Magnetic resonance-guided stereotactic biopsies: results in 100 consecutive cases

Abstract

Background: We present the results of 100 consecutive magnetic resonance (MR)-guided biopsies in cases where computerised tomography (CT) guiding was considered dangerous or impossible.

Method: MR guiding was preferred to CT guiding for cases where lesions were located in the central area, or were not clearly visible on CT scan, or where the visualization of vessels was considered necessary. For most of the patients, calculation of target co-ordinates was performed using dedicated software enabling trajectory previsualization. There were 62 cases of contrast enhanced lesions, 32 cases of lesions without contrast enhancement, and 6 cases of very small lesions appearing hyperintense on T2-weighted images.

Findings: Biopsies allowed a histological diagnosis in 92 cases. In 8 cases, the biopsy was negative (necrosis, gliosis or normal brain tissue). Three patients had a transient worsening of their neurological disturbances. Two patient had a non-regressive loss of motor function. No patient died.

Interpretation: MR guiding for stereotactic biopsies was effective for CT-invisible or ill-defined lesions, lesions located in functional or densely vascularized areas and in the brain stem. The rate of postoperative complications was equivalent to or less than that reported in series of CT-guided biopsies.