Universität zu Köln

Hamisch, Christina A., Minartz, Jana, Blau, Tobias, Hafkemeyer, Vanessa, Ruess, Daniel, Hellerbach, Alexandra, Grau, Stefan J. and Ruge, Maximilian I. (2019). Frame-based stereotactic biopsy of deep-seated and midline structures in 511 procedures: feasibility, risk profile, and diagnostic yield. Acta Neurochir., 161 (10). S. 2065 - 2072. WIEN: SPRINGER WIEN. ISSN 0942-0940

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Abstract

Objectives We evaluated the feasibility, safety, and diagnostic yield of frame-based stereotactic biopsies (SB) in lesions located in deep-seated and midline structures of the brain to analyze these parameters in comparison to other brain areas. Patients and methods In a retrospective, tertiary care single-center analysis, we identified all patients who received SB for lesions localized in deep-seated and midline structures (corpus callosum, basal ganglia, pineal region, sella, thalamus, and brainstem) between January 1996 and June 2015. Study participants were between 1 and 82 years. We evaluated the feasibility, procedural complications (mortality, transient and permanent morbidity), and diagnostic yield. We further performed a risk analysis of factors influencing the latter parameters. Chi-square test, Student t test, and Mann-Whitney rank-sum test were used for statistical analysis. Results Four hundred eighty-nine patients receiving 511 SB procedures (median age 48.5 years, range 1-82; median Karnofsky Performance Score 80%, range 50-100%, 43.8% female/56.2% male) were identified. Lesions were localized in the corpus callosum (29.5%), basal ganglia (17.0%), pineal region (11.5%), sella (7.8%), thalamus (4.3%), brainstem (28.8%), and others (1.1%). Procedure-related mortality was 0%, and permanent morbidity was 0.4%. Transient morbidity was 9.6%. Histological diagnosis was possible in 99.2% (low-grade gliomas 16.2%, high-grade gliomas 40.3%, other tumors in 27.8%, no neoplastic lesions 14.5%, no definitive histological diagnosis 0.8%). Only the pons location correlated significantly with transient morbidity (p < 0.001). Conclusion In experienced centers, frame-based stereotactic biopsy is a safe diagnostic tool with a high diagnostic yield also for deep-seated and midline lesions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hamisch, Christina A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Minartz, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Blau, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Hafkemeyer, Vanessa UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellerbach, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian I. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133185
DOI:	10.1007/s00701-019-04020-1
Journal or Publication Title:	Acta Neurochir.
Volume:	161
Number:	10
Page Range:	S. 2065 - 2072
Date:	2019
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	0942-0940
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RANDOMIZED PHASE-III; BRAIN-STEM TUMORS; HISTONE H3.3; SAFETY; COMPLICATIONS; EFFICACY; RADIOTHERAPY; TEMOZOLOMIDE; METAANALYSIS; MORBIDITY Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13318