Improving Planning Procedure in Brain Biopsy: Coupling Frame-Based Stereotaxy with Navigational Device STP 4.0

Abstract

37 consecutive patients with space-occupying intracerebral lesions were operated via frame-based stereotaxy. After CT-localizing of suspect lesions and computer-supported definition of entry and target coordinates a serial stereotactic biopsy was performed. Biopsy specimens allowed a satisfactory neuropathological examination and diagnostic result in 36 cases (97 %). Only three patients (8.1 %) showed an intraoperative bleeding, which was not associated with any postoperative CT-detectable hematoma, neurosurgical intervention nor with any neurological deficits. In summary we described the method of a computerized planning technique for stereotactic biopsy with the use of a special stereotactic planning program. High percentage of satisfactory neuropathological diagnoses and comfortable and accurate definition of target and entry coordinates justify computer support as a routine method.

Key words

Stereotaxy - ZD-System - Minimal Invasive Surgery - Neuronavigation

References

• 1 Chandrasoma P T, Smith M M, Apuzzo M LJ. Stereotactic biopsy in the diagnosis of brain masses: comparison of results of biopsy and resected surgical specimen.  Neurosurg. 1989;  24 160-165
• 2 Cohen D S, Lustgarten J H, Miller E, Khandji A G, Goodman R R. Effects of coregistration of MR to CT images on MR stereotactic accuracy.  J Neurosurg. 1995;  82 772-779
• 3 Debaene A, Gomez A, La Vieille J, Legre C A, Legre J. Stereotactic CT localization and biopsy of brain tumours using the Leksell frame.  J Neuroradiol. 1988;  15 266-275
• 4 Franzini A, Leocata F, Giorgi C, Allegranza A, Servello D, Broggi G. Role of stereotactic biopsy in multifocal brain lesion: considerations on 100 consecutive cases.  J Neurol Neurosurg Psychiatry. 1994;  57 957-960
• 5 Hariz M I, Bergenheim A T. A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional stereotaxis.  J Neurosurg. 1990;  73 565-571
• 6 Kelly P J. Volumetric stereotactic surgical resection of intra-axial brain mass lesion.  Mayo Clin Proc. 1988;  63 1186-1198
• 7 Krieger M D, Chandrasoma P T, Zee C S, Apuzzo M L. Role of stereotactic biopsy in the diagnosis and management of brain tumors.  Semin Surg Oncol. 1998;  14 13-25
• 8 Ohye C. The idea of stereotaxy toward minimally invasive neurosurgery.  Stereotact Funct Neurosurg. 2000;  74 185-193
• 9 Gumprecht H K, Widenka D C, Lumenta C B. Brainlab vectorvision neuronavigation system: technology and clinical experiences in 131 cases.  Neurosurgery. 1999;  44 97-105
• 10 Dötterl A, Trappe A E, Al-Hami S. Optimized visualization of contrast medium dependent differences in CT/MRI scans by RGB transformation.  Minim Invas Neurosurg. 1999;  42 194-197
• 11 Brommeland T, Hennig R. A new procedure for frameless computer navigated stereotaxy.  Acta Neurochir. 2000;  142 443-448
• 12 Buchholz R D, Ho H W, Rubin J P. Variables affecting the accuracy of stereotactic localization using computerized tomography.  J Neurosurg. 1993;  79 667-673
• 13 Kondziolka D, Firlik A D, Lunsford L D. Complications of stereotactic brain surgery.  Neurol Clin. 1998;  16 35-54
• 14 Daumas-Duport C, Monsaigneon V, Blond S, Munari C, Musolino A, Chodkiewicz J P, Missir O. Serial stereotactic biopsies and CT scan in gliomas: correlative study in 100 astrocytomas, oligo-astrocytomas and oligodendrocytomas.  J Neurooncol. 1987;  4 317-328
• 15 Dorward N L. Neuronavigation - the surgeon's sextant.  Br J Neurosurg. 1997;  11 101-103
• 16 McInerney J, Roberts D W. Frameless stereotaxy of the brain.  Mt Sinai J Med. 2000;  67 300-310
