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Safety and accuracy of frameless electromagnetic-navigated (AXIEMTM)-guided brain lesion biopsies: a large single-unit study

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

Brain biopsies are required to establish a definitive histological diagnosis for brain lesions that have been identified on imaging in order to guide further treatment for patients.

Objective

Various navigation systems are in use but little up to date evidence is available regarding the safety and accuracy of a frameless, electromagnetic technique to target brain lesions.

Methods

Data was collected retrospectively on all patients that had brain biopsies at our institution from 01/01/2010 to 31/12/2017. Operation notes, neuropathology reports, and clinical notes on electronic patient record were used to determine whether biopsy of adequate identifiable abnormal tissue was achieved, whether a definitive diagnosis was established, any adverse events occurred, and if a repeat biopsy was carried out.

Results

Three hundred seventy-one AxiEM (Medtronic, Minneapolis, USA)-guided brain tumor biopsies were performed in this 8-year period. Three hundred forty-nine (94.07%) procedures provided definitive tissue diagnosis, 22 (5.93%) were non diagnostic; in 6 cases (1.62%), repeat biopsy was performed and adverse events which caused clinical compromise were observed in 4 patients (1.08%).

Conclusions

The AxiEM is a fast, effective, and safe frameless and pinless neuronavigational system. It offers a high degree of accuracy required for the establishment of a definitive diagnosis, permitting optimal further treatment, and thus improving patient outcomes.

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Authors and Affiliations

  1. Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK

    Anastasios Giamouriadis, Francesco Vergani, Ranjeev Bhangoo, Richard Gullan & Keyoumars Ashkan

  2. King’s College London School of Medicine, London, UK

    Duranka Perera

  3. Darent Valley Hospital, Kent, UK

    Afshan Safdar

Authors
  1. Anastasios Giamouriadis
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  2. Duranka Perera
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  3. Afshan Safdar
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  4. Francesco Vergani
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  5. Ranjeev Bhangoo
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  6. Richard Gullan
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  7. Keyoumars Ashkan
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Corresponding author

Correspondence to Anastasios Giamouriadis.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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This article is part of the Topical Collection on Brain Tumors

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Giamouriadis, A., Perera, D., Safdar, A. et al. Safety and accuracy of frameless electromagnetic-navigated (AXIEMTM)-guided brain lesion biopsies: a large single-unit study. Acta Neurochir 161, 2587–2593 (2019). https://doi.org/10.1007/s00701-019-04093-y

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  • DOI: https://doi.org/10.1007/s00701-019-04093-y

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