“…Ultimately, 41 articles including 2792 unique patients with brainstem lesions were eligible for the meta-analysis. 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 56 Figure 1. PRISMA flow diagram of study selection.…”
Section: Resultsmentioning
confidence: 99%
“…The characteristics of the 41 eligible studies in the “study-level” analysis are outlined in Table 1 , and those in the “patient-level” analysis are summarized in Table 2 . The retrospective cohort studies (n = 32) 1 , 4 , 7 , 8 , 13 , 14 , 16 , 17 , 19 , 26 , 29 - 37 , 42 - 52 , 54 , 56 outnumbered the prospective cohort studies (n = 9) 18 , 27 , 28 , 38 - 41 , 53 , 55 ; the publication year ranged from 1986 to 2021 (median: 2010); USA ranked at the first place of all original nations (n = 13) 7 , 8 , 13 , 19 , 33 , 35 , 38 , 39 , 45 , 48 ,…”
Section: Resultsmentioning
confidence: 99%
“…All 41 studies were involved in analyzing the diagnostic yield of brainstem stereotactic biopsy. 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 56 The pooled result showed a weighted average diagnostic yield of 97.0% (95% CI, 96.0–97.9%) ( Figure 2 ). The subgroup analysis indicated that the weighted average diagnostic yields with the CT-guided technique, MRI-guided technique, framed navigation, and transcerebellar approach were 95.8% (95% CI, 93.0–98.6%), 95.9% (95% CI, 93.7–98.1%), 97.1% (95% CI, 96.1–98.1%), and 99.1% (95% CI, 98.3–99.9%), respectively.…”
Section: Resultsmentioning
confidence: 99%
“…There was concern regarding brainstem stereotactic biopsy-caused mortality, for which 39 articles 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 52 , 54 , 56 were involved in the analysis. The pooled result in Figure 5 revealed that the weighted average proportion of deaths was .3% (95% CI, .1–.5%).…”
Section: Resultsmentioning
confidence: 99%
“…Multiple studies have suggested that the diagnostic yield of brainstem stereotactic biopsy with CT guidance is 90.4-100.0% 16,42 and that with MRI guidance is 84.6-100.0%. 37,46 Furthermore, according to different patient cohorts, other studies noted that the diagnostic yields of brainstem stereotactic biopsy in the pediatric and adult patient populations were 84.6-100.0% 28,37 and 80.0-100.0%, 49,55 respectively. The present subgroup analysis signifies a nearly identical diagnostic yield between CT-guided and MRIguided stereotactic biopsy and a 1.6% increment in the weighted average diagnostic yield in the pediatric patient population compared to the adult patient population.…”
Objectives To evaluate the diagnostic yield and safety of brainstem stereotactic biopsy for brainstem lesions. Methods We performed a meta-analysis of English articles retrieved from the PubMed, Web of Science, Cochrane Library, and APA psycInfo databases up to May 12, 2021. A binary fixed-effect model, the inverse variance method, or a binary random-effect model, the Dersimonian Laird method, were utilized for pooling the data. This meta-analysis was registered with INPLASY, INPLASY202190034. Findings A total of 41 eligible studies with 2792 participants were included. The weighted average diagnostic yield was 97.0% (95% confidential interval [CI], 96.0-97.9%). The weighted average proportions of temporary complications, permanent deficits, and deaths were 6.2% (95% CI, 4.5–7.9%), .5% (95% CI, .2–.8%), and .3% (95% CI, .1–.5%), respectively. The subgroup analysis indicated a nearly identical weighted average diagnostic yield between MRI-guided stereotactic biopsy and CT-guided stereotactic biopsy (95.9% vs 95.8%) but slightly increased proportions of temporary complications (7.9% vs 6.0%), permanent deficits (1.9% vs .2%), and deaths (1.1% vs .4%) in the former compared to the latter. Moreover, a greater weighted average diagnostic yield (99.2% vs 97.6%) and lower proportions of temporary complications (5.1% vs 6.8%) and deaths (.7% vs 1.5%) were shown in the pediatric patient population than in the adult patient population. Conclusions Brainstem stereotactic biopsy demonstrates striking accuracy plus satisfying safety in the diagnosis of brainstem lesions. The diagnostic yield, morbidity, and mortality mildly vary based on the diversity of assistant techniques and subject populations.
