Abstract
Objectives
To evaluate the safety, feasibility and diagnostic performance of real-time MR-guided brain biopsy using a 1.0-T open MRI scanner.
Methods
Medical records of 86 consecutive participants who underwent brain biopsy under the guidance of a 1.0-T open MRI scanner with real-time and MR fluoroscopy techniques were evaluated retrospectively. All procedures were performed under local anaesthesia and intravenous conscious sedation. Diagnostic yield, diagnostic accuracy, complication rate and procedure duration were assessed. The lesions were divided into two groups according to maximum diameters: ≤ 1.5 cm (n = 16) and > 1.5 cm (n = 70). The two groups were compared using Fisher’s exact test.
Results
Diagnostic yield and diagnostic accuracy were 95.3% and 94.2%, respectively. The diagnostic yield of lesions ≤ 1.5 cm and > 1.5 cm were 93.8% and 95.7%, respectively. There was no significant difference in diagnostic yield between the two groups (p > 0.05). Mean procedure duration was 41 ± 5 min (range 33–49 min). All biopsy needles were placed with one pass. Complication rate was 3.5% (3/86). Minor complications included three cases of a small amount of haemorrhage. No serious complications were observed.
Conclusions
Real-time MR-guided brain biopsy using a 1.0-T open MRI scanner is a safe, feasible and accurate diagnostic technique for pathological diagnosis of brain lesions. The procedure duration is shortened and biopsy work flow is simplified. It could be considered as an alternative for brain biopsy.
Key Points
• Real-time MRI-guided brain biopsy using a 1.0-T open MRI scanner is safe, feasible and accurate.
• No serious complications occurred in real-time MRI-guided brain biopsy.
• Procedure duration is shortened and biopsy work flow is simplified.
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Abbreviations
- NeuroICU:
-
Neuro intensive care unit
- RF:
-
Radiofrequency
- T1W-TSE:
-
T1-weighted turbo spin echo
- T2W-TSE:
-
T2-weighted turbo spin echo
References
Ivan ME, Yarlagadda J, Saxena AP et al (2014) Brain shift during bur hole-based procedures using interventioanl MRI. J Neurosurg 121:149–160
Ersahin M, Karaaslan N, Gurbuz MS et al (2011) The safety and diagnostic value of frame-based and CT-guided stereotactic brain biopsy technique. Turk Neurosurg 21:582–590
Lobão CA, Nogueira J, Souto AA, Oliveira JA (2009) Cerebral biopsy: comparison between frame-based stereotaxy and neuronavigation in an oncology center. Arq Neuropsiquiatr 67:876–881
Hall WA (1998) The safety and efficacy of stereotactic biopsy for intracranial lesions. Cancer 82:1749–1755
Nishihara M, Sasayama T, Kudo H, Kohmura E (2011) Morbidity of stereotactic biopsy for intracranial lesions. Kobe J Med Sci 56:E148–E153
Lu Y, Yeung C, Radmanesh A, Wiemann R, Black PM, Golby AJ (2015) Comparative effectiveness of frame-based, frameless, and intraoperative magnetic resonance imaging–guided brain biopsy techniques. World Neurosurgery 83:261–268
Mohyeldin A, Lonser RR, Elder JB (2016) Real-time magnetic resonance imaging-guided frameless stereotactic brain biopsy: technical note. J Neurosurg 124:1039–1046
Hall WA, Martin AJ, Liu H, Nussbaum ES, Maxwell RE, Truwit CL (1999) Brain biopsy using high-field strength interventional magnetic resonance imaging. Neurosurgery 44:807–813
Fischbach F, Bunke J, Thormann M et al (2011) MR-guided freehand biopsy of liver lesions with fast continuous imaging using a 1.0-T open MRI scanner: experience in 50 patients. Cardiovasc Intervent Radiol 34:188–192
Fischbach F, Eggemann H, Bunke J, Wonneberger U, Ricke J, Strach K (2012) MR-guided freehand biopsy of breast lesions in a 1.0-T open MR imager with a near-real-time interactive platform: preliminary experience. Radiology 265:359–370
Streitparth F, Walter T, Wonneberger U et al (2014) MR guidance and thermometry of percutaneous laser disc decompression in open MRI: an ex vivo study. Cardiovasc Intervent Radiol 37:777–783
Maurer MH, Disch AC, Hartwig T et al (2014) Outcome study of real-time MR-guided cervical periradicular injection therapy in an open 1.0 Tesla MRI system. Cardiovasc Intervent Radiol 37:756–762
Fischbach F, Lohfink K, Gaffke G et al (2013) Magnetic resonance-guided freehand radiofrequency ablation of malignant liver lesions: a new simplified and time-efficient approach using an interactive open magnetic resonance scan platform and hepatocyte-specific contrast agent. Invest Radiol 48:422–428
