Diagnostic yield of stereotactic needle-biopsies of sub-cubic centimeter intracranial lesions

Abstract

Background:Stereotactic brain biopsies are widely used for establishing the diagnosis of intracranial lesions. Here we examine whether stereotactic biopsy of smaller brain lesions, defined for this study as being less than 1 cubic centimeter (1 cc) in volume, are associated with lowered diagnostic yield.Methods:We conducted a retrospective analysis of 267 consecutive patients who underwent stereotactic brain biopsy between 2007 and 2011. Lesion volumes were calculated and were stratified by <1 or >1 cc.Results:A total of 13 of 246 (5.2%) biopsies for lesions >1 cc resulted in nondiagnostic tissue or an incorrect diagnosis. In contrast, 5 of 21 (23.8%) biopsies for <1 cc lesions yielded nondiagnostic or incorrect diagnosis. Posthoc review of tissue from the <1 cc lesions suggests the neuropathologist's expertise in the handling and analysis of limited specimen as a critical parameter of successful diagnosis. The operative morbidities were low for both the <1 and >1 cc biopsies (0% and 1%, respectively).Conclusion:This study demonstrates that stereotactic cerebral biopsy of lesions less than a cubic centimeter in volume results in a lower diagnostic yield versus larger lesions (76.2% versus 94.8%). While auxiliary measures may be taken to improve diagnostic yield, these patients may be best managed in a specialized center with experienced stereotactic neurosurgeons and neuropathologists.

Investigation of Titanium Material Deformation for Positioning Stereotactic Navigation System by von Mises Stress Criteria and Finite Element in Engineering

“…The model consists of 15391,538 elements and 74,781 nodes. The physical properties that were considered were obtained from the scientific literature [5], the load and boundary conditions were applied in agreement with the position of a stereotactic frame fixed to the virtual human head generated in computerized environment. In the analysis of intra-skull stress, two positions were considered to apply four forces of compression to the skull as shown in Fig.…”

“…Therefore, it is important to test or predict reliability. It is possible to test frame devices, but there is a need to do some functional samples and functional samples are very expensive [5]. This research provides irreplaceable computer simulations and theoretical models for predict reliability.…”

“…For the patient's intracranial occlusion, latest study in the area of intraoperative PSNS includes dissimilar models of the head, each of which permits incorporating human skull anatomy [2] with spatially alterable material assets [3]. These prototypes are constructed on physical inspirations like mass-spring techniques [4] or merged energy approach [5]. But, these kinds of models do not have real physical material parameters like soft tissues, though brain biopsy operations have enormous risks [1].…”

“…Currently, stereotactic surgeons have applications as morphological, ablative and modular [5]. Titanium alloy also provides ease of use due to the lightness of the mechanical system.…”

Application of stereotactic biopsy for diagnosing intracranial lesions in patients with AIDS in China

“…[8,9] There are no previous reports on stereotactic biopsy performed in AIDS patients with intracranial lesions in China. In this study, 7 AIDS patients with intracranial lesions who underwent stereotactic biopsy were retrospectively analysed.…”