• 17 Tomancok B, Holl K, Wurm G, Pogady P, Fischer J. Stereotaxiegeführtes versus ultraschallgeführtes Operieren - Ein vergleichender Erfahrungsbericht.  Zentralbl Neurochir. 1996;  57 123-128
• 18 Villalobos H, Germano I M. Clinical evaluation of multimodality registration in frameless stereotaxy.  Comput Aided Surg. 1999;  4 45-49
• 19 Zamorano L, Chavantes C, Dujovny M, Malik G, Ausman J. Stereotactic endoscopic interventions in cystic and intraventricular brain lesions.  Acta Neurochir Suppl. 1992;  54 69-76
• 20 Alp M S, Dujovny M, Misra M, Charbel F T, Ausman J I. Head registration techniques for image-guided surgery.  Neurol Res. 1998;  20 31-37
• 21 Ostertag C B, Warnke P C. Neuronavigation - computerassistierte Neurochirurgie.  Nervenarzt. 1999;  70 517-521
• 22 Young B. Role of stereotactic biopsy in the management of transplant patients with intracranial lesions.  Neurol Clin. 1988;  6 639-644
• 23 Ostertag C B. Reliability of stereotactic brain tumor biopsy. In: Lunsford LD (ed). Modern stereotactic neurosurgery. Bosten: Nijhoff 1988: 129-136
• 24 Ebel H, Rust D S, Scheuerle A. Stellenwert der Stereotaxie in der Neurochirurgie.  Nervenarzt. 1996;  67 650-658
• 25 Hall W A, Martin A, Liu H, Truwit C L. Improving diagnostic yield in brain biopsy: coupling spectroscopic targeting with real-time needle placement.  J Magn Reson Imaging. 2001;  13 12-15
• 26 Ryan M J, Erickson R K, Levin D N, Pelizzari C A, MacDonald R L, Dohrmann G J. Frameless stereotaxy with real-time tracking of patient head movement and retrospective patient-imag registration.  J Neurosurg. 1996;  85 287-292
• 27 Wirtz C R, Tronnier V M, Bonsanto M M, Knauth M, Staubert A, Albert F K, Kunze S. Image-guided neurosurgery with intraoperative MRI: Update of frameless stereotaxy and radicality control.  Stereotact Funct Neurosurg. 1997;  68 39-43
• 28 Bosch D A. Indications for stereotactic biopsy in brain tumors.  Acta Neurochir. 1980;  54 154-179
• 29 Heilbrun M P, Roberts T S, Apuzzo M L, Wells Jr T H, Sabshin J K. Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotactic guidance system.  J Neurosurg. 1983;  59 217-222
• 30 Davis D H, Kelly P J, Marsh W R, Kall Goerss S J. Computer-assisted stereotactic biopsy of intracranial lesions.  Appl Neurophysiol. 1987;  50 172-177
• 31 Apuzzo M LJ, Chandrasoma P T, Cohen D, Zee C S, Zelman V. Computed imaging stereotaxy: Experience and perspective related to 500 procedures applied to brain masses.  Neurosurgery. 1987;  20 930-937
• 32 Stapleton S R, Kiriakopoulos E, Mikulis D, Drake J M, Hoffman H J, Humphreys R, Hwang P, Otsubo H, Holowka S, Logan W, Rutka J T. Combined utility of functional MRI, cortical mapping, and frameless stereotaxy in the resection of lesions in eloquent areas of brain in children.  Pediatr Neurosurg. 1997;  26 68-82
• 33 Truwit C L, Liu H. Prospective stereotaxy: a novel method of trajectory alignment using real-time image guidance.  J Magn Reson Imaging. 2001;  13 452-457
• 34 Wirtz C R, Tronnier V M, Bonsanto M M, Haßfeld S, Knauth M, Kunze S. Neuronavigation - Methoden und Ausblick.  Nervenarzt. 1998;  69 1029-1036
• 35 Schulder M, Fontana P, Lavenhar M A, Carmel P W. The relationship of imaging techniques to the accuracy of frameless stereotaxy.  Stereotact Funct Neurosurg. 1999;  72 136-141
• 36 Kondziolka D, Dempsey P K, Lunsford L D, Kestle J RW, Dolan E J, Kanal E, Tasker R R. A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determination.  Neurosurgery. 1992;  30 402-407
• 37 Maciunas R J, Galloway Jr R L, Latimer J W. The application accuracy of stereotactic frames.  Neurosurgery. 1994;  35 682-694