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Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies

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Abstract

Purpose

Targeted treatment for brainstem lesions requires above all a precise histopathological and molecular diagnosis. In the current technological era, robot-assisted stereotactic biopsies represent an accurate and safe procedure for tissue diagnosis. We present our center’s experience in frameless robot-assisted biopsies for brainstem lesions.

Methods

We performed a retrospective analysis of all patients benefitting from a frameless robot-guided stereotactic biopsy at our University Hospital, from 2001 to 2017. Patients consented to the use of data and/or images. The NeuroMate® robot (Renishaw™, UK) was used. We report on lesion location, trajectory strategy, histopathological diagnosis and procedure safety.

Results

Our series encompasses 96 patients (103 biopsies) treated during a 17 years period. Mean age at biopsy: 34.0 years (range 1–78). Most common location: pons (62.1%). Transcerebellar approach: 61 procedures (59.2%). Most common diagnoses: diffuse glioma (67.0%), metastases (7.8%) and lymphoma (6.8%). Non conclusive diagnosis: 10 cases (9.7%). After second biopsy this decreased to 4 cases (4.1%). Overall biopsy diagnostic yield: 95.8%. Permanent disability was recorded in 3 patients (2.9%, all adults), while transient complications in 17 patients (17.7%). Four cases of intra-tumoral hematoma were recorded (one case with rapid decline and fatal issue). Adjuvant targeted treatment was performed in 72.9% of patients. Mean follow-up (in the Neurosurgery Department): 2.2 years.

Conclusion

Frameless robot-assisted stereotactic biopsies can provide the initial platform towards a safe and accurate management for brainstem lesions, offering a high diagnostic yield with low permanent morbidity.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Neurosurgery Department, CHU-Lille, Roger Salengro Hospital, 1, rue Emile Laine, 59000, Lille, France

    Iulia Peciu-Florianu, Victor Legrand, Serge Blond, Gustavo Touzet & Nicolas Reyns

  2. U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, University of Lille, INSERM, CHU-Lille, F-59000, Lille, France

    Nicolas Reyns

  3. Neurology Department, Neuro-Oncology Unit, CHU-Lille, 59000, Lille, France

    Apolline Monfilliette-Djelad

  4. Neuropathology Department, CHU-Lille, 59000, Lille, France

    Claude-Alain Maurage

  5. Neuroradiology Department, CHU-Lille, 59000, Lille, France

    Quentin Vannod-Michel

Authors
  1. Iulia Peciu-Florianu
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  2. Victor Legrand
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  3. Apolline Monfilliette-Djelad
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  4. Claude-Alain Maurage
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  5. Quentin Vannod-Michel
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  6. Serge Blond
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  7. Gustavo Touzet
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  8. Nicolas Reyns
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Iulia Peciu-Florianu and Victor Legrand. The first draft of the manuscript was written by Iulia Peciu-Florianu and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Iulia Peciu-Florianu.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of College de Neurochirurgie who determined that our study meet the criteria for ethical approval: n° IRB00011687.

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Informed consent was obtained from all individual participants included in the study.

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Peciu-Florianu, I., Legrand, V., Monfilliette-Djelad, A. et al. Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies. J Neurooncol 157, 109–119 (2022). https://doi.org/10.1007/s11060-022-03952-6

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  • DOI: https://doi.org/10.1007/s11060-022-03952-6

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