Frameless Neuronavigation Assisted Brain Biopsy: Safety, Efficiency and Our Experience

Abstract

Objective:Brain biopsy is a commonly used method for diagnosing deeply located or generalized intraparenchymal brain lesions and determining the further treatment options. A number of comparative studies have been performed with open surgical biopsy, framed or frameless biopsy methods. In this study, we shared the results of the framless neuronavigation assisted biopsy in our clinic and diagnostic sensitivity of this method.Methods:Twenty-four cases of frameless neuronavigation assisted biopsy for cerebral intraparenchymal lesions between 2014 and 2016 were retrospectively reviewed. Seven cases had thalamic and 1 case had hypothalamic deep masses. Four cases had deeply located lesions on eloquent brain areas, 6 patients had diffuse lesions passing to the opposite cerebral hemisphere. Five cases had multiple cerebral masses and 1 case had exophytic mass originating from brainstem.Results:Histopathologic diagnosis in 14 of 24 cases was grade IV glial tumor, diffuse grade III glial tumor in 1 and diffuse grade II glial tumor in 2. Histopathologic diagnosis of 5 cases were reported as B-cell lymphoma, whereas 1 case was reported as having gastrointestinal system metastasis. In one case, the diagnosis could not be made despite the biopsy was performed twice. The mitotic index (ki-67) showing tumor aggressiveness was 28.43% and range was 1-90%. Twenty three of the 24 patients had a definite histopathological diagnosis and 1 patient had no histopathological diagnosis.Conclusion:Frameless neuronavigation assisted brain biopsy is one of the most sensitive, safe and easy-to-perform stereotactic biopsy methods. The method which will be used with high accuracy and planning of biopsy require surgical experience.

Keywords

• Biopsy
• brain
• neuronavigation