Computed tomography-guided intracranial biopsy and cyst aspiration: accumulated experience in 60 patients.

We have reviewed our continued experience with computed tomography guided freehand percutaneous brain biopsy using a needle guide sheath of our own devising. The guide sheath is equipped with small metallic marker beads and throws no artifacts. It is useful in demonstrating the exact tip of the guide biopsy sheath in relation to the wall of the intracerebral lesion. The deforming response of the target lesion wall to the guide sheath and the biopsy needle is easily seen using our technique and is highly correlated to obtaining a satisfactory pathologic specimen. Combination of this guide sheath with a suitable computed tomography compatible head frame may represent a highly accurate and reliable but relatively simple guidance system.