The Role of Stereotactic Biopsy in Brain Metastases

Yu, Kenny; Patel, Ankur R.

doi:10.1016/j.nec.2020.06.002

Cited by 8 publications

(7 citation statements)

References 85 publications

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“…[ 22 , 34 , 37 , 51 , 52 ] However, as aforementioned, its use has been reported only in 13 out of 57 studies on stereotactic biopsy in humans. [ 2 , 6 , 12 , 28 , 32 , 34 - 36 , 51 , 52 , 54 , 55 , 57 ] Furthermore, it increases the operative time and, consequently, the risk of complications. [ 35 ] Maybe even more importantly, the accuracy rate of this technique in the central nervous system lesions is only 77.9%, when compared to permanent section.…”

Section: Discussionmentioning

confidence: 99%

“…[ 52 ] However, on reviewing the literature over a period of 5 years (pubmed.com: June 2015/June 2020), only 13 out of the 59 original publications on stereotactic biopsy in humans[ 1 - 59 ] reported the use of frozen section. [ 2 , 6 , 12 , 28 , 32 , 34 - 36 , 51 , 52 , 54 , 55 , 57 ] In cases of cystic lesions, such as brain abscesses, the mere aspiration of pus is enough to confirm appropriate targeting, making pathology consultation unnecessary.…”

Section: Introductionmentioning

confidence: 99%

“…the use of frozen section. [2,6,12,28,32,[34][35][36]51,52,54,55,57] In cases of cystic lesions, such as brain abscesses, the mere aspiration of pus is enough to confirm appropriate targeting, making pathology consultation unnecessary.…”

mentioning

confidence: 99%

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Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Vilela‐Filho¹,

Porfírio²,

Goulart³

2022

Surgical Neurology International

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Background: Confirmation of whether a stereotactic biopsy was performed in the correct site is usually dependent on the frozen section or on novel tumor-specific markers that are not widely available. Immediate postoperative computed tomography (CT) or magnetic resonance (MR) is routinely performed in our service after biopsy. In this retrospective study, we have carefully analyzed these images in an attempt to determine the presence of markers that indicate appropriate targeting. Methods: Medical records and neuroimages of patients who underwent stereotactic biopsy of intracranial lesions were reviewed. The following variables were assessed: age, sex, anatomopathology, lesion site, complications, diagnostic accuracy, and the presence of image markers. Results: Twenty-nine patients were included in this case series. About 96.6% of the biopsies were accurate according to the permanent section. Of the 86.2% of patients with intralesional pneumocephalus on the postoperative images, 51.7% additionally presented petechial hemorrhage. In 13.8% of the cases, no image markers were identified. Conclusion: This is the first report of intralesional pneumocephalus and petechial hemorrhage as indicators of appropriate targeting in stereotactic biopsy. In the majority of the cases, an immediate postoperative head CT, which is widely available, can estimate how adequate the targeting is. To use intralesional pneumocephalus/ petechial hemorrhages as not only postoperative but also as intraoperative markers of appropriate targeting, it is advised that the surgical wound should be temporarily closed and dressed after the biopsy so that the patient can undergo a CT/MR scan and be checked for the presence of theses markers before removing the stereotactic frame.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Vilela‐Filho¹,

Porfírio²,

Goulart³

2022

Surgical Neurology International

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“…Preoperative preparation would be simpler and intraoperative manipulation would be easier. It greatly simplifies the operation procedure, reduces the surgical time, and minimizes the chance of bleeding caused by the puncture and the rates of intracranial infection with less exposure time [ 9 , 37 , 38 , 39 ]. In this study, the average surgical time was 29.5 min, and there were no cases of intracranial infection postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Preliminary clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphoma

Tang

Shi²,

Qian³

et al. 2022

Heliyon

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“…However, most alterations have been identified in primary tumors and not metastases [ 12 ]. Additionally, this is particularly true for brain metastases, because of the difficulty accessing these localizations [ 13 ]. Although primary tumors and metastases can harbor a common genomic signature, significant discrepancies have also been identified between matched samples from a given patient, since metastases can derive from a minority clone in the primary tumor [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Genomics of Breast Cancer Brain Metastases: A Meta-Analysis and Therapeutic Implications

Nguyễn

Hamdan

Angeli

et al. 2023

Cancers

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Breast cancer brain metastases are a challenging daily practice, and the biological link between gene mutations and metastatic spread to the brain remains to be determined. Here, we performed a meta-analysis on genomic data obtained from primary tumors, extracerebral metastases and brain metastases, to identify gene alterations associated with metastatic processes in the brain. Articles with relevant findings were selected using Medline via PubMed, from January 1999 up to February 2022. A critical review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement (PRISMA). Fifty-seven publications were selected for this meta-analysis, including 37,218 patients in all, 11,906 primary tumor samples, 5541 extracerebral metastasis samples, and 1485 brain metastasis samples. We report the overall and sub-group prevalence of gene mutations, including comparisons between primary tumors, extracerebral metastases and brain metastases. In particular, we identified six genes with a higher mutation prevalence in brain metastases than in extracerebral metastases, with a potential role in metastatic processes in the brain: ESR1, ERBB2, EGFR, PTEN, BRCA2 and NOTCH1. We discuss here the therapeutic implications. Our results underline the added value of obtaining biopsies from brain metastases to fully explore their biology, in order to develop personalized treatments.

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The Role of Stereotactic Biopsy in Brain Metastases

Cited by 8 publications

References 85 publications

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Indicators of correct targeting in stereotactic biopsy of intracranial lesions

Preliminary clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphoma

Genomics of Breast Cancer Brain Metastases: A Meta-Analysis and Therapeutic Implications

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