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A low cost system for performing CT stereotaxic brain biopsy
B A Bell1, R Howard, A I Mackenzie
1Department of Neurosurgery, Atkinson Morley's Hospital, London, United Kingdom.
British Journal of Neurosurgery
|January 1, 1989
Summary
A cost-effective stereotactic brain biopsy technique using an adapted pre-CT frame achieved high diagnostic success. This method offers speed and ease of use, with low morbidity and mortality rates for accurate brain lesion diagnosis.
Area of Science:
- Neurosurgery
- Medical Imaging
- Pathology
Background:
- Commercially available CT-compatible stereotactic frames for brain biopsy are expensive, limiting their use in the UK.
- An adapted pre-CT stereotactic frame and a GE 9800 CT scanner were available.
- Previous use of the adapted frame at Atkinson Morley's Hospital for 12 years.
Purpose of the Study:
- To evaluate the feasibility and efficacy of a low-cost, CT-directed stereotactic brain biopsy technique.
- To assess the diagnostic accuracy, speed, ease of use, morbidity, and mortality rates of the adapted system.
Main Methods:
- Adaptation of a pre-CT stereotactic frame for CT-directed biopsies.
- Performed 100 CT-directed stereotactic brain biopsies using the adapted system.
- Evaluated diagnostic success rates, permanent morbidity (4%), and mortality (2%).
Main Results:
- Achieved an 83% initial diagnostic success rate, increasing to 90% with re-biopsy.
- The technique was mastered easily by 12 surgeons, including registrars.
- Low rates of permanent morbidity (4%) and mortality (2%) were observed.
- Identified benign lesions in 7% of patients initially presumed to have malignant tumors.
Conclusions:
- CT-directed stereotactic biopsy using an adapted, low-cost frame is accurate and effective.
- The technique is user-friendly, even for inexperienced neurosurgical staff.
- Histological diagnosis is crucial for all brain lesions, preventing misdiagnosis of benign conditions.