Related Experiment Video
Updated: May 21, 2026
Magnetic Resonance-Guided Stereotaxy for Infusions to the Pig Brain
Published on: March 31, 2023
Perfusion MRI as a neurosurgical tool for improved targeting in stereotactic tumor biopsies
M Lefranc1, P Monet, C Desenclos
1Department of Neurosurgery, Amiens University Hospital, Amiens, France. lefrancm@me.com
Objective:
Stereotactic biopsies are subject to sampling errors (essentially due to target selection). The presence of contrast enhancement is not a reliable marker of malignancy. The goal of the present study was to determine whether perfusion-weighted imaging can improve target selection in stereotactic biopsies.
Methods:
We studied 21 consecutive stereotactic biopsies between June 2009 and March 2010. Perfusion-weighted magnetic resonance imaging (MRI) was integrated into our neuronavigator. Perfusion-weighted imaging was used as an adjunct to conventional MRI data for target determination. Conventional MRI alone was used to determine the trajectory.
Results:
We found a linear correlation between regional cerebral blood volume (rCBV) and vessel density (number of vessels per mm(2); R = 0.64; p < 0.001). Perfusion-weighted imaging facilitated target determination in 11 cases (52.4%), all of which were histopathologically diagnosed as glial tumors. For glial tumors, which presented with contrast enhancement, perfusion-weighted imaging identified a more precisely delimited target in 9 cases, a different target in 1 case, and exactly the same target in 1 other case. In all cases, perfusion-selected sampling provided information on cellular features and tumor grading. rCBV was significantly associated with grading (p < 0.01), endothelial proliferation (p < 0.01), and vessel density (p < 0.01). For lesions with rCBV values ≤1, perfusion-weighted MRI did not help to determine the target but was useful for surgical management.
Conclusions:
For stereotactic biopsies, targeting based on perfusion-weighted imaging is a feasible method for reducing the sampling error and improving target selection in the histopathological diagnosis of tumors with high rCBVs.
Insights
Perfusion-weighted imaging improves stereotactic biopsy target selection for tumors with high regional cerebral blood volume (rCBV). This method reduces sampling errors and enhances histopathological diagnosis accuracy in neuro-oncology.
Area of Science:
- Neuroimaging
- Neurosurgery
- Oncology
Background:
- Stereotactic biopsies are prone to sampling errors, often due to inaccurate target selection.
- Contrast enhancement on conventional MRI is not a definitive indicator of malignancy.
Purpose of the Study:
- To evaluate the efficacy of perfusion-weighted imaging in improving target selection for stereotactic biopsies.
- To determine if perfusion imaging can reduce sampling errors in tumor biopsies.
Main Methods:
- Twenty-one stereotactic biopsies were performed between June 2009 and March 2010.
- Perfusion-weighted MRI was integrated with a neuronavigator as an adjunct to conventional MRI for target determination.
Main Results:
- A linear correlation was observed between regional cerebral blood volume (rCBV) and vessel density (R = 0.64, p < 0.001).
- Perfusion-weighted imaging aided target selection in 52.4% of cases, primarily glial tumors.
- rCBV correlated significantly with tumor grading, endothelial proliferation, and vessel density (p < 0.01).
Conclusions:
- Perfusion-weighted imaging is a feasible technique for stereotactic biopsy targeting.
- This approach can reduce sampling errors and enhance diagnostic accuracy for tumors with high rCBVs.
