TY - JOUR
T1 - Spectroscopy-supported frame-based image-guided stereotactic biopsy of parenchymal brain lesions
T2 - Comparative evaluation of diagnostic yield and diagnostic accuracy
AU - Chernov, Mikhail F.
AU - Muragaki, Yoshihiro
AU - Ochiai, Taku
AU - Taira, Takaomi
AU - Ono, Yuko
AU - Usukura, Masao
AU - Maruyama, Takashi
AU - Nakaya, Kotaro
AU - Nakamura, Ryoichi
AU - Iseki, Hiroshi
AU - Kubo, Osami
AU - Hori, Tomokatsu
AU - Takakura, Kintomo
N1 - Funding Information:
This work was supported by the Program for Promoting the Establishment of Strategic Research Centers, Special Coordination Funds for Promoting Science and Technology, Ministry of Education, Culture, Sports, Science and Technology (Japan). The authors are thankful to Dr. Craig Gough for helping with manuscript preparation.
PY - 2009/7
Y1 - 2009/7
N2 - 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.
AB - 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.
KW - Brain tumor
KW - Diagnostic accuracy
KW - Diagnostic yield
KW - Metabolic imaging
KW - Proton magnetic resonance spectroscopy
KW - Stereotactic biopsy
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U2 - 10.1016/j.clineuro.2009.03.006
DO - 10.1016/j.clineuro.2009.03.006
M3 - Article
C2 - 19427112
AN - SCOPUS:67349145333
SN - 0303-8467
VL - 111
SP - 527
EP - 535
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
IS - 6
ER -