Stereotactic brain biopsy: an audit of sampling reliabilityin a clinical case series

Shastri-Hurst, Neil; Tsegaye, Magnum; Robson, David; Lowe, James; Macarthur, Donald

doi:10.1080/02688690600875507

Cited by 24 publications

(19 citation statements)

References 21 publications

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“…The diagnostic yield in our series is comparable to that of previous reports. 2,5,6,[8][9][10]15,17,[21][22][23][24]27) However, the failure in 6.8% is not negligible. To find possible solutions to improve the diagnostic yield, we analyzed which factors were associated with higher accuracy of sampling the target points in 3 types of biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…These methods have advantages and disadvantages in sampling accuracy, approach to deep lesions, and sample volume. 2,5,6,[8][9][10]15,17,[21][22][23][24]27) Several case series have demonstrated that biopsy also has limitations in the rate of successful diagnosis (diagnostic yield) compared to partial/gross total resection via open craniotomy. 4,12,16,17,22,27) The reported diagnostic yields of frame-based biopsies were 66% to 99.3%, 6,8,10,22,27) and those of frameless biopsies were 89% to 93.8%.…”

Section: Introductionmentioning

confidence: 99%

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Navigation-Guided Endoscopic Biopsy for Intraparenchymal Brain Tumor

Tsuda

Ishikawa

Zaboronok

et al. 2011

Neurol. Med. Chir.(Tokyo)

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To evaluate the efficacy of intraparenchymal brain tumor biopsy using endoscopy and a navigation system (navigation-guided endoscopic biopsy) as a diagnostic tool, a case series of intraparenchymal tumor biopsies was reviewed. Navigation-guided endoscopic biopsy was applied in 9 cases, stereotactic needle biopsy in 16 cases, and open biopsy with or without navigation system in 34 cases. In all biopsy cases, 84.7% of biopsy points were sampled accurately, and 93.2% of diagnoses by biopsy were correct. Comparison of each type of biopsy showed that the resected volumes in navigation-guided endoscopic biopsy and open biopsy tended to be larger than those in stereotactic biopsy, and the mean operation time for the open biopsy procedure was the longest. To define the most applicable device or examination method to increase sampling accuracy, various factors were analyzed in 59 procedures. Navigation-guided endoscopic biopsy was the most accurate of the three types of biopsy, although the statistical difference was not significant. Older patients, histological diagnosis of high-grade glioma or malignant lymphoma, positive photodynamic diagnosis, and positive intraoperative pathology were significant factors in improving the sampling accuracy. Navigation-guided endoscopic biopsy could provide a larger sample volume within a relatively short operation time. The biopsy can be easily combined with both photodynamic diagnosis and intraoperative pathology, significantly improving the histological diagnostic yield.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Navigation-Guided Endoscopic Biopsy for Intraparenchymal Brain Tumor

Tsuda

Ishikawa

Zaboronok

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…Shastri-Hurst et al [24] have previously noted the finding of blood intra-operatively in 7/203 cases as having a positive predictive value of 57% for postoperative deterioration but a sensitivity of only 30%. In our series, 19% of patients met our particular criteria for persistent intra-operative bleeding.…”

Section: Safety Considerations In Stereotactic Biopsymentioning

confidence: 97%

Frame-based stereotaxy in a frameless era: current capabilities, relative role, and the positive- and negative predictive values of blood through the needle

