Clinical Validation of True Frameless Stereotactic Biopsy: Analysis of the First 125 Consecutive Cases
- 1 October 2001
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 49 (4), 830-837
- https://doi.org/10.1097/00006123-200110000-00009
Abstract
OBJECTIVE: A lockable guide device, adjustable for positioning, was used to obtain samples for tissue analysis during brain biopsy procedures performed using an interactive image guidance system. Clinical validation of this technique, which was developed for true frameless stereotactic biopsies, and analyses of the histological yield, complication rate, and patient demographic characteristics for a large series of frameless stereotactic biopsies were the purposes of this study. METHODS: Demographic, radiological, surgical, and clinical data were prospectively collected for a series of 125 frameless stereotactic biopsies performed using the technique described in detail previously. RESULTS: Eighty-six procedures were magnetic resonance imaging-directed and 39 were computed tomography-directed. The mean diameter of the biopsied lesions was 36 mm, and the mean distance from the skin was 35.8 mm. Sixteen percent of the patients harbored multiple lesions, and 5.6% of the biopsied lesions were infratentorial. The mean operative time (including the entire anesthetic time) was 1.5 hours. The smear examination findings were corroborated by conclusive histological results in 96% of the cases, and definitive positive diagnoses were obtained in 122 cases (97.6%). Ten patients experienced surgical complications, but the sustained morbidity rate was 2.4% (including the death of a patient who was in critical clinical condition preoperatively and who died 2 mo later as a result of a chest infection; mortality rate, 0.8%). CONCLUSION: This true frameless stereotactic biopsy technique was associated with low morbidity and mortality rates and an excellent diagnostic yield, with overall results at least as good as those observed for frame-based stereotaxy. The excellent accuracy results demonstrated previously and statistically significant reductions in operative time, as well as improved image presentation, target selection, and simplicity, support the use of this frameless stereotactic technique in preference to frame-based biopsy techniques.Keywords
This publication has 21 references indexed in Scilit:
- Frameless stereotaxy with scalp-applied fiducial markers for brain biopsy procedures: experience in 218 casesJournal of Neurosurgery, 1999
- Accuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studiesJournal of Neurosurgery, 1999
- Postimaging brain distortion: magnitude, correlates, and impact on neuronavigationJournal of Neurosurgery, 1998
- Clinical Experience with Intracranial Brain Needle Biopsy Using Frameless Surgical NavigationComputer Aided Surgery, 1998
- Development and Implementation of Intraoperative Magnetic Resonance Imaging and Its Neurosurgical ApplicationsNeurosurgery, 1997
- Clinical Introduction of an Adjustable Rigid Instrument Holder for Frameless Stereotactic InterventionsComputer Aided Surgery, 1997
- Neuronavigation – Impact on Operating TimeStereotactic and Functional Neurosurgery, 1997
- Diagnosis of Suspected Intracranial MetastasesNeurosurgery Clinics of North America, 1996
- Pitfalls in Diagnostic Stereotactic Brain SurgeryPublished by Springer Science and Business Media LLC ,1988
- Computed Imaging Stereotaxy: Experience and Perspective Related to 500 Procedures Applied to Brain MassesNeurosurgery, 1987