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Vol. 30. Issue 4.
Pages 167-172 (July - August 2019)
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Vol. 30. Issue 4.
Pages 167-172 (July - August 2019)
Clinical Research
MRI-guided frame-based stereotactic brainstem biopsy procedure: A single-center experience
Procedimiento de biopsia de tronco de cerebro estereotáctico guiado por marco de imágenes por resonancia magnética (IRM): Una experiencia en un solo centro
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Ali Akay
Corresponding author
dr.aliakay@gmail.com

Corresponding author.
, Sertaç Işlekel
Department of Neurosurgery, Kent Hospital, İzmir, Turkey
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Table 1. Data of selected trajectory, lesion localization and complications.
Table 2. Demographic, pathologic, radiological data of brainstem biopsy patients.
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Abstract
Introduction and objectives

This study aims at presenting our experience of the MRI-guided frame-based stereotactic brainstem biopsy method, and evaluating the outcomes of the procedure.

Patients and methods

The current study involved 18 cases that underwent MRI-guided frame-based stereotactic biopsy for brainstem lesions between 2011 and 2018 in our clinic. The relevant data regarding the technique of the biopsy procedure, morbidity, histopathological diagnosis it yields and diagnostic accuracy was retrospectively analyzed.

Results

Stereotactic biopsy procedure was performed on 18 patients, including 16 adults and two children. MRI was used as guidance for the biopsy procedure in all patients. The adult patients had the biopsy under local anesthesia; as for the pediatric patients local anesthesia plus sedation was used. All patients received diagnosis based on the histopathological examination of their biopsy samples. No equivocal or negative results, and no major morbidity or mortality was seen in the patients after the procedure.

Conclusions

MRI-guided frame-based stereotactic biopsy can be considered as a safe and efficient diagnostic method for brainstem lesions when its diagnostic yield and its morbidity and/or mortality rates are evaluated. Choosing the best trajectory for each lesion, using MRI as guidance for targeting, taking a limited number of biopsy samples are valuable criteria for the decreased morbidity rates in stereotactic brainstem biopsy procedures.

Keywords:
Brainstem
Complication
Frame-based
MRI-guided stereotactic biopsy
Resumen
Introducción y objetivos

Este estudio tiene como objetivo presentar nuestra experiencia del método estereotáctico de biopsia del tronco encefálico guiado por IRM, y evaluar los resultados del procedimiento.

Pacientes y métodos

El estudio actual incluyó 18 casos que se sometieron a biopsia estereotáctica basada en un marco guiada por IRM para lesiones del tronco encefálico entre 2011 y 2018 en nuestra clínica. Los datos relevantes con respecto a la técnica del procedimiento de biopsia, la morbilidad, el diagnóstico histopatológico que produce y la precisión diagnóstica se analizaron retrospectivamente.

Resultados

Se realizó un procedimiento de biopsia estereotáctica en 18 pacientes, incluidos 16 adultos y 2 niños. La RM se utilizó como guía para el procedimiento de biopsia en todos los pacientes. Los pacientes adultos se hicieron la biopsia bajo anestesia local; en cuanto a los pacientes pediátricos se utilizó anestesia local más sedación. Todos los pacientes recibieron un diagnóstico basado en el examen histopatológico de sus muestras de biopsia. No hubo resultados equívocos ni negativos, y no se observó una mayor morbilidad o mortalidad en los pacientes después del procedimiento.

Conclusiones

La biopsia estereotáctica basada en un marco guiada por IRM se puede considerar como un método de diagnóstico seguro y eficiente para las lesiones del tronco cerebral cuando se evalúa su rendimiento diagnóstico y sus tasas de morbilidad y/o mortalidad. La elección de la mejor trayectoria para cada lesión, utilizando la RM como guía para la selección, tomando un número limitado de muestras de biopsia, son criterios valiosos para la disminución de las tasas de morbilidad en los procedimientos de biopsia estereotáctica del tronco cerebral.

Palabras clave:
Tronco encefálico
Complicación
Basado en marco
Biopsia estereotáctica guiada por IRM

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