Owen

Linskey

2009

J Neurooncol

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Introduction In the modern era of frameless stereotaxis (FL), the role of frame-based (FB) stereotactic needle biopsy is evolving. Methods Retrospective review of prospective database of 106 lesions in 91 consecutive patients undergoing FB stereotactic needle biopsy with a systematic ''geologic core'' technique by a single surgeon. Diagnostic accuracy was calculated comparing biopsy diagnosis with final pathology in 11 patients who underwent subsequent surgical resection. All instances of intra-operative bleeding through the needle were prospectively noted and compared with post-biopsy CT scan. Lesions were classified as risky for FL technique if they were (1) infratentorial or pineal, (2) within 10 mm of the circle of Willis or root of the Sylvian fissure, or (3) within 10 mm of deep cerebral veins. Results Diagnostic yield was 94%. Diagnostic accuracy was 91%. Of 18 lesions involving the corpus callosum, 13 (72.2%) were GBM 2 were anaplastic astrocytoma, and 1 each were found to be anaplastic oligodendroglioma, primary central nervous system lymphoma (PCNSL) and tumescent MS. Of 25 multifocal lesions, malignant primary brain tumor was diagnosed in 17 (68%) (11 GBM, 3 PCNSL, 2 anaplastic ologodendroglioma, and 1 anaplastic astrocytoma). Mortality was 0%. Three patients developed temporary neurologic deficits and one had permanent deficit. Absence of persistent blood through the biopsy needle had a negative predicative value of 98.8% for subsequent neuroimaging blood [5 mm diameter. According to our criteria, 80% of patients would have been candidates for FL biopsy. Conclusions Stereotactic biopsy is an effective, safe and important technique for histologic diagnosis of brain lesions, particularly for multifocal and corpus callosum lesions. Postbiopsy CT can be safely reserved for patients who demonstrate persistent bleeding through the biopsy needle. FB stereotaxy remains an important technique for the 20% with small or deep seated lesions or when it is advantageous to avoid an incision, a burr hole or general anesthesia.

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“…The stereotactic neurosurgical approach is the less invasive possibility of gaining adequate specimens for neuropathological diagnostics [17]. Several studies have revealed that stereotactic brain biopsies provide an exact neuropathological diagnosis in up to 80-95% of the cases [18,19,20]. However, diagnostic neuropathological accuracy was associated with the number of bits taken during the stereotactic procedure and could be increased from 76.5%, achieved by single biopsies, up to 100% if 5 or more samples were taken [21].…”

Section: Discussionmentioning

confidence: 99%

Confounding Factors in Diagnostics of <b><i>MGMT</i></b> Promoter Methylation Status in Glioblastomas in Stereotactic Biopsies

Weise

Harter²,

Eibach³

et al. 2014

Stereotact Funct Neurosurg

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Background: In nonresectable glioblastoma (GBM), stereotactic biopsies are performed to retrieve tissue for diagnostic purposes. The analysis of O⁶-methylguanine-DNA methyltransferase (MGMT) promoter methylation adds prognostic and predictive information. Objectives: The aim of the study was to detect confounding factors that limit the number of conclusive MGMT promoter methylation results. Methods: We analyzed 71 consecutive GBM patients undergoing stereotactic biopsy on whom MGMT analysis was performed by methylation-specific polymerase chain reaction. Specimens were correlated to imaging by coregistration and prospective documentation of biopsy localization. Our findings were validated in an additional 62 GBM stereotactic biopsies. Results: Our results demonstrate that the best MGMT promoter methylation results were obtained from samples (n = 71) taken in a tangential manner from tumor areas showing contrast enhancement in magnetic resonance imaging. In the additional validation series of 62 stereotactically biopsied GBM, we were able to increase the rate of conclusive MGMT promoter methylation results from 76.1 to 85.48% by strictly planning the route of biopsy in a tangential manner if possible. Conclusions: These results underline that within the contrast-enhanced tumor part, choosing the trajectory in a tangential manner increases the diagnostic yield for conclusive MGMT promoter methylation analyses in stereotactic biopsies as a basis for patient stratification and individualized therapy.

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Stereotactic brain biopsy: an audit of sampling reliabilityin a clinical case series

Cited by 24 publications

References 21 publications

Navigation-Guided Endoscopic Biopsy for Intraparenchymal Brain Tumor

Navigation-Guided Endoscopic Biopsy for Intraparenchymal Brain Tumor

Frame-based stereotaxy in a frameless era: current capabilities, relative role, and the positive- and negative predictive values of blood through the needle

Confounding Factors in Diagnostics of <b><i>MGMT</i></b> Promoter Methylation Status in Glioblastomas in Stereotactic Biopsies

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