Diagnostic Yield and Complication of Frameless Stereotactic Brain Biopsy

Abstract

Background:With the advancement of neuronavigation technologies, frameless stereotactic brain biopsy has been developed. Previous studies proved that frameless stereotactic brain biopsy was as effective and safe as frame-based stereotactic brain biopsy. The authors aimed to find the factors associated with diagnostic yield and complication rate of frameless intracranial biopsy.Materials and Methods:Frameless stereotactic brain biopsy procedures, between March 2009 and April 2017, were retrospectively reviewed from medical records including imaging studies. Using logistic regression analysis, various factors were analyzed for association with diagnostic yield and postoperative complications.Results:Eighty-nine frameless stereotactic brain biopsy procedures were performed on 85 patients. The most common pathology was primary central nervous system lymphoma (43.8%), followed by low-grade glioma (15.7%), and high-grade glioma (15%), respectively. The diagnostic yield was 87.6%. Postoperative intracerebral hematoma occurred in 19% of cases; however, it was symptomatic in only one case. The size of the lesion was associated with both diagnostic yield and postoperative intracerebral hematoma complication. Lesions, larger than 3 cm in diameter, were associated with a higher rate of positive biopsy result (P = 0.01). Lesion 3 cm or smaller than 3 cm in diameter, and intraoperative bleeding associated with a higher percentage of postoperative intracerebral hematoma complications (P = 0.01).Conclusions:For frameless stereotactic brain biopsy, the size of the lesion is the essential factor determining diagnostic yield and postoperative intracerebral hematoma complication.

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

“…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].…”

“…The volume or size of the biopsied lesion is a vital component affecting diagnostic yield. One clinical study found that a lesion diameter of > 3 cm is essential in predicting diagnostic yield, while small lesions were associated with postoperative hematoma [6]. On the other hand, the reported meta-analysis results are unlikely to be applicable to lesions < 1 cm in maximal diameter [37].…”

“…A neuronavigation reference star was attached to the head clamp after the patients being positioned. Navigation was then registered by laser pointer surface registration [6]. After registration, the skin surface accuracy was finally checked.…”

Multicenter DSC–MRI-Based Radiomics Predict IDH Mutation in Gliomas

“…Characterization of the IDH mutation status has therefore become imperative prior to treatment selection and patient stratification [8]. However, this still relies on invasive tissue sampling and analysis, harboring inherent limitations, including post-operative complications and sample error [9]. The non-invasive classification of gliomas based on imaging was proposed as an alternative to this approach, leading to the identification of imaging features as correlates to molecular subtypes.…”

A New Era in Stereotactic Brain Biopsy: Frameless Navigation-Based System

“…Taweesomboonyat et al . presented their experience in frameless stereotactic brain biopsy in their article: “Diagnostic yield and complication of frameless stereotactic brain biopsy.”[1]…”