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Frameless image-guided stereotaxy with real-time visual feedback for brain biopsy
Jens Gempt1, Niels Buchmann, Yu-Mi Ryang
1Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Germany.
Acta Neurochirurgica
|August 1, 2012
Summary
This study shows the BrainLAB VarioGuide frameless stereotactic system is a safe and effective tool for cerebral biopsies. It offers comparable lesion localization to traditional methods with shorter operation times.
Area of Science:
- Neurosurgery
- Medical Technology
- Image-Guided Therapy
Background:
- Frame-based stereotaxy is the current standard for cerebral biopsies and functional neurosurgery.
- Frameless stereotactic systems are continuously evolving and gaining acceptance.
- This study evaluates the feasibility of a specific frameless image-guided stereotactic system.
Purpose of the Study:
- To assess the feasibility of the BrainLAB VarioGuide frameless stereotactic system for intracranial biopsies.
- To compare its performance with frame-based stereotactic systems.
Main Methods:
- Prospective evaluation of 96 diagnostic biopsies in 91 patients using the BrainLAB VarioGuide system (February 2007 - August 2010).
- Pre-operative magnetic resonance (MR) imaging and, in selected cases, fluoroethyl-tyrosine (FET)-positron emission tomography (PET) imaging fused to MR images.
- Assessment of lesion volume, biopsy trajectory length, procedure duration, and diagnostic yield.
Main Results:
- The study included 96 biopsies in 91 patients with lesion volumes ranging from 0.17 to 121.8 cm³ and trajectory lengths from 25.3 to 101.9 mm.
- A high diagnostic yield of 93.8% was achieved.
- Mean operation time (skin incision to wound closure) was 42 minutes, with a total operating room time of 99 minutes.
Conclusions:
- The VarioGuide frameless stereotactic system demonstrated safety and accuracy in clinical practice.
- Its lesion localization capability appears comparable to frame-based systems.
- The system allows for brief operation times and provides real-time visual feedback for needle positioning.
