Spectroscopy-supported frame-based image-guided stereotactic biopsy of parenchymal brain lesions: Comparative evaluation of diagnostic yield and diagnostic accuracy

Mikhail F. Chernov*, Yoshihiro Muragaki, Taku Ochiai, Takaomi Taira, Yuko Ono, Masao Usukura, Takashi Maruyama, Kotaro Nakaya, Ryoichi Nakamura, Hiroshi Iseki, Osami Kubo, Tomokatsu Hori, Kintomo Takakura

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Objective: Comparative evaluation of diagnostic efficacy of stereotactic brain biopsy performed with and without additional use of spectroscopic imaging (1H-MRS) for target selection was done. Methods: From 2002 to 2006, 30 patients with parenchymal brain lesions underwent 1H-MRS-supported frame-based stereotactic biopsy, whereas in 39 others MRI-guided technique was used. Comparison of diagnostic yield of the procedure in these two groups was performed. Additionally, the diagnostic accuracy was evaluated in 37 lesions, which were surgically resected within 1 month thereafter. Results: Stereotactic biopsy permitted establishment of a definitive histopathological diagnosis in 57 cases and diagnosis of low-grade glioma without specific tumor typing in 8 cases. In 4 cases tissue sampling was non-diagnostic. In 5 out of 8 cases with incomplete diagnosis and in all non-diagnostic cases target selection was performed without the use of 1H-MRS (P = 0.2073). The diagnostic yields of 1H-MRS-supported and MRI-guided procedures were 100% and 90%, respectively (P = 0.1268). Comparison of the histopathological diagnoses after stereotactic biopsy and surgical resection revealed complete diagnostic agreement in 13 cases, minor disagreement in 14 cases, and major disagreement in 10 cases. Among these last 10 cases, initial undergrading of non-enhancing WHO grade III gliomas was the most common (7 cases). The diagnostic accuracy of 1H-MRS-supported and MRI-guided procedures was 67% and 79%, respectively (P = 0.4756). Conclusion: While in the present study the diagnostic yield of 1H-MRS-supported frame-based stereotactic brain biopsy was 100%, its statistically significant diagnostic advantages over MRI-guided technique were not proved. Optimal selection of the spectroscopic target for tissue sampling remains unclear.

Original languageEnglish
Pages (from-to)527-535
Number of pages9
JournalClinical Neurology and Neurosurgery
Issue number6
Publication statusPublished - 2009 Jul
Externally publishedYes


  • Brain tumor
  • Diagnostic accuracy
  • Diagnostic yield
  • Metabolic imaging
  • Proton magnetic resonance spectroscopy
  • Stereotactic biopsy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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