Intra-parenchymal tumor biopsy using neuroendoscopy with navigation

Area of Science:

• Neurosurgery
• Oncology
• Medical Technology

Background:

• Traditional methods for intra-parenchymal tumor biopsy include stereotactic procedures and open biopsies.
• Neuroendoscopy is established for ventricular and para-ventricular tumor biopsies, offering direct visual monitoring.
• A need exists for improved biopsy techniques for intra-parenchymal tumors.

Observation:

• A novel technique combining neuroendoscopy with navigational guidance was developed and applied to three patients.
• Procedures involved advancing a sheath with a navigation tool to target tissues under direct endoscopic visualization.
• Tissue specimens were collected using forceps, and hemostasis was managed with an aspirator tip as a monopolar coagulator.

Findings:

• The combined neuroendoscopy and navigation guidance technique was successfully used for intra-parenchymal tumor biopsies in three patients.
• Histological diagnoses of astrocytoma (two patients) and radiation necrosis (one patient) were obtained.
• No new neurological deficits were observed post-procedure.

Implications:

• This combined approach offers a safe and precise method for obtaining biopsies of intra-parenchymal tumors.
• Further development of hemocoagulation instruments is needed to optimize the procedure for highly vascularized tumors.
• This technique has the potential to improve diagnostic accuracy for deep-seated brain tumors.