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Stereotactic biopsy for multifocal, diffuse, and deep-seated brain tumors using Leksell's system
Kazumichi Yamada1, Satoshi Goto, Masato Kochi
1Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto, Japan. yamadakazu@fc.kuh.kumamoto-u.ac.jp
Summary
Stereotactic biopsy using the Leksell system effectively diagnoses brain tumors, with low morbidity and no mortality. Careful consideration of vascularity is crucial for safe and accurate tissue sampling.
Area of Science:
- Neurosurgery
- Neuropathology
- Neuroradiology
Background:
- Stereotactic biopsy is essential for diagnosing surgically inaccessible brain lesions.
- Accurate tissue diagnosis guides appropriate therapeutic strategies for brain tumors.
Purpose of the Study:
- To evaluate the efficacy and safety of the Leksell stereotactic system for biopsy of deep-seated and complex brain lesions.
- To determine the diagnostic yield and complication rates associated with stereotactic biopsy.
Main Methods:
- Selective stereotactic biopsy of 91 surgically inaccessible brain lesions using the Leksell stereotactic system.
- Histopathological analysis of biopsied tissue to confirm diagnoses.
- Exclusion of lesions adjacent to major vascular structures to minimize risks.
Main Results:
- Histological confirmation was achieved in 92.3% of cases.
- Primary tumors constituted 75.8% of lesions, including malignant gliomas (48.4%) and lymphomas (19.8%).
- Overall morbidity was low (1.1% for hemorrhage, 2.2% for seizures), with no mortality. Hemorrhage risk increased with positive tumor stain on angiography.
Conclusions:
- The Leksell stereotactic system is a valuable tool for diagnostic tissue sampling of brain lesions.
- It effectively aids in selecting therapy for patients with malignant brain tumors.
- Careful patient selection and consideration of lesion vascularity are important for minimizing procedural risks.