Santa Casa de BH e Faculdade Santa Casa BH, Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
Neurosurg Rev. 2024 Sep 3;47(1):523. doi: 10.1007/s10143-024-02758-6.
Stereotactic needle biopsy stands as a crucial method for diagnosing intracranial lesions unsuitable for surgical intervention. Nonetheless, the potential for sampling errors lead to innovative approaches to enhance diagnostic precision. This study contrasts the outcomes of patients undergoing fluorescein-assisted frameless stereotactic needle biopsy with those receiving traditional biopsies to evaluate the impact on diagnostic accuracy and safety. This study included patients with contrast-enhancing intracranial lesions, comprising a prospective group undergoing fluorescein-assisted biopsies and a retrospective group undergoing conventional biopsies at the same institution. We've collected data on demographics, procedural specifics, diagnostic outcomes, and postoperative events. A comparative analysis involved 43 patients who received fluorescein-assisted biopsies against 77 patients who underwent conventional biopsies. The average age was 60.5 years. The fluorescein group exhibited a 93% success rate in diagnosis, markedly higher than the 70.1% in the non-fluorescein group (OR = 5.67; 95%IC: 1.59-20.24; p < 0.01). The rate of complications was statistically similar across both cohorts. Despite its established value, stereotactic needle biopsy is susceptible to inaccuracies and complications. The application of fluorescence-based adjuncts like 5-ALA and fluorescein has been investigated to improve diagnostic fidelity and reduce risks. These technologies potentially minimize the necessity for multiple biopsies, decrease surgical duration, and provide immediate verification of tumor presence. Fluorescein-assisted stereotactic biopsy emerges as an effective, secure alternative to conventional methods.
立体定向针活检是诊断不适合手术干预的颅内病变的重要方法。然而，采样误差的可能性导致了创新方法的出现，以提高诊断精度。本研究对比了接受荧光辅助无框架立体定向针活检和传统活检的患者的结果，以评估对诊断准确性和安全性的影响。本研究包括增强对比颅内病变的患者，包括在同一机构接受荧光辅助活检的前瞻性组和接受传统活检的回顾性组。我们收集了人口统计学、程序细节、诊断结果和术后事件的数据。对比分析涉及 43 名接受荧光辅助活检的患者和 77 名接受传统活检的患者。平均年龄为 60.5 岁。荧光组的诊断成功率为 93%，明显高于非荧光组的 70.1%（OR=5.67；95%CI：1.59-20.24；p<0.01）。两组的并发症发生率在统计学上相似。尽管立体定向针活检已经确立了其价值，但它仍容易出现不准确和并发症。已经研究了基于荧光的辅助手段，如 5-ALA 和荧光素，以提高诊断准确性并降低风险。这些技术有可能减少多次活检的必要性、缩短手术时间，并提供肿瘤存在的即时验证。荧光辅助立体定向活检是一种有效、安全的替代传统方法。
