The role of frameless stereotactic biopsy in contemporary neuro-oncology: molecular specifications and diagnostic yield in biopsied glioma patients

Mader, Marius Marc-Daniel; Rotermund, Roman; Martens, Tobias; Westphal, Manfred; Matschke, Jakob; Abboud, Tammam

doi:10.1007/s11060-018-03024-8

Cited by 17 publications

(13 citation statements)

References 44 publications

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“…According to the literature, diagnostic yield and procedure-related complications are not significantly different between framebased and frameless brain biopsies. Table 1 summarizes the results of recent reports investigating the safety and diagnostic yield of frameless stereotactic biopsy [6,[25][26][27][28][29][30][31][32][33][34]. The frame-based technique provides a diagnostic yield of 81.3-99.2%, while the diagnostic yield of frameless stereotactic brain biopsy has been presented to range between 89% and 99.3% for various techniques [7,33,35,36].…”

Section: Clinical Results Of Accuracy and Safetymentioning

confidence: 99%

“…Currently, as decisions regarding the treatment strategy for brain tumors are increasingly based on molecular characteristics of the tissue, tissue sampling of small molecular imaging hotspots is vital and thus requires a higher precision of stereotactic biopsy techniques [39]. In several biopsied glioma cohorts applying the frameless system, diagnostic yield ranged from 92.4-93% [30].…”

Section: Clinical Results Of Accuracy and Safetymentioning

confidence: 99%

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Frameless stereotactic brain biopsy: technical considerations and clinical results regarding safety and efficacy

Kim

Song

2021

J Korean Ster Func Neurosurg

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While frame-based stereotactic techniques have been the gold standard for highly precise, reliable, and accurate approaches to intracranial targets for decades, frameless stereotactic systems have evolved, with advantages including greater flexibility and patient comfort, and are widely used. Numerous studies have demonstrated comparable results regarding target accuracy and procedure-related complications in frameless stereotactic methods compared to frame-based systems. However, there are several technical concerns. This review examines frameless stereotactic brain biopsy techniques in the context of diagnostic yield and safety (i.e., procedural mortality or morbidity).

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Section: Clinical Results Of Accuracy and Safetymentioning

confidence: 99%

Section: Clinical Results Of Accuracy and Safetymentioning

confidence: 99%

Frameless stereotactic brain biopsy: technical considerations and clinical results regarding safety and efficacy

Kim

Song

2021

J Korean Ster Func Neurosurg

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“…In recent years, the high diagnostic yield of different navigated frameless biopsy techniques has become evident, ranging from 87 to 100% [34]. Previous studies on VarioGuide biopsies reported a diagnostic yield ranging from 90 to 94.6% [12, 26, 27, 13, 35, 36]. Here, we found a slightly higher diagnostic rate of 96.7% with iCT registration and 95% with standard registration, probably as a result of the consequent implementation of intraoperative examination of the specimens into the workflow.…”

Section: Discussionmentioning

confidence: 99%

Comparing Fiducial-Based and Intraoperative Computed Tomography-Based Registration for Frameless Stereotactic Brain Biopsy

Saß

Pojskić

Bopp

et al. 2020

Stereotact Funct Neurosurg

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Objective: The aim of this work was to compare fiducial-based and intraoperative computed tomography (iCT)-based registration for frameless stereotactic brain biopsy. Methods: Of 50 frameless stereotactic biopsies with the VarioGuide, 30 cases were registered as iCT based and 20 as fiducial based. Statistical analysis of the target registration error (TRE), dose length product, effective radiation dose (ED), operation time, and diagnostic yield was performed. Results: The mean TRE was significantly lower using iCT-based registration (mean ± SD: 0.70 ± 0.32 vs. 2.43 ± 0.73 mm, p < 0.0001). The ED was significantly lower when using iCT-based registration compared to standard navigational CT (mean ± SD: 0.10 ± 0.13 vs. 2.23 ± 0.34 mSv, p < 0.0001). Post-biopsy iCT was associated with a significant lower (p < 0.0001) ED compared to standard CT (mean ± SD: 1.04 ± 0.18 vs. 1.65 ± 0.26 mSv). The mean surgical time was shorter using iCT-based registration, although the mean total operating room (OR) time did not differ significantly. The diagnostic yield was 96.7% (iCT group) versus 95% (fiducial group). Post-biopsy imaging revealed severe bleeding in 3.3% (iCT group) versus 5% (fiducial group). Conclusion: iCT-based registration for frameless stereotactic biopsies increases the accuracy significantly without negative effects on the surgical time or the overall time in the OR. Appropriate scan protocols in iCT registration contribute to a significant reduction of the radiation exposure. The high accuracy of the iCT makes it the more favorable registration strategy when taking biopsies of small tumors or lesions near eloquent brain areas.

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“…The molecular features currently relevant (i.e., IDH 1-2, MGMT methylation) for the integrated diagnosis are generally homogeneously represented throughout the tumor tissue 115,134,135 . Therefore, a sampling error resulting in misclassification of acknowledged tumor molecular features that have current therapeutic and prognostic relevance 5 , is unlikely both during open surgery and bioptic procedures if adequately performed.…”

Section: The Information Yield Of Advance Imaging To Brain Surgerymentioning

confidence: 99%

Advancing Imaging to Enhance Surgery

Riva

Lopci

Nibali

et al. 2021

Neurosurgery Clinics of North America

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Conventional MR imaging (cMRI) has an established role as a crucial disease parameter in the multidisciplinary management of Glioblastoma guiding diagnosis, treatment planning, assessment, and follow-up. Yet, cMRI cannot provide adequate information regarding tissue heterogeneity and the infiltrative extent beyond the contrast-enhancement.Advanced MR and PET imaging and newer analytical methods are transforming images into data (radiomics) and providing non-invasive biomarkers of molecular features (radiogenomics), conveying to surgery an enhanced information for improving decision-making. This review analyzes the shift from image to information-guidance that is relevant for the surgical treatment of glioblastoma.

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The role of frameless stereotactic biopsy in contemporary neuro-oncology: molecular specifications and diagnostic yield in biopsied glioma patients

Cited by 17 publications

References 44 publications

Frameless stereotactic brain biopsy: technical considerations and clinical results regarding safety and efficacy

Frameless stereotactic brain biopsy: technical considerations and clinical results regarding safety and efficacy

Comparing Fiducial-Based and Intraoperative Computed Tomography-Based Registration for Frameless Stereotactic Brain Biopsy

Advancing Imaging to Enhance Surgery

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