Ragel Brian T, Ryken Timothy C, Kalkanis Steven N, Ziu Mateo, Cahill Daniel, Olson Jeffrey J
Rebound Orthopedics and Neurosurgery, 200 NE Mother Joseph Place, Suite 210, Vancouver, WA, 98664, USA.
Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS, USA.
J Neurooncol. 2015 Dec;125(3):481-501. doi: 10.1007/s11060-015-1866-2. Epub 2015 Nov 3.
What is the optimal role of biopsy in the initial management of presumptive low-grade glioma in adults?
Adult patients with imaging suggestive of a low-grade glioma.
Stereotactic biopsy is recommended when definitive surgical resection is limited by lesions that are deep-seated, not resectable, and/or located within eloquent cortex, or in patients unable to undergo craniotomy due to medical co-morbidities to obtain the critical tissue diagnosis needed for targeted treatment planning for patients with low-grade gliomas.
What is the best technique for brain biopsy?
Adult patients with imaging suggestive of a low-grade glioma.
Frameless and frame-based stereotactic brain biopsy for low-grade gliomas are recommended based on clinical circumstances as they provide similar diagnostic yield, diagnostic accuracy, morbidity, and mortality. It is recommended the surgeon consider advanced imaging techniques (e.g., perfusion, spectroscopy, metabolic studies) to target specific regions of interest to potentially improve diagnostic accuracy.
活检在成人疑似低级别胶质瘤初始治疗中的最佳作用是什么？
影像学提示为低级别胶质瘤的成年患者。
当明确的手术切除受深部、不可切除和/或位于功能区皮质内的病变限制，或因合并症无法进行开颅手术的患者，为获得低级别胶质瘤患者靶向治疗计划所需的关键组织诊断时，建议进行立体定向活检。
脑活检的最佳技术是什么？
影像学提示为低级别胶质瘤的成年患者。
根据临床情况，推荐对低级别胶质瘤进行无框架和有框架立体定向脑活检，因为它们具有相似的诊断率、诊断准确性、发病率和死亡率。建议外科医生考虑采用先进的成像技术（如灌注、光谱、代谢研究）来靶向特定的感兴趣区域，以潜在地提高诊断准确性。
