Comparison of Frame-Based Versus Frameless Image-Guided Intracranial Stereotactic Brain Biopsy: A Retrospective Analysis of Safety and Efficacy

Ungar, Lior; Nachum, Ortal; Zibly, Zion; Wohl, Anton; Harel, Ran; Attia, Moshe; Spiegelmann, Roberto; Zaubermann, Jacob; Feldman, Zeev; Knoller, Nachshon

doi:10.1016/j.wneu.2021.07.063

Cited by 13 publications

(4 citation statements)

References 16 publications

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“…The difference in small asymptomatic hemorrhaged detection may be related to the higher CT image currently available. 19…”

Section: Discussionmentioning

confidence: 99%

“…The difference in small asymptomatic hemorrhaged detection may be related to the higher CT image currently available. 19 Some authors suggest that the frame-based technique should be indicated in the case of tumors located in the brainstem, basal ganglia, pineal, lesions located less than 10 mm from vascular structures as well as those located less than 5 mm from vascular structures, due to its greater accuracy. 20,21 Considering these indications, Owen et al believed that lesions that did not present these criteria should have frameless biopsies; in 100 cases of brainstem biopsies, 82% should undergo a frameless biopsy as an alternative to frame-based biopsies.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

Braga,

Dellaretti,

Faria

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Objective To compare the efficacy and safety of frameless and frame-based techniques for biopsies of intracranial lesions in an exclusive assistance service at a public health center in Brazil (SUS). Method A review of 65 medical records of patients with brain lesions who underwent a frame-based or frameless biopsy from September 2017 to July 2019 was performed. Results Among the 65 patients who underwent biopsy, 42 were male, and 23 were female. The mean age was 53.1 years. Most patients (49; 75.4%) presented hemispheric lesions, and, of these, 27 were in the frontal lobe (41,5%). The diagnostic rate was 78.5% (51 of 65 patients), and glial neoplasia was the most common diagnosis. In addition to glial neoplasia, a wide range of pathologies were diagnosed, such as toxoplasmosis, metastasis, lymphoma, inflammatory lesions, and abscesses. Among the 14 patients (21.5%) with inconclusive results, 8 had gliosis without neoplasia (12.3%), 4 had necrosis (6.1%), and 2 had insufficient samples (3%).The morbidity rate was 9.2%, with 4 cases of hemorrhage, 1 case of infection, and 1 case of worsening of neurological deficits. The mortality rate was 6.1% and occurred in all cases with hemorrhage.There were no significant differences in the diagnosis or complication (morbidity and mortality) rates between the frame-based and frameless groups. Conclusion The frame-based and frameless techniques for stereotactic biopsy present similar efficacy and safety.

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“…The difference in small asymptomatic hemorrhaged detection may be related to the higher CT image currently available. 19…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

Braga,

Dellaretti,

Faria

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Frameless methods relate to the skull by optical means but also rely solely on preoperative images. While studies have reported undistinguishable safety and efficacy for frame-based and frameless biopsy methods [20][21][22], some studies have also presented a reduction in the overall surgery time [20,23,24] and increased ease of use [25,26] for frameless biopsy methods. Implementing optical guidance in frameless neuronavigation biopsies could offer similar clinical benefits to those for frame-based methods, i.e., quantified in situ indication of high-grade tumor tissue and increased blood flow along the needle trajectory before the tissue is removed.…”

Section: Introductionmentioning

confidence: 99%

Combined Use of Frameless Neuronavigation and In Situ Optical Guidance in Brain Tumor Needle Biopsies

