Table of Contents

Stereotactic biopsy indications

Frame based stereotactic biopsy (FSB) remains the 'gold standard' for obtaining diagnostic samples of intracranial lesions to guide therapy. Nevertheless, diagnostic yield is highly variable.

The diagnostic yield from contemporary FSB is high and is dependent predominantly on lesion size. 1).

They have limitations with regard to flexibility and patient comfort because of the bulky head ring attached to the patient.

The stereotactic biopsy with advanced image guidance represents a safe, reliable and minimally invasive method for pathological diagnosis of intracranial lesions. Moreover, the developments of biochemical imaging gives a new concept to the stereotactic biopsy 2).


Stereotactic biopsy indications:

a) deeply located cerebral lesions: especially near eloquent brain

b) brainstem lesions: may be approached through the cerebral hemisphere 3).

c) multiple small lesions (e.g. in some AIDS patients)

d) patient medically unable to tolerate general anesthesia for open biopsy

see Brain Biopsy for angiitis.

Brain biopsy for Creutzfeldt-Jakob Disease Diagnosis

Brain biopsy for Creutzfeldt-Jakob Disease Diagnosis

References

1)
Maragkos GA, Penumaka A, Ahrendsen JT, Salem MM, Nelton EB, Alterman RL. Factors Affecting the Diagnostic Yield of Frame-Based Stereotactic Intracranial Biopsies. World Neurosurg. 2019 Dec 25. pii: S1878-8750(19)33134-1. doi: 10.1016/j.wneu.2019.12.102. [Epub ahead of print] PubMed PMID: 31883483.
2)
Tian ZM, Wang YM, Yu X, Zhao QJ, Hui R, Liu R, Li ZC. [Clinical experience of stereotactic biopsy for the brain lesions]. Zhonghua Wai Ke Za Zhi. 2010 Oct 1;48(19):1459-62. Chinese. PubMed PMID: 21176652.
3)
Hood TW, Gebarski SS, McKeever PE, et al. Stereotactic Biopsy of Intrinsic Lesions of the Brain Stem. J Neurosurg. 1986; 65:172–176