Feasibility of freehand CT and 3-T MR guided brain aspiration biopsies with 18/20-gauge coaxial needles


Algin O., AYBERK G.

JAPANESE JOURNAL OF RADIOLOGY, cilt.40, sa.7, ss.740-748, 2022 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 40 Sayı: 7
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s11604-022-01257-2
  • Dergi Adı: JAPANESE JOURNAL OF RADIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.740-748
  • Anahtar Kelimeler: Central nervous system, Tumors, MRI, 3-tesla (3T), Brain biopsy, Lymphoma, STEREOTACTIC BIOPSY, MANAGEMENT
  • Ankara Üniversitesi Adresli: Hayır

Özet

Background and purpose An accurate histopathological examination with minimal neuronal damage is essential for optimizing treatment strategies of central nervous system lesions. We investigated the feasibility and safety of CT and 3-tesla (3 T) MR-guided freehand brain aspiration biopsies with 18/20-gauge coaxial needles in performing a single imaging unit. Materials and methods We reviewed CT and 3 T-MR guided freehand aspiration biopsies with 18/20-gauge coaxial needles of 33 patients (11-female and 22-male, mean and median ages: 53 years, min-max 21-79 years) in our tertiary hospital within an 8-year-period were included in this retrospective study. Lesion sizes, diagnostic yield, morbidity, and mortality rates of these biopsies without a scalp incision, surgical burr-hole, or stereotactic-instrumentation/neuro-navigation guidance were assessed. All biopsies were performed with local anesthesia and sedation within a single imaging unit of our radiology department. All free-hand biopsies were done as in-patient procedures and the patients were closely observed after the biopsies. Results The mean diameter of the lesions was 27 mm (median 25; range 15-46 mm). The diagnostic yield of all free-hand brain biopsies was 88% [one inconclusive result (90%) for 3 T-MR; three inconclusive results (87%) for CT]. There was no major hemorrhage or hematoma, no clinical deterioration, or no infection in our patients on early- and late-phase examinations. Postprocedural minor hemorrhage with a <= 2 cm diameter was observed in two patients. The morbidity rate of the study population is 6%. There was no procedure-related infection or mortality in the post-procedural 3 weeks. Conclusions Freehand CT or 3 T-MR guided aspiration biopsy was a safe and feasible method for pathological diagnosis of intracranial lesions. Biopsy workflow was simplified with this technique. It could be considered a valuable alternative for stereotaxic biopsies, especially for centers that do not have stereotaxic equipment or experience.