Correlation of CT and MR with Impedance Monitoring and Histopathology in Stereotactic Biopsies

ABSTRACT:Magnetic Resonance Imaging (MR) and Computer Assisted Tomography (CT) guided stereotaxis combined with intraoperative impedance monitoring and multiple sequential biopsies provides the opportunity to correlate the results of radiologic imaging with impedance and histopathology. The authors present the methods used and preliminary results obtained from 30 stereotactic biopsies with complete correlation in 12 cases. Impedance changes correlate accurately with lesion margins as defined by histology. CT images of enhancing lesions correlate quite closely to the histopathologic lesion margins whereas the appearance of the lesion on MR images is often larger than subsequently identified by either impedance or at pathologic examination. Impedance monitoring is a useful adjunct to stereotactic biopsy as it helps to accurately define lesion margins and can help direct the choice of biopsy sites.

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CT-guided and computer assisted stereotactic biopsy

Acta Neurochirurgica ◽

10.1007/bf01401842 ◽

1993 ◽

Vol 125 (1-4) ◽

pp. 142-149 ◽

Cited By ~ 42

Author(s):

J. Voges ◽

R. Schr�der ◽

H. Treuer ◽

O. Pastyr ◽

W. Schlegel ◽

...

Keyword(s):

Stereotactic Biopsy ◽

Computer Assisted ◽

Ct Guided

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Multimodal brain magnetic resonance imaging and perfusion computer assisted tomography scanning in evaluation of cerebroprotective efﬁcacy of antihypertensive therapy

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2009-15-3-280-284 ◽

2009 ◽

Vol 15 (3) ◽

pp. 280-284

Author(s):

E. V. Fedorenko ◽

H. -J. Wittsack ◽

A. M. Russina ◽

N. L. Afanasieva ◽

V. M. Gulyaev ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Blood Pressure ◽

Magnetic Resonance ◽

Systolic Blood Pressure ◽

Antihypertensive Therapy ◽

Computer Assisted ◽

Diagnostic Study ◽

Resonance Imaging ◽

Computer Assisted Tomography ◽

The Brain

A multimodal diagnostic study of the brain was carried out in 22 patients with arterial hypertension (mean systolic blood pressure 152,8 ± 7,6 mm Hg, mean diastolic blood pressure 94,6 ± 5,2 mm Hg), without cardiovascular events in anamnesis. Magnetic resonance imaging (MRI) imaging and dynamic contrast-enhanced perfusion X-ray computer assisted tomography scan (DynCT) of the brain were performed at admission and after six months of antihypertensive treatment. Based on the MRI and DynCT visual data the extent of periventricular oedema, dimensions of liquor system and regional cerebral blood flow (as ml/min/100 g tissue) were quantified. The quantitative MRI and DynCT indices were analyzed regarding the decrease of blood pressure. Significant decrease of periventricular oedema and improvement in perfusion of basal ganglii area were observed in patients demonstrated decrease in systolic blood pressure for 12-28 mm Hg. The degree of the blood pressure decrease was not associated with the significant MRI and DynCT data improvement. Hencefore, we conclude that the brain MRI and perfusion DynCT data can be employed for evaluation of cerebroprotective effects of antihypertensive therapy.

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CT Guided Stereotactic Brain Tumor Biopsy

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v9i2.44880 ◽

2020 ◽

Vol 9 (2) ◽

pp. 86-93

Author(s):

Moududul Haque ◽

Sudipta Kumar Mukherjee ◽

Mustafa Kamal ◽

ABM Manwar Hossain

Keyword(s):

Brain Tumor ◽

Stereotactic Biopsy ◽

Low Cost ◽

Brain Lesions ◽

Normal Brain ◽

Normal Brain Tissue ◽

Tumor Biopsy ◽

Ct Guided ◽

Image Guided ◽

Stereotactic Biopsies

153 cases of CT guided stereotactic biopsies for intra-axial deep seated brain lesions performed by one neurosurgeon has been analyzed regarding procedure, success rate and complications. Of the 153 cases, positive tissue biopsy was found in 143 cases. In 6 patients, biopsy showed gliotic grain tissue or normal brain tissue.4 patients had complications after the procedure. Three patient developed intracerebral haemorrhage of the two died, and other died Massive MI. There was no post operative new deficits seen. CT guided Stereotactic biopsy is a very effective and low cost procedure caomparing with frameless image guided brain biopsies or open craniotomy for biopsy due to it’s higher complication rate. The detail procedure are being discussed Bang. J Neurosurgery 2020; 9(2): 86-93

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Computer-Assisted CT-Guided Stereotactic Biopsy and Brachytherapy of Brain Tumors

Stereotactic and Functional Neurosurgery ◽

10.1159/000100291 ◽

1994 ◽

Vol 63 (1-4) ◽

pp. 52-55 ◽

Cited By ~ 1

Author(s):

R.Q. Quiñones-Molina ◽

A. Alaminos ◽

H. Molina ◽

J. Muñoz ◽

G. López ◽

...

