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

D. Winkler; C. Trantakis; D. Lindner; A. Richter; J. Schober; J. Meixensberger

doi:10.1055/s-2003-37964

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2003; 46(1): 37-40
DOI: 10.1055/s-2003-37964

Original Article

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

D. Winkler¹ , C. Trantakis¹ , D. Lindner¹ , A. Richter² , J. Schober³ , J. Meixensberger¹

¹Department of Neurosurgery, University of Leipzig, Germany
²Department of Radiology, University of Leipzig, Germany
³Department of Neuropathology, University of Leipzig, Germany

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

Full Text

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

D. Winkler, M. D.

Klinik für Neurochirurgie · Universität Leipzig

Johannisallee 34

04103 Leipzig

Germany

Fax: + 49-341-9712009

Phone: + 49-341-9712000

Email: wind@medizin.uni-leipzig.de