Stereotactic biopsies of brainstem lesions: dilemma on the best trajectory

Mathon, Bertrand; Malaizé, Henri; Amelot, Aymeric

doi:10.1007/s00701-021-04924-x

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…Jaradat et al 57 recommended that a supratentorial transfrontal approach was indicated for lesions in the midbrain, upper pons, and medulla oblongata, and an infratentorial transcerebellar approach was suitable for lesions within the lower pons. In contrast, a study by Mathon and coworkers 58 highlighted a greater complication rate in the supratentorial transfrontal approach than in the infratentorial transcerebellar approach. In light of this, they proposed that only midbrain lesions should be used for biopsy with a supratentorial transfrontal approach, whereas lesions located within other parts could be safely attained by an infratentorial transcerebellar approach.…”

Section: Discussionmentioning

confidence: 90%

Stereotactic Biopsy for Brainstem Lesions: A Meta-analysis with Noncomparative Binary Data

He¹,

He²,

Qi³

et al. 2021

Cancer Control

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Objectives To evaluate the diagnostic yield and safety of brainstem stereotactic biopsy for brainstem lesions. Methods We performed a meta-analysis of English articles retrieved from the PubMed, Web of Science, Cochrane Library, and APA psycInfo databases up to May 12, 2021. A binary fixed-effect model, the inverse variance method, or a binary random-effect model, the Dersimonian Laird method, were utilized for pooling the data. This meta-analysis was registered with INPLASY, INPLASY202190034. Findings A total of 41 eligible studies with 2792 participants were included. The weighted average diagnostic yield was 97.0% (95% confidential interval [CI], 96.0-97.9%). The weighted average proportions of temporary complications, permanent deficits, and deaths were 6.2% (95% CI, 4.5–7.9%), .5% (95% CI, .2–.8%), and .3% (95% CI, .1–.5%), respectively. The subgroup analysis indicated a nearly identical weighted average diagnostic yield between MRI-guided stereotactic biopsy and CT-guided stereotactic biopsy (95.9% vs 95.8%) but slightly increased proportions of temporary complications (7.9% vs 6.0%), permanent deficits (1.9% vs .2%), and deaths (1.1% vs .4%) in the former compared to the latter. Moreover, a greater weighted average diagnostic yield (99.2% vs 97.6%) and lower proportions of temporary complications (5.1% vs 6.8%) and deaths (.7% vs 1.5%) were shown in the pediatric patient population than in the adult patient population. Conclusions Brainstem stereotactic biopsy demonstrates striking accuracy plus satisfying safety in the diagnosis of brainstem lesions. The diagnostic yield, morbidity, and mortality mildly vary based on the diversity of assistant techniques and subject populations.

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Section: Discussionmentioning

confidence: 90%