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Magnetic Resonance-Guided Stereotaxy for Infusions to the Pig Brain
Published on: March 31, 2023
Endoscopic biopsy for lesions located in the parenchyma of the brain: preoperative planning based on stereotactic
Takafumi Tanei1, Norimoto Nakahara, Shigenori Takebayashi
1Department of Neurosurgery, Nagoya Central Hospital, Aichi, Japan. nsgtakasyun@msn.com
Abstract:
Endoscope biopsy guided navigation for intra-parenchymal lesions is safe and effective, but determination of the entry point and trajectory of the endoscopic biopsy is less clear. We describe preoperative planning based on stereotactic methods, and achieving the plan using several techniques. The preoperative planning was based on stereotactic methods such as determining target, entry point, and trajectory. A transparent sheath was advanced under guidance of the navigation system and specimens collected under visual endoscopic monitoring. After collecting specimens, intraoperative magnetic resonance imaging was performed for confirming accurate sampling. Correct specimens were obtained in 6 cases as confirmed by intraoperative magnetic resonance imaging. The histological diagnoses were diffuse large B-cell type malignant lymphoma (n = 3), astrocytoma (n = 1), glioblastoma (n = 1), and inflammatory changes without neoplastic cells (n = 1). No postoperative intracranial hemorrhage or other operative complications occurred. Preoperative planning based on stereotactic methods and procedures guided by navigation systems can achieve endoscopic biopsy for intraparenchymal lesions safely and accurately.
Insights
Stereotactic planning and navigation systems enable safe and accurate endoscopic biopsy for intraparenchymal brain lesions. This method precisely guides biopsies, ensuring correct tissue samples are obtained with minimal complications.
Area of Science:
- Neurosurgery
- Medical Imaging
- Pathology
Background:
- Endoscopic biopsy navigation for intraparenchymal lesions is safe and effective.
- Determining the optimal entry point and trajectory for endoscopic biopsy remains a challenge.
Purpose of the Study:
- To describe a preoperative planning method using stereotactic principles.
- To detail the techniques for achieving accurate endoscopic biopsy of intraparenchymal lesions.
Main Methods:
- Preoperative planning involved stereotactic determination of target, entry point, and trajectory.
- A navigation system guided the advancement of a transparent sheath.
- Specimens were collected under visual endoscopic monitoring, with intraoperative MRI confirming accuracy.
Main Results:
- Accurate specimens were obtained in all 6 cases, confirmed by intraoperative MRI.
- Diagnoses included lymphoma, astrocytoma, glioblastoma, and inflammatory changes.
- No postoperative complications such as intracranial hemorrhage occurred.
Conclusions:
- Preoperative stereotactic planning combined with navigation-guided procedures ensures safe and accurate endoscopic biopsy for intraparenchymal lesions.
- This integrated approach enhances diagnostic yield and patient safety.
