The safety and efficacy of stereotactic biopsy for intracranial lesions

Hall, Walter A.

doi:10.1002/(sici)1097-0142(19980501)82:9<1756::aid-cncr23>3.0.co;2-2

Cited by 290 publications

(211 citation statements)

References 15 publications

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“…Regarding neoplasic lesions, the rate was 83%, while 83% were obtained considering all tissue samples. Our results are in accordance to those verified in literature, with positivity rates varying from 64 to 95%, with lower rates for inflammatory lesions or low malignancy grade lesions 5,[23][24][25][26] .…”

Section: Discussionsupporting

confidence: 92%

“…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] .…”

Section: Intracranial Lesions Stereotactic Biopsymentioning

confidence: 99%

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

Silva

Vasconcellos

Lara

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: Image guided stereotactic biopsy (SB) provides cerebral tissue samples for histological analysis from minimal lesions or those that are located in deep regions, being crucial in the elaboration of therapeutic strategies, as well as the prevention of unnecessary neurosurgical interventions. Method: Sixty patients with central nervous lesions underwent SB from November 1999 to March 2008. They were followed up to 65 months. Preoperative diagnosis was based on clinical presentation and neuro-radiological features, pathologic diagnosis, clinical outcome. The compatibility of these findings with the pathologic diagnosis was analyzed. Results: Considering diagnosis confirmation when inflammatory hypothesis were made, our accuracy was of 76%, with 94% of those cases having clinic-pathological correspondence after an average of 65.2 months of follow up. Considering diagnosis confirmation with the preoperative hypothesis of neoplasm, our accuracy was of 69% with 90% of these cases having clinic-pathological correspondence after an average of 47.3 months of follow-up. Morbidity rate was of 5% and mortality was zero. The diagnosis rate was 95%. Conclusion: Stereotactic biopsy represents a safe and precise method for diagnosis. Anatomic and histopathological analyses have high compatibility with long-term clinical outcome.KEY WORDS: stereotactic biopsy, morbidity, accuracy, pathology.Biopsia estereotáctica para lesões intracranianas: compatibilidade clínico patológica em 60 casos resumo -Objetivo: A biopsia estereotáctica (BE) guiada por imagem propicia amostras de tecido cerebral para análises histológicas, sendo decisiva na estratégia terapêutica e prevenção de intervenções neurocirúrgicas desnecessárias. Método: 60 pacientes com lesões do sistema nervoso central foram submetidos à biópsia estereotáctica no período de novembro de 1999 a março de 2008. Foram analisados a acurácia do método, a capacidade de confirmar o diagnóstico clínico pré-operatório e o comportamento evolutivo com sua compatibilidade com o diagnóstico patológico. Resultados: As três lesões mais freqüentes foram: neoplasias neuroepiteliais, processos inflamatórios e infecções. Considerando a confirmação diagnóstica quando pensava-se em lesão inflamatória, nossa acurácia foi 76%, com 94% destes casos tendo compatibilidade clínico patológica após média de 65,2 meses de acompanhamento. Considerando a confirmação diagnóstica com a hipótese pré-operatória de lesão neoplásica, nossa acurácia foi 69%, com 90% destes casos tendo compatibilidade clínico-patológica após média de 47,3 meses de acompanhamento. O índice de morbidade foi 5%. A mortalidade foi nula e o índice de diagnóstico foi 95%. Conclusão: A biopsia estereotáctica é um método seguro e preciso para o diagnóstico. O exame anátomo-patológico possui alta compatibilidade com a evolução clínica dos doentes a longo prazo. PALAVRAS-CHAVE: biopsia estereotáctica, morbidade, acurácia, anatomopatológico.

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Section: Discussionsupporting

confidence: 92%

Section: Intracranial Lesions Stereotactic Biopsymentioning

confidence: 99%

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

Silva

Vasconcellos

Lara

et al. 2009

Arq. Neuro-Psiquiatr.

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“…2,3,22) Review of the largest published series of 7471 stereotactic brain biopsies found the average diagnostic yield was 91% (80-99%), the mortality was 0.7% (0.5-2.6%), and the morbidity was 3.5% (0-13%). 8) In our series, none of the biopsy samples yielded normal brain tissue, and a final histological diagnosis was obtained in all cases. This overall diagnostic yield of 100% is only a preliminary value based on 19 patients, but falls within the range for conventional frameless stereotaxy 8) and iMR imaging, with a diagnostic yield of 96-100%.…”

Section: Discussionmentioning

confidence: 71%

“…8) In our series, none of the biopsy samples yielded normal brain tissue, and a final histological diagnosis was obtained in all cases. This overall diagnostic yield of 100% is only a preliminary value based on 19 patients, but falls within the range for conventional frameless stereotaxy 8) and iMR imaging, with a diagnostic yield of 96-100%. 2,9,10,16,26) The morbidity and mortality in our series were both 0%, but we observed two cases of wound infection, one needing surgical revision.…”

Section: Discussionmentioning

confidence: 76%

“…Intracranial hemorrhage occurs as a complication in 0% to 11.5% of stereotactic brain biopsy procedures. 6,8,13,23) This type of complication is infrequent, but has potentially drastic sequelae for a stereotactic procedure. Our approach allowed a reduction in the number of biopsy specimens obtained from the target, thus reducing the potential risk of morbidity associated with large numbers of biopsy attempts.…”

Section: Discussionmentioning

confidence: 99%

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Frameless Stereotactic Surgery Using Intraoperative High-Field Magnetic Resonance Imaging

Nimsky

Fujita

Ganslandt

et al. 2004

Neurol. Med. Chir.(Tokyo)

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This study evaluated the clinical validity of frameless stereotaxy using high-field intraoperative magnetic resonance (iMR) imaging combined with an in-room neuronavigation system. A 1.5 Tesla MR scanner in conjunction with a ceiling-mounted neuronavigation system was used during 32 frameless stereotaxy procedures consisting of 19 brain biopsies and 13 catheter placements between April 2002 and mid-October 2003. Evaluation of the procedure was based on either the rate of histological diagnostic yield or the ability to accurately position the catheter in the target region. This technique allowed successful registration with a mean error of 1.2 ± 0.8 mm and resulted in successful placement of the instrument within the target tissue. Intraoperatively, frozen section analysis showed all biopsy samples contained pathological tissue and locations of sampling points were confirmed by iMR imaging. Specific final diagnosis was made in all 19 brain biopsies. The tip of the catheter was successfully placed into the target in all 13 patients confirmed by iMR imaging. The catheter was repositioned based on iMR imaging in four of 13 patients, increasing the rate of successful placement. There were no procedure-related neurological deficits or mortality, but we encountered two cases of wound infection, one needing surgical revision. Total additional procedure time related to the induction of iMR imaging was 76.7 ± 23.3 minutes. This initial experience of the combination of conventional frameless stereotaxy and high-field iMR imaging improved the quality of frameless stereotaxy with low morbidity and mortality, but did not translate into a significant reduction of procedure-related time.

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Biopsy versus resection for high grade glioma

Hart

Grant

Solyom

et al. 2000

Cochrane Database of Systematic Reviews

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The safety and efficacy of stereotactic biopsy for intracranial lesions

Abstract: Stereotactic brain biopsy is an extremely safe and effective procedure for evaluating intracranial lesions. Complex surgical planning can decrease the risk of potential complications and the use of intraoperative pathologic examination can improve the diagnostic yield for this procedure.

Cited by 290 publications

References 15 publications

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

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

Frameless Stereotactic Surgery Using Intraoperative High-Field Magnetic Resonance Imaging

Biopsy versus resection for high grade glioma

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