Mazzucchi Edoardo, Galieri Gianluca, Pignotti Fabrizio, Rinaldi Pierluigi, Sabatino Giovanni, La Rocca Giuseppe
Unit of Neurosurgery, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy.
Institute of Neurosurgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, 00168 Rome, Italy.
J Pers Med. 2024 Mar 28;14(4):357. doi: 10.3390/jpm14040357.
Stereotactic needle biopsy (SNB) may be performed to collect tissue samples from lesions not amenable to open surgery. Integration of tractography, intraoperative imaging and fluorescence has been applied to reduce risk of complications and confirm the adequacy of bioptic specimens. Clinical and radiological data from patients who underwent stereotactic needle biopsy with the use of intraoperative CT, tractography and 5-aminolevulinic acid (5-ALA) fluorescence in a single Hospital were retrospectively reviewed to evaluate the accuracy and safety of the procedure. Seven patients were included in the study, and all the collected specimens showed red fluorescence. In six of them, the final histopathological diagnosis was grade 4 glioblastoma IDH-wt and in the other case it was Diffuse large B-Cell Lymphoma. The integration of tractography, intraoperative CT and 5-ALA as an intraoperative marker of diagnostic samples may be suggested in biopsies of suspect gliomas and lymphomas. The cost-effectiveness of the procedure should be evaluated in future studies.
立体定向针吸活检（SNB）可用于从无法进行开放手术的病变中采集组织样本。术中神经纤维束成像、术中成像和荧光技术的结合已被应用于降低并发症风险并确认活检标本的充分性。对在一家医院接受使用术中CT、神经纤维束成像和5-氨基乙酰丙酸（5-ALA）荧光进行立体定向针吸活检的患者的临床和放射学数据进行回顾性分析，以评估该手术的准确性和安全性。该研究纳入了7名患者，所有采集的标本均显示红色荧光。其中6例最终组织病理学诊断为4级异柠檬酸脱氢酶野生型胶质母细胞瘤，另一例为弥漫性大B细胞淋巴瘤。在疑似胶质瘤和淋巴瘤的活检中，可建议将神经纤维束成像、术中CT和5-ALA作为诊断样本的术中标记物相结合。该手术的成本效益应在未来的研究中进行评估。
