Stereotactic biopsies of brain lesions

Teixeira, Manoel Jacobsen; Fonoff, Erich Talamoni; Mandel, Maurício; Alves, Hélvio Leite; Rosemberg, Sérgio

doi:10.1590/s0004-282x2009000100018

Cited by 15 publications

(14 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the major complications of stereotactic brain biopsy is haemorrhage [2,3,5,11,14,23]. The risk of symptomatic haemorrhage ranged from 0.4 to 4.7% in studies in the twentieth century, as reviewed by previous authors [8,9], and remained around 1-5% from many series after the year 2000 [1,2,3,4,5,6,7,10,11,12,13,14,15,16]. Craniotomy for haematoma evacuation [2,5,11,23,24,25] or intra-operative balloon compression [26] might be required for haemorrhage complication.…”

Section: Discussionmentioning

confidence: 99%

“…One of the reasons for such a wide range might be that postoperative haemorrhage is not strictly defined. Punctate haemorrhages seen at the site of biopsy were not classified as haemorrhages in some studies [7,13]. There are only few prospective studies in the literature focusing on haemorrhage after stereotactic brain biopsy [9,36,40].…”

Section: Discussionmentioning

confidence: 99%

“…The main risk associated with the procedure is haemorrhage with a reported incidence of symptomatic haemorrhage between 0.4 and 5% [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Despite their relatively low incidence, haemorrhagic complications carry by far the highest risk of devastating neurological outcome.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Yuen¹,

Zhu²,

Chan³

et al. 2014

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Aim: To compare the risk of postoperative haemorrhage with different sizes of brain biopsy needles. Patients and Method: A cohort of patients using a 2.5-mm outer diameter side-cutting biopsy needle was compared to a subsequent cohort using a 1.8-mm needle of the same type. All data were collected prospectively. A CT scan was done within 12 h after surgery. Any visible haemorrhage at the operated site was documented. Results: From 2007 to 2013, 54 stereotactic brain biopsies (all frameless except for one frame-based) were performed. The 2.5-mm group comprised 29 procedures from 2007 to 2009. The 1.8-mm group comprised the subsequent 25 procedures. The diagnostic yields were 90 and 96% in the 2.5- and the 1.8-mm group, respectively (p = 0.615). Comparing the 2.5- and the 1.8-mm group, haemorrhage was significantly reduced: incidence (72 vs. 40%, p = 0.016); size of haemorrhage (mean 7.2 vs. 2.6 mm, p = 0.002); proportion of haemorrhage size >10 mm (34.5 vs. 4%, p = 0.006). Symptomatic haemorrhage rates were 3.4 and 0.0% in the 2.5- and the 1.8-mm group, respectively (p = 1.00). Conclusion: The 1.8-mm outer diameter needle carried a lower risk of postoperative haemorrhage than the 2.5-mm one, without compromising the diagnostic yield.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Yuen¹,

Zhu²,

Chan³

et al. 2014

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…6,[8][9][10][11]14,20,27,39 The size and location of tumors were quite different in the 32 cases without microrecording compared with the 12 cases with microrecording. Despite the larger tumors in the former, histological diagnosis could not be confirmed in 2 cases, with a diagnostic yield per patient of 93.8%.…”

Section: Discussion Diagnostic Yieldmentioning

confidence: 96%

“…Previous series of stereotactic biopsy including more than 150 patients since 2005 had postoperative complication rates from 2.9% to 12.1%, and mortality rates from 0.6% to 1.34%. 6,[8][9][10][11]14,20,27,39 Mortality rates are higher in cases of thalamic or basal ganglia lesion, and complication rates are increased in cases of brainstem lesion. 8,14 In the present study, the mortality rate was 0% and the symptomatic hemorrhage rate was 0% despite the target tumors located in the thalamus, midbrain, or cortex.…”

