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Updated: Mar 8, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Diffuse intrinsic pontine gliomas in children: Interest of robotic frameless assisted biopsy. A technical note
H A Coca1, H Cebula1, M Benmekhbi1
1Service de neurochirurgie CHU Hautepierre, 67098, Strasbourg cedex, France.
Insights
Frameless robotic-guided biopsy is a safe and effective method for diagnosing pediatric Diffuse Intrinsic Pontine Gliomas (DIPG). This technique simplifies the diagnostic process, offering accurate results for children with this challenging brain tumor.
Area of Science:
- Pediatric neurosurgery
- Oncology
- Neurosurgical oncology
Background:
- Diffuse Intrinsic Pontine Gliomas (DIPG) are aggressive pediatric brain tumors with a poor prognosis.
- Advances in molecular biology have expanded the role of DIPG biopsy for clinical trials.
- Traditional stereotactic frame-assisted biopsies can be complex in pediatric patients.
Purpose of the Study:
- To evaluate the feasibility and safety of frameless robotic-guided biopsy for DIPG in children.
- To assess the diagnostic accuracy and procedural efficiency of this minimally invasive technique.
Main Methods:
- Retrospective study of five pediatric patients with DIPG.
- All patients underwent frameless robotic-guided biopsy via a transcerebellar approach.
- Data collected included procedure time, neurological outcomes, and histological diagnoses.
Main Results:
- The median age of patients was 8.6 years; all presented with typical DIPG symptoms and MRI findings.
- The mean procedure time was 56 minutes, with no new postoperative neurological deficits.
- Histological diagnosis was achieved in all cases, identifying various glioma subtypes.
Conclusions:
- Frameless robotic-assisted biopsy is a simpler, effective, and safe method for pediatric DIPG diagnosis.
- This technique offers high accuracy for achieving histological confirmation.
- It represents an advantageous approach for pediatric neurosurgical oncology.
Introduction:
Diffuse intrinsic pontine gliomas (DIPG) constitute 10-15% of all brain tumors in the pediatric population; currently prognosis remains poor, with an overall survival of 7-14 months. Recently the indication of DIPG biopsy has been enlarged due to the development of molecular biology and various ongoing clinical and therapeutic trials. Classically a biopsy is performed using a stereotactic frame assisted procedure but the workflow may sometimes be heavy and more complex especially in children. In this study the authors present their experience with frameless robotic-guided biopsy of DIPG in a pediatric population.
Patients And Methods:
Retrospective study on a series of five consecutive pediatric patients harboring DIPG treated over a 4-year period. All patients underwent frameless robotic-guided biopsy via a transcerebellar approach.
Results:
Among the 5 patients studied 3 were male and 2 female with a median age of 8.6 years [range 5 to 13 years]. Clinical presentation included ataxia, hemiparesis and cranial nerve palsy in all patients. MRI imaging of the lesion showed typical DIPG features (3 of them located in the pons) with hypo-intensity on T1 and hyper-intensity signal on T2 sequences and diffuse gadolinium enhancement. The mean procedure time was 56minutes (range 45 to 67minutes). No new postoperative neurological deficits were recorded. Histological diagnosis was achieved in all cases as follows: two anaplastic astrocytomas (grade III), two glioblastomas, and one diffuse astrocytoma (grade III).
Conclusion:
Frameless robotic assisted biopsy of DIPG in pediatric population is an easier, effective, safe and highly accurate method to achieve diagnosis.
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