MRI imaging for planning stereotactic biopsies of the brain lesions
https://doi.org/10.24835/1607-0763-1046
Abstract
Aim of the study. To evaluate the influence of modern MRI imaging, CT- and MRI fusion in STB planning on effectiveness of morphological verification and risks of intraoperative complications.
Materials and methods. The most common indications for brain tumor biopsy is definitive diagnosis of the intracranial lesion and differentiation of the neoplastic and non-neoplastic pathology. During 2019 170 patients (95 men and 75 femmes) 7–69 years old underwent stereotactic biopsy an Integra LifeSciences Corporation Cosman–Roberts–Wells® (CRW®) system. In 80 cases, we used CT and MRI fusion by NeuroSight program to select the target point, entry point and trajectory of the brain biopsy. In 90 cases we use only CT images for stereotactic brain biopsy planning.
Results. Among 80 patients with use of combined CT-MRI fusion only one case was not histologically verified. In 90 patients with use of only CT-imaging for STB 3 cases were histologically not verified. There were no hemorrhagic complications among 80 patients in CT-MRI fusion group. In 3 cases intracranial hematomas were identified that required surgical treatment after STB with use of CT-imaging for STB panning.
Conclusion. The use of modern MRI and PET-CT imaging for STB planning increases its informativity and reduces the probability of hemorrhagic complications. Stereotactic biopsies remain a safe and reliable method for obtaining histological material. The use of modern imaging methods in biopsy planning increases their accuracy and reduces possible complications.
About the Authors
S. A. MaryashevRussian Federation
Sergey A. Maryashev – Doct. of Sci. (Med.), Neurosurgeon
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
A. A. Poddubskiy
Russian Federation
Artem A. Poddubskiy – Neurosurgeon
+7-964-560-67-58
107392, Moscow, Alymova str., 3-118
Competing Interests:
The authors declare no conflict of interest.
I. N. Pronin
Russian Federation
Igor N. Pronin – Full Мember of the Russian Academy of Sciences, Doct. of Sci. (Med.), Professor, Head of Neuroradiology department, Deputy Director
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
G. L. Kobyakov
Russian Federation
Grigory L. Kobyakov – Doct. of Sci. (Med.), Professor, deputy chief doctor in oncology
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
V. Y. Zhukov
Russian Federation
Vadim Yu. Zhukov – Cand. of Sci. (Med.), Neurosurgeon
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
P. V. Rodionov
Russian Federation
Pavel V. Rodionov – Head engineer
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
D. I. Pitskhelauri
Russian Federation
David I. Pitskhelauri – Doct. of Sci. (Med.), Professor, Head of 7th Neurosurgery department
125047, Moscow, 4rd Tverskaya-Yamskaya str., 16
Competing Interests:
The authors declare no conflict of interest.
References
1. Broggi M., Broggi G. Stereotactic biopsy: an established procedure, but still modern? Wld Neurosurg. 2015; 83 (3): 285–287. http://doi.org/10.1016/j.wneu.2014.08.059
2. Apuzzo M.L., Chandrasoma P.T., Cohen D. et al. Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. Neurosurgery. 1987; 20 (6): 930–937. http://doi.org/10.1227/00006123-198706000-00019
3. Kondziolka D., Lunsford L.D. The role of stereotactic biopsy in the management of gliomas. J. Neurooncol. 1999; 42 (3): 205–213. http://doi.org/10.1023/a:1006105415194
4. Weber M.A., Giesel F.L., Stieltjes B. MRI for identification of progression in brain tumors: from morphology to function. Exp. Rev. Neurother. 2008; 8: 1507–1525.
5. Coffey R.J., Lunsford L.D. Stereotactic surgery for mass lesions of the midbrain and pons. Neurosurgery. 1985; 17 (1): 12–18. http://doi.org/10.1227/00006123-198507000-00003
6. Heper A.O., Erden E., Savas A. et al. An analysis of stereotactic biopsy of brain tumors and nonneoplastic lesions: a prospective clinicopathologic study. Surg. Neurol. 2005; 64 (Suppl. 2): S82–88. http://doi.org/10.1016/j.surneu.2005.07.055
7. Gralla J., Nimsky C., Buchfelder M. et al. Frameless stereotactic brain biopsy procedures using the Stealth Station: indications, accuracy and results. Zentralbl. Neurochir. 2003; 64 (4): 166–170. http://doi.org/10.1055/s-2003-44620
8. Tilgner J., Herr M., Ostertag C., Volk B. Validation of intraoperative diagnoses using smear preparations from stereotactic brain biopsies: intraoperative versus final diagnosis –influence of clinical factors. Neurosurgery. 2005; 56 (2): 257–265. http://doi.org/10.1227/01.neu.0000148899.39020.87
9. Dammers R., Schouten J.W., Haitsma I.K. et al. Towards improving the safety and diagnostic yield of stereotactic biopsy in a single centre. Acta Neurochir. 2010; 152 (11): 1915–1921. http://doi.org/10.1007/s00701-010-0752-0
10. Callovini G.M. Is it appropriate to redefine the indication for stereotactic brain biopsy in the MRI era? Correlation with final histological diagnosis in supratentorial gliomas. Minim. Invasive Neurosurg. 2008; 51 (2): 109–113. http://doi.org/10.1055/s-2008-1058096
11. McGirt M.J., Woodworth G.F., Coon A.L. et al. Independent predictors of morbidity after imageguided stereotactic brain biopsy: a risk assessment of 270 cases. J. Neurosurg. 2005; 102 (5): 897–901. http://doi.org/10.3171/jns.2005.102.5.0897
12. Chen C.C., Hsu P.W., Erich Wu T.W. et al. Stereotactic brain biopsy: Single center retrospective analysis of complications. Clin. Neurol. Neurosurg. 2009; 111 (10): 835–839. http://doi.org/10.1016/j.clineuro.2009.08.013
13. Regis J., Bouillot P., Rouby-Volot F. et al. Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases. Neurosurgery. 1996; 39 (5): 907–912: discussion 912–904.67.
14. Yap L., Crooks D., Warnke P. Low grade astrocytoma of the pituitary stalk. Acta Neurochir. 2007; 149 (3): 307–311:discussion 311–302.68. http://doi.org/10.1007/s00701-006-1090-0
15. Dellaretti M., Reyns N., Touzet G. et al. Stereotactic biopsy for brainstem tumors: comparison of transcerebellar with transfrontal approach. Stereotact. Funct. Neurosurg. 2012; 90 (2): 79–83. http://doi.org/10.1159/000335502
16. Kickingereder P., Willeit P., Simon T., Ruge M.I. Diagnostic value and safety of stereotactic biopsy for brainstem tumors: a systematic review and meta-analysis of 1480 cases. Neurosurgery. 2013; 72 (6): 873–881. http://doi.org/10.1227/NEU.0b013e31828bf445
17. Goncalves-Ferreira A.J., Herculano-Carvalho M., Pimentel J. Stereotactic biopsies of focal brainstem lesions. Surg. Neurol. 2003; 60 (4): 311–320. discussion 320. http://doi.org/10.1016/s0090-3019(03)00379-3
Review
For citations:
Maryashev S.A., Poddubskiy A.A., Pronin I.N., Kobyakov G.L., Zhukov V.Y., Rodionov P.V., Pitskhelauri D.I. MRI imaging for planning stereotactic biopsies of the brain lesions. Medical Visualization. 2022;26(2):18-38. (In Russ.) https://doi.org/10.24835/1607-0763-1046