The value of Frame-based CT guided stereotactic biopsy in the treatment of different brain tumors

M. Karan MD P. Vulekovic MD PhD

Dj. Jajic MD PhDT. Cigic Md PhD

V. Papic MD PhD Dj. Djilvesi MDB. Jelaca MD

Neurosurgery ClinicClinical Centre of Vojvodina, Novi

SadSerbia

Introduction

Frame-based stereotactic brain biopsy is an effective way for acquiring histological diagnosis.

This diagnostic method reach all brain locations

It is appropriate for patients of all ages and medical conditions

Aim

To evaluate results of the stereotactic biopsy in tretament of different intracranial lesions in our facility

Material and methods

Retrospective research at the Clinical Center of Vojvodina

From January 2009 to December 201261 patients with different intracranial lesionsAge ranged from 16 to 81, mean age of 70,15

yearsCT guided stereotactic biopsy in the general

anesthesia

Material and methods

Hystological diagnosis of deep intrinsic lesion

Diffuse, infiltrative or multiple lesionsHystological diagnosis of intracranial

lesion in patients in poor medical condition

Decompression and hystological diagnosis of cystic lesion

•Indications

Material and methodsPreoperative preparation:

Frame placementCT scan contrast agentCoordinates Transffer to the operating theater

•Laboratory tests•CT scan•MRI, MRS•Informed consent

Material and methods Standard Lexel stereotactic frame modified by Karl-Dieter Lerch CL instruments GmbH, Germany

Material and methodsPatient positioningPartialy hair shaving14mm Burr holeAspiration biopsy 8-10 bits, side-cutting

Sedan needleFrozen section PH analisysParaffine embedded specimensControl CT scan

ResultsThalamus was the most common location

(58%) of lesion. Diagnostic yield was 100% There were no transient or permanent

neurological deficits after the procedure Patients were discharged usually on the 4th or

5th postoperative day.

ComplicationsThere were no transient or permanent

neurological deficits after the procedure Karnofsky performance index was unchanged

in all of our patients

Conclusion

Frame-based stereotactic biopsy is safe and reliable procedure in the diagnosis and management of brain lesions