A Sequential Comparison on the Risk of Haemorrhage with Different Sizes of Biopsy Needles for Stereotactic Brain Biopsy

Yuen, Jason; Zhu, Cannon Xian Lun; Chan, Danny Tat Ming; Ng, Rebecca Yuen Ting; Nia, Wai; Poon, Wai Sang; Ng, Ho Keung; Mok, Vincent; Wong, Ka Sing; Cheung, Tom C.Y.; Siu, Deyond Y.W.

doi:10.1159/000360862

Cited by 14 publications

(17 citation statements)

References 75 publications

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“…Only speculations are possible as to why this has occurred, statistical evidence not pointing to any reason in particular. Some reports [ 18 ] suggest that the size of the needle correlates with the risk of hemorrhage, but this could not be established in our series (outer needle diameter 2.2 and 1.8 mm and cutting window length 7 and 10 mm for the Stealth Treon TM Vertek® and Brainlab® Varioguide, respectively).…”

Section: Discussioncontrasting

confidence: 59%

Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected?

Verploegh¹,

Volovici²,

Haitsma³

et al. 2015

Acta Neurochir

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BackgroundFrameless stereotactic neuronavigation has proven to be a feasible technology to acquire brain biopsies with good accuracy and little morbidity and mortality. New systems are constantly introduced into the neurosurgical armamentarium, although few studies have actually evaluated and compared the diagnostic yield, morbidity, and mortality of various manufacturer’s frameless neuronavigation systems. The present study reports our experience with brain biopsy procedures performed using both the Medtronic Stealth TreonTM Vertek® and BrainLAB® Varioguide frameless stereotactic brain biopsy systems.Patients and methodsAll 247 consecutive biopsies from January 2008 until May 2013 were evaluated retrospectively. One hundred two biopsies each were performed using the Medtronic (2008–2009) and BrainLAB® system (2011–2013), respectively. The year 2010 was considered a transition year, in which 43 biopsies were performed with either system. Patient demographics, perioperative characteristics, and histological diagnosis were reviewed, and a comparison was made between the two brain biopsy systems.ResultsThe overall diagnostic yield was 94.6 %, i.e., 11 biopsies were nondiagnostic, 5 (4.9 %) with the Medtronic and 6 (5.9 %) with the BrainLAB® system. No differences besides the operating time (108 vs 120 min) were found between the two biopsy methods. On average, 6.6 tissue samples were taken with either technique. Peri- and postoperative complications were seen in 5.3 % and 12.9 %, consisting of three symptomatic hemorrhages (1.2 %). Biopsy-related mortality occurred in 0.8 % of all biopsies.ConclusionsRegarding diagnostic yield, complication rate, and biopsy-related mortality, there seems to be no difference between the frameless biopsy technique from Medtronic and BrainLAB®. In contemporary time, the neurosurgeon has many tools to choose from, all with a relatively fast learning curve and ever improving feasibility. Thus, the issue of choice involves not the results, but the familiarity, end-user friendliness, and overall comfort when operating the system.

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Section: Discussioncontrasting

confidence: 59%

Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected?

Verploegh¹,

Volovici²,

Haitsma³

et al. 2015

Acta Neurochir

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“…STB[ 2 3 4 5 13 15 18 19 20 21 22 23 24 ] has been demonstrated to be a low-risk procedure and may be performed with extreme accuracy (1 mm variance), especially with use of recent system compatible with CT scan and/or MRI. On the other hand, ultrasound-guided biopsy is also safe, cheap, quick, simple to perform, and technically reliable real-time method for superficially located lesions as well as for deep-seated lesions, independent of size.…”

Section: Discussionmentioning

confidence: 99%

Comparison of stereotactic and ultrasound-guided biopsy of solid supratentorial tumor: A preliminary report

et al. 2017

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Introduction:The computed tomography (CT) guided stereotactic biopsy (STB) is considered as method of choice for biopsy of intracranial mass lesions. However, it's disadvantages are frame fixation, time requirement for transportation between CT scan suit to the operation theater with added much higher equipment cost in the relatively resource scarred developing country. Ultrasound-guided biopsy (USGB) is relatively simpler, economical, less time consuming, and real-time procedure.Clinical Materials and Methods:Thirty-seven consecutively admitted patients with supratentorial brain tumors, who underwent biopsy of the lesion using CT compatible stereotactic and ultrasound-guided (USGB) procedure formed cohort of the study. Based on location and size of the lesions, the cases were divided into two groups, superficial and deep. Twenty-two patients underwent ultrasound-guided biopsy and 15 with STB.Results:The diagnostic yield of STB was 93% and 91% for ultrasound-guided biopsy. The mean operation time of STB group was 149.00 min and 94 min for USGB, which was statistically significant. Two cases in each group developed hematoma; however, one case in USGB group needed surgical evacuation. The real-time monitoring detected two hematoma intraoperatively, which were further also confirmed on postoperative CT scan head.Conclusions:The ultrasound-guided biopsy procedure (USGB) was simple, relatively shorter time-consuming procedure and equally efficacious and utilizing economical equipment and can act as a safer alternative to CT STB process for biopsy of the intracranial mass lesion. Furthermore, USGB also provided intra-operative real-time monitoring, which provided clue for close monitoring in the postoperative period after completion of biopsy to look for development of fresh hematoma development not only at the biopsy site but also along the biopsy track and adjoining area. Perhaps, a longer period of ultrasonic monitoring following the procedure would be of greater help to detect hematoma formation, which is one of the most common complications of the biopsy procedure.

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“…6 However, a brain tumor biopsy not only is costly 7 but also poses risks inherent to an invasive procedure. 8,9 An imaging based characterization also presents other advantages, 10 such as permitting interrogation of tumor heterogeneity characteristics and an assessment of tumor pathophysiology. More recently, it has also been suggested that GBMs harbor multiple cell subpopulations; 11 hence, an imaging based examination can also provide an insight into the molecular programs driving the disease.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of tumor‐derived MRI‐texture features for discrimination of molecular subtypes and prediction of 12‐month survival status in glioblastoma

et al. 2015

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The authors evaluated the performance of five types of texture features in predicting GBM molecular subtypes and 12-month survival status. The authors' results show that texture features are predictive of molecular subtypes and survival status in GBM. These results indicate the feasibility of using tumor-derived imaging features to guide genomically informed interventions without the need for invasive biopsies.

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A Sequential Comparison on the Risk of Haemorrhage with Different Sizes of Biopsy Needles for Stereotactic Brain Biopsy

Cited by 14 publications

References 75 publications

Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected?

Contemporary frameless intracranial biopsy techniques: Might variation in safety and efficacy be expected?

Comparison of stereotactic and ultrasound-guided biopsy of solid supratentorial tumor: A preliminary report

Evaluation of tumor‐derived MRI‐texture features for discrimination of molecular subtypes and prediction of 12‐month survival status in glioblastoma

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