Intraoperative magnetic resonance-guided frameless stereotactic biopsies - initial clinical experience

Abstract

Background and purpose: We present our early experience in intraoperative magnetic resonance (iMRI)-guided stereotactic frameless biopsies with special regard to its safety, efficacy and diagnostic value.

Material and methods: The records of patients who underwent frameless stereotactic iMRI-guided biopsies between June 2009 and April 2011 were analysed prospectively. All the operations were performed under local anaesthesia, with the use of a passive side-cutting biopsy needle. The needle was introduced into the pathological lesion with the help of optic neuronavigation system guidance. The iMRI scans served as reference images. We analysed the patients' demographic and epidemiological data, the preparation and surgery times, diagnostic values of collected specimens, lengths of the hospital stay (LOS) and the complication rate.

Results: Fifteen iMRI-guided stereotactic biopsies were performed in the analysed period. The mean patient age was 52 ± 18 yrs, the median WHO score was 2 (range: 1-3), there were 9 (60%) males in the study group. The average preparation time was 53 ± 24 minutes and the operation time 69 ± 25 minutes. No major complications were noted. The median total length of hospital stay was 5 days. The histopathological diagnoses were as follows: glioblastoma multiforme - 6 cases, low-grade gliomas - 4 cases, lymphomas - 3 cases, and other pathologies - 2 cases. In all the cases biopsy material allowed specified histopathological diagnoses to be obtained.

Conclusions: Frameless stereotactic iMRI-guided brain tumour biopsy is a safe and diagnostically effective procedure. The use of iMRI might increase the diagnostic value and safety of stereotactic biopsy and positively influence its economic balance.