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无框架神经导航辅助下的电磁跟踪脑活检:我是怎么做的?

Frameless neuronavigation-assisted brain biopsy with electromagnetic tracking: how I do it?

机构信息

Division of Neurosurgery, Department of Biotechnology and Life Sciences, Ospedale Di Circolo E Fondazione Macchi, University of Insubria, 21100, Varese, Italy.

出版信息

Acta Neurochir (Wien). 2022 Dec;164(12):3317-3322. doi: 10.1007/s00701-022-05252-4. Epub 2022 May 23.

DOI:10.1007/s00701-022-05252-4
PMID:35599273
Abstract

BACKGROUND

In recent years, thanks to several technological innovations, stereotactic cerebral biopsies have evolved from frame-based to frameless neuronavigation-assisted techniques.

METHODS

The authors provide herein a detailed step-by-step description of the technique, shedding light on surgical tips and how to avoid complications. The practical application of the technique is demonstrated with a high-quality video.

CONCLUSION

The neuronavigation-assisted brain biopsy with electromagnetic tracking is a "true frameless" procedure. It represents a simple, safe, and effective innovation for frameless biopsy of cerebral lesions. This technique is time efficient, offering a high degree of accuracy required for the establishment of a definitive diagnosis, enabling optimal further treatment, and thus improving patient outcome.

摘要

背景

近年来,得益于几项技术创新,立体定向脑活检已从基于框架的技术发展为无框架神经导航辅助技术。

方法

作者在此提供了该技术的详细分步描述,介绍了手术技巧和如何避免并发症。该技术的实际应用通过高质量的视频演示。

结论

电磁跟踪神经导航辅助脑活检是一种“真正的无框架”手术。它代表了一种简单、安全、有效的无框架脑病变活检创新技术。该技术省时高效,为明确诊断提供了所需的高度准确性,从而实现了最佳的进一步治疗,并改善了患者的预后。

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Frameless neuronavigation-assisted brain biopsy with electromagnetic tracking: how I do it?无框架神经导航辅助下的电磁跟踪脑活检:我是怎么做的?
Acta Neurochir (Wien). 2022 Dec;164(12):3317-3322. doi: 10.1007/s00701-022-05252-4. Epub 2022 May 23.
2
Comparison of Frame-Based Versus Frameless Image-Guided Intracranial Stereotactic Brain Biopsy: A Retrospective Analysis of Safety and Efficacy.基于框架与无框架影像引导颅内立体定向脑活检的比较:安全性和有效性的回顾性分析。
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A prospective study of the safety and efficacy of frameless, pinless electromagnetic image-guided biopsy of cerebral lesions.一项关于无框架、无针电磁影像引导脑病变活检安全性和有效性的前瞻性研究。
Neurosurgery. 2012 Mar;70(1 Suppl Operative):29-33; discussion 33. doi: 10.1227/NEU.0b013e31822d75af.
4
Frame-based stereotactic biopsy remains an important diagnostic tool with distinct advantages over frameless stereotactic biopsy.基于框架的立体定向活检仍然是一种重要的诊断工具,相对于无框架立体定向活检具有明显优势。
J Neurooncol. 2005 Jun;73(2):173-9. doi: 10.1007/s11060-004-4208-3.
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Blurring the boundaries between frame-based and frameless stereotaxy: feasibility study for brain biopsies performed with the use of a head-mounted robot.模糊基于框架和无框架立体定向之间的界限:使用头戴式机器人进行脑活检的可行性研究。
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Frameless image-guided stereotactic brain biopsy procedure: diagnostic yield, surgical morbidity, and comparison with the frame-based technique.无框架影像引导立体定向脑活检术:诊断率、手术并发症及与有框架技术的比较
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Targeting accuracy of neuronavigation: a comparative evaluation of an innovative wearable AR platform vs. traditional EM navigation.神经导航的靶向准确性:创新型可穿戴增强现实平台与传统电磁导航的比较评估
Front Digit Health. 2025 Jan 14;6:1500677. doi: 10.3389/fdgth.2024.1500677. eCollection 2024.
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Charting the success of neuronavigation in brain tumor surgery: from inception to adoption and evolution.

本文引用的文献

1
Frameless Stereotactic Biopsy with DTI-Based Tractography Integration: How to Adjust the Trajectory-A Case Series.无框架立体定向活检与基于 DTI 的束追踪整合:如何调整轨迹——病例系列。
World Neurosurg. 2020 Nov;143:346-352. doi: 10.1016/j.wneu.2020.08.041. Epub 2020 Aug 10.
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Complications after frame-based stereotactic brain biopsy: a systematic review.基于框架的立体定向脑活检的并发症:系统评价。
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Safety and accuracy of frameless electromagnetic-navigated (AXIEM)-guided brain lesion biopsies: a large single-unit study.
绘制神经导航在脑肿瘤手术中的成功历程:从诞生到采用和发展。
J Neurooncol. 2024 Oct;170(1):1-10. doi: 10.1007/s11060-024-04778-0. Epub 2024 Jul 24.
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360 Degrees Endoscopic Access to and Through the Orbit.360 度内镜进入和通过眼眶。
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Exoscopic Microsurgery: A Change of Paradigm in Brain Tumor Surgery? Comparison with Standard Operative Microscope.外视镜显微手术:脑肿瘤手术的范式转变?与标准手术显微镜的比较。
Brain Sci. 2023 Jul 6;13(7):1035. doi: 10.3390/brainsci13071035.
无框架电磁导航(AXIEM)引导脑病变活检的安全性和准确性:一项大型单中心研究。
Acta Neurochir (Wien). 2019 Dec;161(12):2587-2593. doi: 10.1007/s00701-019-04093-y. Epub 2019 Oct 23.
4
Frameless stereotactic neuronavigated biopsy: A retrospective study of morbidity, diagnostic yield, and the potential of fluorescence: A single-center clinical investigation.无框架立体定向神经导航活检:一项关于发病率、诊断率及荧光潜力的回顾性研究:单中心临床调查
Clin Neurol Neurosurg. 2019 Jun;181:28-32. doi: 10.1016/j.clineuro.2019.03.004. Epub 2019 Mar 31.
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Comparison of Frame-Based Versus Frameless Intracranial Stereotactic Biopsy: Systematic Review and Meta-Analysis.基于框架与无框架颅内立体定向活检的比较:系统评价和荟萃分析。
World Neurosurg. 2019 Jul;127:607-616.e4. doi: 10.1016/j.wneu.2019.04.016. Epub 2019 Apr 8.
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Frameless stereotactic biopsy for precision neurosurgery: diagnostic value, safety, and accuracy.无框架立体定向活检在精准神经外科中的应用:诊断价值、安全性和准确性。
Acta Neurochir (Wien). 2019 May;161(5):967-974. doi: 10.1007/s00701-019-03873-w. Epub 2019 Mar 20.
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Stereotactic Biopsy Platforms with Intraoperative Imaging Guidance.具有术中成像引导的立体定向活检平台
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The Fluoropen: a simple low-cost device to detect intraoperative fluorescein fluorescence in stereotactic needle biopsy of brain tumors.荧光笔:一种用于在脑肿瘤立体定向穿刺活检术中检测术中荧光素荧光的简单低成本设备。
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Clinical validation of true frameless stereotactic biopsy: analysis of the first 125 consecutive cases.真正的无框架立体定向活检的临床验证:对连续125例首例病例的分析。
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