Gocmen Selcuk, Haciyakupoglu Ersin, Acka Gokhan, Aponte-Mendoza Zuleyka, Onguru Onder, Tasci Mustafa, Kahraman Serdar
Department of Neurosurgery, Anadolu Medical Center-Johns Hopkins Medicine, Kocaeli, Turkey.
Department of Neurosurgery, Heinrich- Braun-Klinikum, Zwickau, Germany.
Neurol India. 2025 Jan 1;73(1):82-87. doi: 10.4103/ni.ni_1344_21. Epub 2025 Feb 7.
This study aimed to report our experiences with the safety and reliability of frameless stereotactic brain biopsy, including eloquent areas and small-sized lesions.
We reviewed 88 consecutive cases of brain lesions diagnosed with neuronavigation-guided frameless stereotactic biopsy in two different neurosurgical institutes (Turkey and Germany). In addition to a standard technique, magnetic resonance imaging (MRI)-computed tomography (CT) fusion images were used to enhance the accuracy of targeting. To stabilize the navigation system on the target, the deviation from average accuracy was set at 1 mm with MRI alone. The deviation from average accuracy was 0.5 mm on fused MRI-CT images.
There were 43 males and 45 females with a mean age of 62 years. The lesion diameter was ≤2 cm in 24 patients and >2 cm in 64 patients. The lesion was in the eloquent region in 16 patients. Histopathological diagnostic success rate was 98.8%. Overall, 56, 21, 5, and 3 patients were diagnosed with glial tumor, lymphoma, abscess, and metastasis, respectively, and 1 patient each with acute myeloid leukemia, radiation necrosis, and nonneoplastic neuroglial tissue was observed as a pathological result.
The frameless biopsy system is gaining popularity because it is reliable and has a low complication rate. It provides rapid and accurate pathological results even for deeply located or small (size ≤2 cm) lesions. The frameless biopsy systems were used safely with a very high diagnostic accuracy rate according to the learning curve.
本研究旨在报告我们在无框架立体定向脑活检的安全性和可靠性方面的经验，包括功能区和小病灶。
我们回顾了在两个不同神经外科机构（土耳其和德国）连续进行的88例经神经导航引导的无框架立体定向活检诊断的脑病变病例。除了标准技术外，还使用磁共振成像（MRI）-计算机断层扫描（CT）融合图像来提高靶向准确性。为了在目标上稳定导航系统，仅使用MRI时将平均准确性偏差设定为1毫米。在MRI-CT融合图像上，平均准确性偏差为0.5毫米。
共有43例男性和45例女性，平均年龄62岁。24例患者的病变直径≤2厘米，64例患者的病变直径>2厘米。16例患者的病变位于功能区。组织病理学诊断成功率为98.8%。总体而言，分别有56例、21例、5例和3例患者被诊断为胶质瘤、淋巴瘤、脓肿和转移瘤，病理结果观察到1例急性髓系白血病、放射性坏死和非肿瘤性神经胶质组织患者。
无框架活检系统因其可靠且并发症发生率低而越来越受欢迎。即使对于深部或小（直径≤2厘米）病灶，它也能提供快速准确的病理结果。根据学习曲线，无框架活检系统使用安全，诊断准确率非常高。
