Frame-based stereotactic biopsy of deep-seated and midline structures in 511 procedures: feasibility, risk profile, and diagnostic yield.

Autor: Hamisch CA; Department of General Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Cologne, Germany. christina.hamisch@uk-koeln.de., Minartz J; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany., Blau T; Department of Neuropathology, University Hospital of Essen, 45122, Essen, Germany., Hafkemeyer V; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany., Rueß D; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany., Hellerbach A; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany., Grau SJ; Department of General Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Cologne, Germany.; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, 53113, Bonn, Germany., Ruge MI; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, University Hospital of Cologne, 50937, Köln, Germany.; Center of Integrated Oncology (CIO), Universities of Cologne and Bonn, 53113, Bonn, Germany.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2019 Oct; Vol. 161 (10), pp. 2065-2071. Date of Electronic Publication: 2019 Jul 29.
DOI: 10.1007/s00701-019-04020-1
Abstrakt: Objectives: We evaluated the feasibility, safety, and diagnostic yield of frame-based stereotactic biopsies (SB) in lesions located in deep-seated and midline structures of the brain to analyze these parameters in comparison to other brain areas.
Patients and Methods: In a retrospective, tertiary care single-center analysis, we identified all patients who received SB for lesions localized in deep-seated and midline structures (corpus callosum, basal ganglia, pineal region, sella, thalamus, and brainstem) between January 1996 and June 2015. Study participants were between 1 and 82 years. We evaluated the feasibility, procedural complications (mortality, transient and permanent morbidity), and diagnostic yield. We further performed a risk analysis of factors influencing the latter parameters. Chi-square test, Student t test, and Mann-Whitney rank-sum test were used for statistical analysis.
Results: Four hundred eighty-nine patients receiving 511 SB procedures (median age 48.5 years, range 1-82; median Karnofsky Performance Score 80%, range 50-100%, 43.8% female/56.2% male) were identified. Lesions were localized in the corpus callosum (29.5%), basal ganglia (17.0%), pineal region (11.5%), sella (7.8%), thalamus (4.3%), brainstem (28.8%), and others (1.1%). Procedure-related mortality was 0%, and permanent morbidity was 0.4%. Transient morbidity was 9.6%. Histological diagnosis was possible in 99.2% (low-grade gliomas 16.2%, high-grade gliomas 40.3%, other tumors in 27.8%, no neoplastic lesions 14.5%, no definitive histological diagnosis 0.8%). Only the pons location correlated significantly with transient morbidity (p < 0.001).
Conclusion: In experienced centers, frame-based stereotactic biopsy is a safe diagnostic tool with a high diagnostic yield also for deep-seated and midline lesions.
Databáze: MEDLINE
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