Keyword(s):

Brain Tumors ◽

Stereotactic Biopsy ◽

Computer Assisted ◽

Ct Guided

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Intraoperative Impedance Monitoring during CT-Guided Stereotactic Biopsies

Stereotactic and Functional Neurosurgery ◽

10.1159/000099482 ◽

1989 ◽

Vol 52 (1) ◽

pp. 1-17 ◽

Cited By ~ 7

Author(s):

Dennis E. Bullard

Keyword(s):

Ct Guided ◽

Impedance Monitoring ◽

Stereotactic Biopsies

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Computer-Assisted Tomography and Magnetic Resonance Imaging

Root Methods ◽

10.1007/978-3-662-04188-8_11 ◽

2000 ◽

pp. 343-363 ◽

Cited By ~ 17

Author(s):

S. Asseng ◽

L. A. G. Aylmore ◽

J. S. MacFall ◽

J. W. Hopmans ◽

P. J. Gregory

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Computer Assisted ◽

Resonance Imaging ◽

Computer Assisted Tomography

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Complications of CT-guided stereotactic biopsy of intra-axial brain lesions

Journal of Neurosurgery ◽

10.3171/jns.1994.81.2.0165 ◽

1994 ◽

Vol 81 (2) ◽

pp. 165-168 ◽

Cited By ~ 171

Author(s):

Mark Bernstein ◽

Andrew G. Parrent

Keyword(s):

Intracranial Hypertension ◽

Stereotactic Biopsy ◽

Brain Lesions ◽

The Other ◽

Ct Guided ◽

Major Morbidity ◽

Content Type ◽

Number Of Patients ◽

Stereotactic Biopsies ◽

Fine Print

✓ A series of 300 consecutive stereotactic biopsies for intra-axial brain lesions performed by one neurosurgeon was critically analyzed regarding complications of the procedure. Complications were incurred by a total of 19 patients (6.3%). Five patients (1.7%) died following the procedure, all due to intracranial hypertension: one from subarachnoid hemorrhage, one from intracerebral hemorrhage, and three from increased edema without hemorrhage. The three patients who died without hemorrhage all had marked intracranial hypertension at the time of biopsy. All five patients who died harbored a glioblastoma multiforme. The surviving 14 patients (4.7%) with complications suffered increased neurological deficit due to hemorrhage. In 10 (3.3%), the deficit was mild and/or transient; in the other four (1.3%), a major deficit was incurred which markedly affected the remainder of the patient's life. Therefore, mortality or major morbidity was seen in 3.0% of patients and minor morbidity in 3.3%. Stereotactic biopsy is a very effective procedure with a complication rate significantly lower than that of craniotomy (particularly in the population of patients selected for stereotactic biopsy), but in a small number of patients the outcome is devastating.

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Nondiagnostic CT-guided stereotactic biopsies in a series of 407 cases: influence of CT morphology and operator experience

Journal of Neurosurgery ◽

10.3171/jns.1993.79.6.0839 ◽

1993 ◽

Vol 79 (6) ◽

pp. 839-844 ◽

Cited By ~ 29

Author(s):

Alok Ranjan ◽

Vedantam Rajshekhar ◽

Thomas Joseph ◽

Mathew J. Chandy ◽

Sushil M. Chandi

Keyword(s):

Stereotactic Biopsy ◽

Target Selection ◽

Consecutive Series ◽

Ct Guided ◽

Content Type ◽

Negative Biopsy ◽

Significant Difference ◽

Stereotactic Biopsies ◽

Biopsy Rate ◽

Fine Print

Nondiagnostic biopsies were analyzed in a consecutive series of 407 patients undergoing computerized tomography (CT)-guided stereotactic biopsies. These were categorized as either negative biopsies, when normal tissue or nonspecific pathology was found, or inconclusive, when a definitive diagnosis could not be made although representative tissue was obtained. Nineteen biopsies (4.7%) were negative and 10 (2.4%) were inconclusive, giving an overall nondiagnostic biopsy rate of 7.1% (29 of the 407 cases). Suspected neoplastic masses (390 cases) were classified on the basis of their CT morphology into four groups: Group 1 included purely hypodense nonenhancing masses; Group 2 included isodense nonenhancing masses; Group 3 included ring-enhancing masses; and Group 4 included mixed-density enhancing masses. Although a higher proportion of hypodense nonenhancing masses (six of 56, or 10.7%) yielded a negative result, there was no statistically significant difference in the negative biopsy rates for the different CT categories (p = 0.06). The negative biopsy rates for the 6 years of the study, 1987 to 1992 (1987 being an incomplete year) were as follows: 13.3%, 6%, 3.2%, 3%, 5.8%, and 2.7%. There was no significant decrease in the negative biopsy rate as experience with this procedure increased (p = 0.20). A total of eight surgeons independently performed the biopsies. There was no significant difference (p = 0.24) in the negative biopsy rate of the surgeon with the most experience (124 biopsies, 2.4% negative biopsy rate) compared with that of the seven other surgeons combined (283 biopsies; 5.7% negative biopsy rate). These findings suggest that the yield in a stereotactic biopsy is independent of the CT appearance of the mass. Adherence to certain basic principles in patient and target selection will ensure a reasonable percentage of positive yield with stereotactic biopsy procedures even if the surgeon is relatively inexperienced. There does not appear to be a learning curve in the performance of CT-guided stereotactic biopsies. The management of patients with nondiagnostic biopsies is discussed.

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