suggest that stereotactic biopsy of brain masses is a safe and accurate technique that can obtain adequate tissue for histological diagnosis, thus providing the best avaible treatment for patients. Cytological evaluation of the streotactic biopsy also is a highly effective tool for obtaining sufficient material during the procedure in many cases.

Evaluation of 126 consecutive cases of stereotactic procedures: brain biopsy, diagnostic yield, accuracy, non-diagnostic results, hemorrhagic complications and follow up.

“…Brain biopsy (2,17,19), aspiration of abscesses (18), accurate placement of intraventricular shunts (19) and/or intracystic catheter, and tumor resection via a small craniotomy with minimal morbidity were among the procedures performed in this study.…”

“…None of the patients received antiplatelet agents prior to procedure. Other issues related with imaging, targeting, biopsy procedures, specimen preparation and pathological evaluation have been described previously (2).…”

“…Jain et al (22) suggested that multiple bits were associated with a high diagnostic yield, even reaching 100 % for 5 to 6 bits; however, Zoeller et al (39) found no statistically significant correlation between the number of biopsies and non-diagnosis. The diagnosis and grading of glial tumors are special applications of the stereotactic biopsy (2,5,13,21,23,27), and one of the main problems is the representation of the whole lesion within the biopsy material (21,24). Callovini (5) concluded that, in the lesions of the corpus callosum, histological analysis seems not to be required in order to proceed to complementary therapies, presuming these lesions are high grade gliomas.…”

Emprego da cromatografia líquida de alta eficiência na determinação de cortisol sérico em substituição à técnica de radioimunoensaio

“…A comparação do diagnóstico histopatológico obtido à BE com o da ressecção cirúrgica tem revelado índices de concordância entre 43% e 100% (1,25,51,59,89) . Em uma série de 47 pacientes (25) o diagnóstico histopatológico obtido com a BE foi comparado com o conseguido após a ressecção cirúrgica do tumor (38 pacientes) ou depois da autópsia (nove pacientes).…”

Correlation among magnetic resonance imaging findings, prognostic factors for survival, and histological diagnosis of intrinsic brainstem lesions in children

“…1,8,[11][12][13]17 In some published studies, a high number of complications occurred in association with stereotactic brainstem biopsy, reaching up to 10%. 4 As a consequence, the authors of those studies propagate a noninvasive approach; 2 however, other studies have proven that stereotactic biopsy is a safe and reliable method with a high diagnostic yield.…”