“…Ultimately, 41 articles including 2792 unique patients with brainstem lesions were eligible for the meta-analysis. 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 56 Figure 1. PRISMA flow diagram of study selection.…”
Section: Resultsmentioning
confidence: 99%
“…The characteristics of the 41 eligible studies in the “study-level” analysis are outlined in Table 1 , and those in the “patient-level” analysis are summarized in Table 2 . The retrospective cohort studies (n = 32) 1 , 4 , 7 , 8 , 13 , 14 , 16 , 17 , 19 , 26 , 29 - 37 , 42 - 52 , 54 , 56 outnumbered the prospective cohort studies (n = 9) 18 , 27 , 28 , 38 - 41 , 53 , 55 ; the publication year ranged from 1986 to 2021 (median: 2010); USA ranked at the first place of all original nations (n = 13) 7 , 8 , 13 , 19 , 33 , 35 , 38 , 39 , 45 , 48 ,…”
Section: Resultsmentioning
confidence: 99%
“…All 41 studies were involved in analyzing the diagnostic yield of brainstem stereotactic biopsy. 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 56 The pooled result showed a weighted average diagnostic yield of 97.0% (95% CI, 96.0–97.9%) ( Figure 2 ). The subgroup analysis indicated that the weighted average diagnostic yields with the CT-guided technique, MRI-guided technique, framed navigation, and transcerebellar approach were 95.8% (95% CI, 93.0–98.6%), 95.9% (95% CI, 93.7–98.1%), 97.1% (95% CI, 96.1–98.1%), and 99.1% (95% CI, 98.3–99.9%), respectively.…”
Section: Resultsmentioning
confidence: 99%
“…There was concern regarding brainstem stereotactic biopsy-caused mortality, for which 39 articles 1 , 4 , 7 , 8 , 13 , 14 , 16 - 19 , 26 - 52 , 54 , 56 were involved in the analysis. The pooled result in Figure 5 revealed that the weighted average proportion of deaths was .3% (95% CI, .1–.5%).…”
Section: Resultsmentioning
confidence: 99%
“…Multiple studies have suggested that the diagnostic yield of brainstem stereotactic biopsy with CT guidance is 90.4-100.0% 16,42 and that with MRI guidance is 84.6-100.0%. 37,46 Furthermore, according to different patient cohorts, other studies noted that the diagnostic yields of brainstem stereotactic biopsy in the pediatric and adult patient populations were 84.6-100.0% 28,37 and 80.0-100.0%, 49,55 respectively. The present subgroup analysis signifies a nearly identical diagnostic yield between CT-guided and MRIguided stereotactic biopsy and a 1.6% increment in the weighted average diagnostic yield in the pediatric patient population compared to the adult patient population.…”
Objectives To evaluate the diagnostic yield and safety of brainstem stereotactic biopsy for brainstem lesions. Methods We performed a meta-analysis of English articles retrieved from the PubMed, Web of Science, Cochrane Library, and APA psycInfo databases up to May 12, 2021. A binary fixed-effect model, the inverse variance method, or a binary random-effect model, the Dersimonian Laird method, were utilized for pooling the data. This meta-analysis was registered with INPLASY, INPLASY202190034. Findings A total of 41 eligible studies with 2792 participants were included. The weighted average diagnostic yield was 97.0% (95% confidential interval [CI], 96.0-97.9%). The weighted average proportions of temporary complications, permanent deficits, and deaths were 6.2% (95% CI, 4.5–7.9%), .5% (95% CI, .2–.8%), and .3% (95% CI, .1–.5%), respectively. The subgroup analysis indicated a nearly identical weighted average diagnostic yield between MRI-guided stereotactic biopsy and CT-guided stereotactic biopsy (95.9% vs 95.8%) but slightly increased proportions of temporary complications (7.9% vs 6.0%), permanent deficits (1.9% vs .2%), and deaths (1.1% vs .4%) in the former compared to the latter. Moreover, a greater weighted average diagnostic yield (99.2% vs 97.6%) and lower proportions of temporary complications (5.1% vs 6.8%) and deaths (.7% vs 1.5%) were shown in the pediatric patient population than in the adult patient population. Conclusions Brainstem stereotactic biopsy demonstrates striking accuracy plus satisfying safety in the diagnosis of brainstem lesions. The diagnostic yield, morbidity, and mortality mildly vary based on the diversity of assistant techniques and subject populations.
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