Stereotactic biopsy for brain tumors: is it always necessary?

Vaquero, Jesús; Martínez, R.; Manrique, Manuel Jesús González

doi:10.1016/s0090-3019(00)00213-5

Cited by 40 publications

(32 citation statements)

References 8 publications

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“…Based on the literature, stereotactic biopsy may provide the diagnosis in 80 to 99% of cases [5][6][7][8][9] . In the present study, 93% of samples demonstrated histopathological alterations and a clinical diagnosis was achieved in 83.6% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Hall et al 11 evaluated by metaanalysis, 7500 biopsies of the 17 largest series and concluded that the diagnosis was established in 91% of cases. Whereas negative biopsies may reflect technical or operator error or instrument failure, an inconclusive result is more of an inherent limitation of the procedure 8,10 . The accuracy of most stereotactic systems has been calculated to lie within 1 mm of the selected target.…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, the stereotactic biopsy becomes an interesting choice [5][6][7] . Given the importance of sampling intracranial lesions, and the equivocal reports on the morbidity associated with stereotactic biopsy procedures continued evaluation of this technique is critical [8][9][10][11] . In the present study we reviewed our 5-year experience with stereotactic biopsy procedures, analyzing preoperative radiographic/neuroimaging predictors of nondiagnostic tissues, diagnostic yield and complication rates of frame-based technique.…”

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confidence: 99%

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Stereotactic biopsies of brain lesions

Teixeira

Fonoff

Mandel

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective:In the majority of cases, the correct treatment of brain lesions is possible only when the histopathological diagnosis is made. Several deep-seated lesions near eloquent areas are not safely approached by the classical neurosurgical procedures. These patients can get benefit by a minimally invasive procedure. Method: We present a series of 176 consecutive patients submitted to stereotactic biopsies due to a great variety of brain lesions. Results: Histological diagnosis found in this series: glioma in 40.1% of the patients, other neoplasms in 12.2% and infectious or inflammatory diseases in 29.1 %. The result was inconclusive in 5.2% of the procedures. One patient died (0.6%) and two (1.2%) presented operative complications. The criteria, advantages and risks of the stereotactic biopsies are discussed. Conclusion: The efficacy of the method is adequate and morbid-mortality rates were low.KEY WORDS: brain biopsy, stereotaxy, brain lesions, cancer. biópsia estereotáxica de lesões encefálicasResumo -Objetivo: O diagnóstico anatomopatológico das lesões encefálicas é muitas vezes necessário para a instituição do tratamento adequado. Entretanto, muitas lesões localizadas profundamente no encéfalo ou em centros nervosos de grande importância funcional não podem ser acessadas sem riscos, com a aplicação dos procedimentos neurocirúrgicos habituais. Método: Apresentamos uma série de 176 doentes submetidos a biópsias estereotáxicas de lesões encefálicas. Resultados: Em 40,1% dos casos, o diagnóstico foi de glioma, em 12,2% de outras neoplasias e em 29,1%, de doenças infecciosas ou inflamatórias. O resultado foi inconclusivo em 5,2% dos doentes. Um (0,6%) doente faleceu e dois (1,2%) apresentaram graves complicações operatórias. Os critérios de seleção, as vantagens e os riscos da biópsia estereotáxica são discutidos. Conclusão: A eficácia do método é boa e a morbimortalidade das biópsias estereotáxicas é baixa. PALAVRAS-CHAVE: biópsia encefálica, estereotaxia, lesões encefálicas, neoplasia cerebral. The institution of an appropriate treatment plan for brain lesions demands a histopathological diagnosis 1-3 .Even when lesions are located deep in the brain or inaccessible by open surgery, the presumptive diagnosis, based solely on the clinical picture and subsidiary exams, is not a valid option. In these cases, the stereotactic biopsy becomes an interesting choice [5][6][7] . Given the importance of sampling intracranial lesions, and the equivocal reports on the morbidity associated with stereotactic biopsy procedures continued evaluation of this technique is critical [8][9][10][11] . In the present study we reviewed our 5-year experience with stereotactic biopsy procedures, analyzing preoperative radiographic/neuroimaging predictors of nondiagnostic tissues, diagnostic yield and complication rates of frame-based technique. During 1994During to 1999 patients with brain lesions identified by computadorized tomography (CT) or magnetic resonance (MRI) were submitted to stereotactic biopsy in the Hospital d...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Stereotactic biopsies of brain lesions

