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Intraparenchymal brain lesion biopsy guided by a rigid endoscope and navigation system
Eiichi Ishikawa1, Tetsuya Yamamoto1, Masahide Matsuda1
1Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Background:
The authors report a continuous case series of navigation-guided rigid endoscopic biopsy via the transcortical route for intraparenchymal brain lesions to assess the feasibility and efficacy of the method.
Methods:
Thirty-four patients with intraparenchymal brain lesions found on neurovisualization underwent navigation-guided rigid endoscopic biopsy. Most of the preoperative diagnoses were glioma WHO Grade II-IV (16 cases) or malignant lymphoma (15 cases). Intraoperative photodynamic diagnosis and intraoperative pathological diagnosis were used in 28 and 29 cases, respectively. In 2 cases with small and deep lesions, intraoperative magnetic resonance imaging was used for confirming the accuracy of the biopsy point.
Results:
The sampling accuracy determined by postoperative imaging and the definitive diagnosis ratio were 94% (32 out of 34 cases) and 97% (33 out of 34 cases), respectively. There was no postoperative mortality. In 2 patients, mild postoperative permanent morbidity (5.9%), presumably related to this technique, was observed in the early cases in the current group (34 case series).
Conclusion:
The method was estimated as safe and feasible for diagnostic tissue sampling of intraparenchymal brain lesions.
