Role of stereotactic biopsy in the diagnosis and management of brain tumors

Krieger, Mark D.; Chandrasoma, Parakrama; Zee, Chi‐Shing; Apuzzo, Michael L.J.

doi:10.1002/(sici)1098-2388(199801/02)14:1<13::aid-ssu3>3.3.co;2-d

Cited by 13 publications

(27 citation statements)

References 28 publications

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“…Over the next 3 decades, the use of medical robots has rapidly expanded to several specific fields, such as soft-tissue, urological, orthopedic, general laparoscopic, and cardiac surgeries. 38,45,56 Robotic assistance was developed in neurosurgical procedures with the aim of improving feasibility and effectiveness of several procedures that require a high level of accuracy and safety, such as biopsy, 36 OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety.…”

supporting

confidence: 74%

“…These results are in line with those of Lefranc et al 38,39 and other groups that have reported a complication rate ranging between 0% and 9.3%. 9,28,36,57 In summary, our results confirm that stereotactic biopsy under ROSA guidance combines the advantages of both frameless and frame-based methods, in terms of technical aspects, timing, and diagnostic accuracy.…”

Section: 39mentioning

confidence: 99%

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Robot-assisted procedures in pediatric neurosurgery

Benedictis¹,

Trezza

Carai³

et al. 2017

Neurosurgical Focus

140

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OBJECTIVEDuring the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population.METHODSBetween 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging.RESULTSThe authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications.CONCLUSIONSTo the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical result, while minimizing postoperative morbidity.

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supporting

confidence: 74%

Section: 39mentioning

confidence: 99%

Robot-assisted procedures in pediatric neurosurgery

Benedictis¹,

Trezza

Carai³

et al. 2017

Neurosurgical Focus

140

View full text Add to dashboard Cite

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“…An analysis of over 3800 cases reported in the published literature reveals an overall morbidity rate of 3.2% and a mortality rate of 0.6%. 34 This result has confirmed the rel- ative safety of the procedure. Factors that have been associated with complications from stereotactic biopsy have been surgical experience and localization of the lesions.…”

Section: Correlation Of Stereotactic Biopsy To Resectionsupporting

confidence: 61%

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

Aker¹,

Hakan²,

Karadereler³

et al. 2005

Neuropathology

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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.

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“…9 Most common complication following needle biopsy was reported to be hemorrhage. 10 We had one case of tract hematoma in our series which was managed conservatively.…”

Section: Discussionmentioning

confidence: 97%

Clinical Experience with Frameless Neuronavigation Guided Biopsy for Intracranial Space Occupying Lesion

et al. 2019

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Biopsy is mandatory for histological diagnosis of non-resectable brain tumors. Of various techniques, neuronavigation guided biopsy provides intraoperative real-time reference and allows biopsy from multiple trajectories. The aim of this study is to assess the efficacy and accuracy of frameless neuronavigation biopsy. We retrospectively reviewed the medical archives of patients with intracranial space occupying lesion who underwent frameless neuronavigation biopsy at our institute between 2016 to 2018. All operations were performed under general anesthesia. Data were analyzed by SPSS version 20. P value of <0.05 was considered significant. There were 46 patients who underwent neuronavigation guided biopsy over the period of two years. Median age of patients was 46.5 years. Supratentorial tumors accounted for 95.8% of cases. Mean tumor diameter was 3.35 cm. Accuracy was 89.1%. More than half were glial tumors. Histopathology was inconclusive in 10.9% cases. Complication rate was 4.3%: one tract hematoma and one new neurological deficit. Frameless neuronavigation guided biopsy of intracranial space occupying lesion is safe and efficacious procedure with high diagnostic yield.

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Role of stereotactic biopsy in the diagnosis and management of brain tumors

Cited by 13 publications

References 28 publications

Robot-assisted procedures in pediatric neurosurgery

Robot-assisted procedures in pediatric neurosurgery

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

Clinical Experience with Frameless Neuronavigation Guided Biopsy for Intracranial Space Occupying Lesion

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