McGirt MJ, Woodworth GF, Coon AL et al (2005) Independent predictors of morbidity after image-guided stereotactic brain biopsy: a risk assessment of 270 cases. J Neurosurg 102:897–901
Paleologos TS, Dorward NL, Wadley JP, Thomas DG (2001) Clinical validation of true frameless stereotactic biopsy: analysis of the first 125 consecutive cases. Neurosurgery 49:830–837
Air EL, Leach JL, Warnick RE, McPherson CM (2009) Comparing the risks of frameless stereotactic biopsy in eloquent and noneloquent regions of the brain: a retrospective review of 284 cases. J Neurosurg 111:820–824
Shooman D, Belli A, Grundy PL (2010) Image-guided frameless stereotactic biopsy without intraoperative neuropathological examination. J Neurosurg 113:170–178
Dammers R, Schouten JW, Haitsma IK, Vincent AJ, Kros JM, Dirven CM (2010) Towards improving the safety and diagnostic yield of stereotactic biopsy in a single center. Acta Neurochir (Wien) 152:1915–1921
Owen CM, Linskey ME (2009) Frame-based stereotaxy in a frameless era: current capabilities, relative role, and the positive and negative predictive values of blood through the needle. J Neurooncol 93:139–149
Woodworth G, McGirt MJ, Samdani A, Garonzik I, Olivi A, Weingart JD (2005) Accuracy of frameless and frame-based image-guided stereotactic brain biopsy in the diagnosis of glioma: comparison of biopsy and open resection specimen. Neurol Res 27:358–362
Woodworth GF, McGirt MJ, Samdani A, Garonzik I, Olivi A, Weingart JD (2006) Frameless image-guided stereotactic brain biopsy procedure: diagnostic yield, surgical morbidity, and comparison with the frame-based technique. J Neurosurg 104:233–237
Yamaguchi F, Takahashi H, Teramoto A (2007) Photodiagnosis for frameless stereotactic biopsy of brain tumor. Photodiagn Photodyn Ther 4:71–75
Grunert P, Espinosa J, Busert C et al (2002) Stereotactic biopsied guided by an optical navigation system: technique and clinical experience. Minim Invasive Neurosurg 45:11–15
Waters JD, Gonda DD, Reddy H, Kasper EM, Warnke PC, Chen CC (2013) Diagnostic yield of stereotactic needle-biopsies of sub-cubic centimeter intracranial lesions. Surg Neurol Int 4:S176–S181
Krieqer MD, Chandrasoma PT, Zee CS, Apuzzo ML (1998) Role of stereotactic biopsy in the diagnosis and management of brain tumors. Semin Surg Oncol 14:13–25
Smith JS, Quinones-Hinojosa A, Barbaro NM, McDermott MW (2005) Frame-based stereotactic biopsy remains an important diagnostic tool with distinct advantages over frameless streotatic biopsy. J Neurooncol 73:173–179
Gempt J, Buchmann N, Ryang YM et al (2012) Frameless image-guided stereotaxy with real-time visual feedback for brain biopsy. Acta Neurochir (Wien) 154:1663–1667
Dammers R, Haitsma IK, Schouten KJM, Avezaat CJ, Vincent AJ (2008) Safety and efficacy of frameless and frame-based intracranial biopsy techniques. Acta Neurochir (Wien) 150:23–29
Frati A, Pichierri A, Bastianello S et al (2011) Frameless stereotactic cerebral biopsy: our experience in 296 cases. Stereotact Funct Neurosurg 89:234–245
Khatab S, Spliet W, Woerdeman PA (2014) Frameless image-guided stereotactic brain biopsies: emphasis on diagnostic yield. Acta Neurochir (Wien) 156:1441–1450
Funding
This study has received funding by Shandong Science and technology development plan (2014GGH218005).
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The scientific guarantor of this publication is Chengli Li.
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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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All authors kindly provided statistical advice for this manuscript.
No complex statistical methods were necessary for this paper.
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Written informed consent was obtained from all subjects (patients) in this study.
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Institutional review board approval was obtained.
Methodology
• retrospective
• diagnostic or prognostic study
• performed at one institution
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He, X., Liu, M., Liu, C. et al. Real-time MR-guided brain biopsy using 1.0-T open MRI scanner. Eur Radiol 29, 85–92 (2019). https://doi.org/10.1007/s00330-018-5531-y
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DOI: https://doi.org/10.1007/s00330-018-5531-y