Stereotactic Biopsy for Intracranial Space-Occupying Lesions: Clinical Analysis of 550 Cases

Abstract

Object: To investigate the role of stereotactic biopsy in planning the optimal management of intracranial space-occupying lesions. Patients and Methods: Between December 1989 and December 1999, stereotactic biopsy was performed in 550 patients with intracranial mass lesions that were deep-seated or located in the functional area. There were 340 males and 210 females, and their ages ranged from 4 to 75 years. All the procedures were done under local anesthesia with a Leksell stereotactic system. A CT scan was used to determine the coordinates in the first 420 cases and the Aero Tech Stereotactic Surgical Plan System in the subsequent 130 patients. Results: Brain tumors were diagnosed pathologically in 475 patients (86.4%), inflammatory process in 44 (8.0%), other lesions in 12 (2.2%) and no conclusive diagnosis was found in 19 (3.4%). The overall positive rate of biopsy was 96.6%, and the positive rate for brain tumor was 86.4%. Intracranial hematomas after biopsy were found in 13 cases (2.4%). Seizures occurred during the operation in 7 cases (1.2%), and slight and transient neurological deficits were found in 23 cases (4.2%). There were no deaths or other serious complications. Conclusions: The results suggest that the stereotactic biopsy is a reliable method to obtain histopathological diagnosis of intracranial mass lesions, and it is also of great help in selecting the appropriate management.

Frameless Stereotactic Cerebral Biopsy: Our Experience in 296 Cases

“…The frame-based stereotactic technique is considered the 'gold standard' for mini-invasive biopsies of intracranial tissues [1][2][3][4][5] . This technique provides excellent safety, reliability and accuracy rates (mortality 0-2%, morbidity 1-5%, diagnostic yield over 95%), but requires a pretty cumbersome reference system based on a stereotactic frame mounted on the patient's scalp [1,2,[4][5][6][7][8][9][10][11] .…”

“…This technique provides excellent safety, reliability and accuracy rates (mortality 0-2%, morbidity 1-5%, diagnostic yield over 95%), but requires a pretty cumbersome reference system based on a stereotactic frame mounted on the patient's scalp [1,2,[4][5][6][7][8][9][10][11] . The preoperative procedure requires time to mount the stereotactic frame on the patient's head, to calculate the coordinates of the targets and to set the parameters directly on the frame [6][7][8][9][10][11][12][13][14][15][16][17] .…”

Stereotactic biopsy for intracranial lesions: clinical-pathological compatibility in 60 patients

“…The clinical indication is precise for those cases of unclear diagnosis where the precise nature is not clear. Despite high anatomical accuracy given by computed tomography (CT) and magnetic resonance imaging (MRI), pathological analysis does not always provide the correct diagnosis to the physician, leading to possible underestimation for the lesion heterogeneity and diffuse vascularization [5][6][7][8][9][10][11][12][13][14] .…”

“…A recent meta-analysis including 7471 patients showed positivity for histopathological diagnosis of SB material in 91% of the cases, with morbidity rates of 3.5% and mortality rates of 0.7% 5 , while transitory neurological deficits were reported in 9% of the patients [6][7][8][9][10][11][12][13][14] . We present a critic analysis of clinical outcome and lesion's behavior associated with pathologic findings and correspondence in the long term outcome.…”

Application of a Robotic Telemanipulation System in Stereotactic Surgery

“…Surgical robotics also plays significant roles in facilitating the development of surgical instruments and sharing medical expertise between large and small, urban and rural hospitals. Based on such experience of more than 4,000 frame and 1,500 frameless stereotactic operations [9][10][11] , the Navy General Hospital of the Chinese People's Liberation Army and Yan'an University Affiliated Hospital jointly performed successfully 10 telemanipulation frameless stereotactic operations using the CAS-BH5 robot system during September to December 2005. The study protocol was approved by the local ethics committee, and informed consent was obtained from all patients or their closest relatives before inception of the study.…”