Integrated PET/MRI for planning navigated biopsies in pediatric brain tumors

Preuß, Matthias; Werner, Peter; Barthel, Henryk; Nestler, Ulf; Christiansen, Holger; Hirsch, Wolfgang; Fritzsch, Dominik; Hoffmann, Karl‐Titus; Bernhard, Matthias K.; Sabri, Osama

doi:10.1007/s00381-014-2412-9

Cited by 49 publications

(29 citation statements)

References 14 publications

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“…Since quality of the pre-and intraoperative scans (CT, MRI , PET) have improved over the last years, stereotactic procedures have gained in safety resulting in an improved contrast between tumor tissue and brain [17,19,30]. Postoperative neurological deficits are therefore observed seldom.…”

Section: Approachmentioning

confidence: 98%

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Stereotactic biopsy of brainstem lesions: 21 years experiences of a single center

et al. 2016

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Stereotactic biopsies are procedures performed to obtain tumor tissue for diagnostic examinations. Cerebral lesions of unknown entities can safely be accessed and tissue can be examined, resulting in correct diagnosis and according treatment. Stereotactic procedures of lesions in highly eloquent regions such as the brainstem have been performed for more than two decades in our department. In this retrospective study we focus on results, approaches, modalities of anesthesia, and complications. We performed a retrospective analysis of our prospective database, including 26 patients who underwent stereotactic biopsy of the brainstem between April 1994 and June 2015. All of the patients underwent preoperative MRI. Riechert-Mundinger-frame was used before 2000, thereafter the Leksell stereotactic frame was used. After 2000 entry and target points were calculated by using BrainLab stereotactic system. We evaluated histopathological results as well as further treatment; additionally we compared complications of local versus general anesthesia and complications of a frontal versus a trans-cerebellar approach. Median age of all patients was 33 years, and median number of tissue samples taken was 12. In all patients a final histopathological diagnosis could be established. 5 patients underwent the procedure under local anesthesia, 21 patients in general anesthesia. In 19 patients a frontal approach was performed, while in 7 patients a trans-cerebellar approach was used. Complications occurred in five patients. Thereby no significant difference was found with regard to approach (frontal versus trans-cerebellar) or anesthesia (local versus general). Stereotactic biopsies even of lesions in the brainstem are a save way to obtain tumor tissue for final diagnosis, resulting in adequate treatment. Approach can be trans-cerebellar or frontal and procedure can be performed either under local or general anesthesia without significant differences concerning complication rate.

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Section: Approachmentioning

confidence: 98%

“…Median number of tissue samples taken was 12 (range [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Samples were taken in 1 mm steps using a biopsy forceps.…”

Section: Histopathological Diagnosismentioning

confidence: 99%

Stereotactic biopsy of brainstem lesions: 21 years experiences of a single center

et al. 2016

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“…Representative histopathological specimens were obtained in all patients. Additional anaesthesia as well as CT-related radiation exposure could also be avoided [75]. In another small PET/MRI series mainly in patients with HGG, both modalities provided sufficient diagnostic quality and the [ 18 F]FET PET findings were in accordance with those of conventional MRI [50].…”

Section: First Experiences With Hybrid Pet/mri In Neurooncologymentioning

confidence: 72%

Current status and future role of brain PET/MRI in clinical and research settings

Werner

Barthel

Drzezga

et al. 2015

Eur J Nucl Med Mol Imaging

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Hybrid PET/MRI systematically offers a complementary combination of two modalities that has often proven itself superior to the single modality approach in the diagnostic work-up of many neurological and psychiatric diseases. Emerging PET tracers, technical advances in multiparametric MRI and obvious workflow advantages may lead to a significant improvement in the diagnosis of dementia disorders, neurooncological diseases, epilepsy and neurovascular diseases using PET/MRI. Moreover, simultaneous PET/MRI is well suited to complex studies of brain function in which fast fluctuations of brain signals (e.g. related to task processing or in response to pharmacological interventions) need to be monitored on multiple levels. Initial simultaneous studies have already demonstrated that these complementary measures of brain function can provide new insights into the functional and structural organization of the brain.

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“…In brain tumor imaging, due to the high amino-acid metabolism in astrocytes two specific radiopharmaceuticals, namely C-MET for biopsy planning and for neuronavigation in children with brain tumors [59].…”

Section: Application Of Pet/mr Scans In Neurologymentioning

confidence: 99%