Validation of Intraoperative Diagnoses Using Smear Preparations from Stereotactic Brain Biopsies: Intraoperative versus Final Diagnosis—Influence of Clinical Factors

Abstract

Intraoperative diagnosis with stereotactic biopsy has high validity. Immediate treatment based on the intraoperative diagnosis can be justified (e.g., for metastases or glioblastomas). Stereotactic biopsy with an exact histopathological diagnosis is strongly recommended for planning adequate therapy for patients with unidentified brain lesions.

Primary Central Nervous System Lymphoma: A Clinicopathological and Cytomorpholgical Study from A Tertiary Care Centre in Chennai, India

“…Tilgner et al found almost 90% complete correlation for the group of primary and secondary lymphomas in their study to validate intraoperative diagnoses using smear preparation from stereotactic brain biopsies (Tilgner et al, 2005). However we have encountered certain diagnostic pitfalls in our experience.…”

Sources of Error in Neuropathology Intraoperative Diagnosis

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Specialists institute a variety of diagnostic audits to identify areas of weakness and to optimize clinical performance [1][2][3][4][5] . In pathology, one common diagnostic event well-suited to this type of analysis is the intraoperative consultation where touch, smear and frozen section preparations have long been used to assist surgical decision making [6][7][8][9] .

Neurosurgeons incorporate a neuropathologist's interpretation into the surgical plan through intraoperative consultations on small biopsies 5,6,8,10 .

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“…In pathology, one common diagnostic event well-suited to this type of analysis is the intraoperative consultation where touch, smear and frozen section preparations have long been used to assist surgical decision making [6][7][8][9] .Neurosurgeons incorporate a neuropathologist's interpretation into the surgical plan through intraoperative consultations on small biopsies 5,6,8,10 . These consultations represent a diagnostic challenge for the neuropathologist that imposes sampling and technical limitations under a relative time constraint.…”

“…Neurosurgeons incorporate a neuropathologist's interpretation into the surgical plan through intraoperative consultations on small biopsies 5,6,8,10 . These consultations represent a diagnostic challenge for the neuropathologist that imposes sampling and technical limitations under a relative time constraint.…”

Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery

“…Nondiagnostic tissue samples occurred at a rate of 4.6%-5%. 10,30 In the current practice setting, there is a high degree of subjectivity in the management of patients with cerebral metastasis who have radiographic and/or clinical progression after SRS. While our study is limited by the small sample size, it represents a systematic effort to address a clinically important question.…”