Section: Postoperative Complication and Mortality Ratementioning

confidence: 99%

Microrecording and image-guided stereotactic biopsy of deep-seated brain tumors

Iijima¹,

Hirato²,

Miyagishima³

et al. 2015

JNS

View full text Add to dashboard Cite

OBJECT Image-guided stereotactic brain tumor biopsy cannot easily obtain samples of small deep-seated tumor or selectively sample the most viable region of malignant tumor. Image-guided stereotactic biopsy in combination with depth microrecording was evaluated to solve such problems. METHODS Operative records, MRI findings, and pathological specimens were evaluated in 12 patients with small deep-seated brain tumor, in which image-guided stereotactic biopsy was performed with the aid of depth microrecording. The tumors were located in the caudate nucleus (1 patient), thalamus (7 patients), midbrain (2 patients), and cortex (2 patients). Surgery was performed with a frameless stereotactic system in 3 patients and with a frame-based stereotactic system in 9 patients. Microrecording was performed to study the electrical activities along the trajectory in the deep brain structures and the tumor. The correlations were studied between the electrophysiological, MRI, and pathological findings. Thirty-two patients with surface or large brain tumor were also studied, in whom image-guided stereotactic biopsy without microrecording was performed. RESULTS The diagnostic yield in the group with microrecording was 100% (low-grade glioma 4, high-grade glioma 4, diffuse large B-cell lymphoma 3, and germinoma 1), which was comparable to 93.8% in the group without microrecording. The postoperative complication rate was as low as that of the conventional image-guided method without using microelectrode recording, and the mortality rate was 0%, although the target lesions were small and deep-seated in all cases. Depth microrecording revealed disappearance of neural activity in the tumor regardless of the tumor type. Neural activity began to decrease from 6.3 ± 4.5 mm (mean ± SD) above the point of complete disappearance along the trajectory. Burst discharges were observed in 6 of the 12 cases, from 3 ± 1.4 mm above the point of decrease of neural activity. Injury discharges were often found at 0.5–1 mm along the trajectory between the area of decreased and disappeared neural activity. Close correlations between electrophysiological, MRI, and histological findings could be found in some cases. CONCLUSIONS Image-guided stereotactic biopsy performed using depth microrecording was safe, it provided accurate positional information in real time, and it could distinguish the tumor from brain structures during surgery. Moreover, this technique has potential for studying the epileptogenicity of the brain tumor.

show abstract

Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre

et al. 2010

View full text Add to dashboard Cite

BackgroundPreviously, we reported on our single centre results regarding the diagnostic yield of stereotactic needle biopsies of brain lesions. The yield then (1996–2006) was 89.4%. In the present study, we review and evaluate our experience with intraoperative frozen-section histopathologic diagnosis on-demand in order to improve the diagnostic yield.MethodsOne hundred sixty-four consecutive frameless biopsy procedures in 160 patients (group 1, 2006–2010) were compared with the historic control group (group 2, n = 164 frameless biopsy procedures). Diagnostic yield, as well as demographics, morbidity and mortality, was compared. Statistical analysis was performed by Student's t, Mann–Whitney U, Chi-square test and backward logistic regression when appropriate.ResultsDemographics were comparable. In group 1, a non-diagnostic tissue specimen was obtained in 1.8%, compared to 11.0% in group 2 (p = 0.001). Also, both the operating time and the number of biopsies needed were decreased significantly. Procedure-related mortality decreased from 3.7% to 0.6% (p = 0.121). Multivariate analysis only proved operating time (odds ratio (OR), 1.012; 95% confidence interval (CI), 1.000–1.025; p = 0.043), a right-sided lesion (OR, 3.183; 95% CI, 1.217–8.322; p = 0.018) and on-demand intraoperative histology (OR, 0.175; 95% CI, 0.050–0.618; p = 0.007) important factors predicting non-diagnostic biopsies.ConclusionsThe importance of a reliable pathological diagnosis as obtained by biopsy must not be underestimated. We believe that when performing stereotactic biopsy for intracranial lesions, next to minimising morbidity, one should strive for as high a positive yield as possible. In the present single centre retrospective series, we have shown that using a standardised procedure and careful on-demand intraoperative frozen-section analysis can improve the diagnostic yield of stereotactic brain biopsy procedures as compared to a historical series.

show abstract

Stereotactic biopsies of brain lesions

Cited by 15 publications

References 18 publications

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

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

Microrecording and image-guided stereotactic biopsy of deep-seated brain tumors

Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre

Contact Info

Product

Resources

About