2023

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Brain tumor needle biopsies are performed to retrieve tissue samples for neuropathological analysis. Although preoperative images guide the procedure, there are risks of hemorrhage and sampling of non-tumor tissue. This study aimed to develop and evaluate a method for frameless one-insertion needle biopsies with in situ optical guidance and present a processing pipeline for combined postoperative analysis of optical, MRI, and neuropathological data. An optical system for quantified feedback on tissue microcirculation, gray–whiteness, and the presence of a tumor (protoporphyrin IX (PpIX) accumulation) with a one-insertion optical probe was integrated into a needle biopsy kit that was used for frameless neuronavigation. In Python, a pipeline for signal processing, image registration, and coordinate transformation was set up. The Euclidian distances between the pre- and postoperative coordinates were calculated. The proposed workflow was evaluated on static references, a phantom, and three patients with suspected high-grade gliomas. In total, six biopsy samples that overlapped with the region of the highest PpIX peak without increased microcirculation were taken. The samples were confirmed as being tumorous and postoperative imaging was used to define the biopsy locations. A 2.5 ± 1.2 mm difference between the pre- and postoperative coordinates was found. Optical guidance in frameless brain tumor biopsies could offer benefits such as quantified in situ indication of high-grade tumor tissue and indications of increased blood flow along the needle trajectory before the tissue is removed. Additionally, postoperative visualization enables the combined analysis of MRI, optical, and neuropathological data.

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“…[11][12][13][14][15][16][17][18][19][20][21][22] There were different definitions for diagnostic accuracy or diagnostic yield in the literature, creating het-erogenetic results. AEbelø et al22 and Bradac et al23 considered diagnostic yield as "the likelihood that a22 It creates a dilemma if a biopsy result of "negative for malignancy" is either considered a positive yield (providing information and excluding neoplasm) or a negative yield (not making the true diagnosis).…”

mentioning

confidence: 99%

Diagnostic Accuracy and Field for Improvement of Frameless Stereotactic Brain Biopsy: A Focus on Nondiagnostic Cases

Zhu

Chan

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Objective To evaluate the diagnostic accuracy of frameless stereotactic brain biopsy, compare it with the current international standard, and review the era for improvement. Background The diagnostic accuracy of frameless stereotactic brain biopsy has been reported but there is limited literature focusing on the reasons for non-diagnostic cases. Methods: This is a retrospective analysis of consecutive, prospectively collected frameless stereotactic brain biopsy procedures from 2007 to 2020. We evaluated the diagnostic accuracy of the frameless stereotactic brain biopsy procedures using structurally-defined criteria. The biopsy result was classified as conclusive, inconclusive, or negative, based on the pathological, radiological, and clinical diagnosis concordance. For inconclusive or negative results, we further evaluated the preoperative planning and postoperative imaging to review the errors. A literature review for the diagnostic accuracy of frameless stereotactic biopsy was performed for the validity of our results. The objective of the study is to identify the causes of non-diagnostic results for future improvement. Results: There were 106 patients with 109 biopsy procedures performed from 2007 to 2020. The conclusive diagnosis was reached in 103 (94.5%) procedures. The inconclusive diagnosis was noted in four (3.7%) procedures and the negative biopsy was yielded in two (1.9%) procedures. Symptomatic hemorrhage was noted in one patient (0.9%). There was no mortality case (0.0%) in our series. The registration error and inaccurate targeting occurred in three trigonal lesions (2.8%), sampling of the non-representative part of the lesion occurred in two cases (1.8%), and one biopsy (0.9%) for lymphoma was negative due to the commencement of steroids. The literature review suggested that our diagnostic accuracy under the structurally-defined diagnosis criteria was comparable with the published literature, while the causes for non-diagnostic cases were uniquely performed and summarized. Conclusion: The stereotactic biopsy is a safe procedure with high diagnostic accuracy only if meticulous preoperative planning and careful intraoperative registration is performed. The common pitfalls precluding a conclusive diagnosis are registration errors and biopsies at non-representative sites.

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Comparison of Frame-Based Versus Frameless Image-Guided Intracranial Stereotactic Brain Biopsy: A Retrospective Analysis of Safety and Efficacy

Cited by 13 publications

References 16 publications

Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

Combined Use of Frameless Neuronavigation and In Situ Optical Guidance in Brain Tumor Needle Biopsies

Diagnostic Accuracy and Field for Improvement of Frameless Stereotactic Brain Biopsy: A Focus on Nondiagnostic Cases

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