Teixeira

Fonoff

Mandel

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Moriarty et al [1] found the accuracy of the system using phantom frames to be less than 0.2 mm, and in their series of adult biopsies, they noted radiographic and histologic success rates of 100 and 97%, respectively. These results are slightly better than the results of other series using standard frame-based or frameless systems, therefore hopefully preventing the necessity of additional procedures [1,[8][9][10][11][12][13]. In addition, the iMRI technique offers the advantage of identifying hemorrhagic complications while still in the operating room [9][10][11]14].…”

Section: Discussionmentioning

confidence: 81%

Interventional MRI-Guided Frameless Stereotaxy in Pediatric Patients

Vitaz¹,

Hushek²,

Shields³

et al. 2002

Stereotact Funct Neurosurg

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Introduction: We prospectively reviewed our experience with intraoperative MRI (iMRI)-guided stereotactic procedures in pediatric patients. Methods: All procedures were performed within the magnet bore of the General Electric Signa SP MRI system, which allows for either continuous real-time or periodic imaging. The internal optical tracking system was used to plan and monitor target localization and instrument trajectory. Results: Fifteen patients underwent 16 frameless stereotactic procedures, consisting of 4 tumor biopsies and 12 cyst aspirations and stereotactic catheter placements (average age 6 years, range 6 weeks to 18 years). There were no hemorrhagic, neurologic or infectious complications. Conclusion: iMRI is an important component in expanding the horizon of minimally invasive neurosurgery for pediatric patients. Thus far, we have found this technology to be safe, reliable and extremely useful for frameless stereotactic procedures.

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“…A therapeutic impact of radiotherapy has not yet been established [14], and both indications and extent of the surgery are still unclear [15]. Some studies suggest a therapeutic benefit from tumor debulking [16,17,18], whereas other reports emphasize that malignant GCTs should be treated with radiation therapy and chemotherapy without surgery [19,20]. …”

Section: Discussionmentioning

confidence: 99%

Primary Pure and Nonsecreting Embryonal Carcinoma of the Anterior Third Ventricle: A Case Report

Nsir

Darmoul²,

Hadhri³

et al. 2015

Pediatr Neurosurg

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Central nervous system germ cell tumors (GCTs) account for less than 5% of primary brain tumors in children and adolescents but continue to attract much attention. To the best of our knowledge, a primary pure and nonsecreting embryonal carcinoma of the anterior third ventricle has never been previously reported. A 15-year-old boy presented with signs of increased intracranial pressure for the past 2 weeks complicated by 2 episodes of generalized tonic-clonic seizures 1 day before admission. Neurological examination was normal, and funduscopic examination disclosed a grade II papilledema bilaterally. CT and MRI revealed a well-demarcated and enhancing mass within the anterior third ventricle associated with a left lateral ventricle hydrocephalus. There was no evidence of tumor within the pineal or suprasellar region, and systemic and cerebrospinal fluid evaluation demonstrated normal levels of α-fetoprotein and human chorionic gonadotropin. Radical surgery was advised, and total tumor resection was achieved via a transcallosal transforaminal approach. The postoperative course was uneventful, and the final histological diagnosis was a pure embryonal carcinoma. Further screening showed no other location, and adjunctive high-dose chemotherapy was administered. The patient has been symptom free with no clinical or radiological sign of progression at the most recent follow-up examination 2 years after surgery. Primary pure and nonsecreting embryonal carcinoma can develop within the anterior third ventricle and should be considered in the differential diagnosis of anterior third ventricular masses especially in young patients. Accurate identification, radical surgery and high-dose chemotherapy can result in better tumor control and improve the postoperative outcome.

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Stereotactic biopsy for brain tumors: is it always necessary?

Cited by 40 publications

References 8 publications

Stereotactic biopsies of brain lesions

Stereotactic biopsies of brain lesions

Interventional MRI-Guided Frameless Stereotaxy in Pediatric Patients

Primary Pure and Nonsecreting Embryonal Carcinoma of the Anterior Third Ventricle: A Case Report

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