Further experience utilizing the Gildenberg technique for computed tomography-guided stereotactic biopsies

Area of Science:

• Neurosurgery
• Radiology
• Neuropathology

Background:

• Computed tomography (CT)-guided stereotactic biopsy is crucial for diagnosing brain lesions.
• The Gildenberg technique offers a method for precise tissue acquisition.

Purpose of the Study:

• To review initial experiences with the Gildenberg technique for CT-guided stereotactic biopsies.
• To assess the efficacy and diagnostic yield of this technique.

Main Methods:

• Review of 50 patients undergoing CT-guided stereotactic biopsies using the Gildenberg technique.
• Categorization of lesions based on CT characteristics: ring-enhancing lesions (REL), enhancing lesions with surrounding low density (ELLD), and low density lesions.
• Analysis of tissue acquisition success, number of biopsies required, and correlation with histopathological diagnoses.

Main Results:

• Adequate tissue was obtained in 49 out of 50 patients (98%).
• Diagnosis was achieved in one biopsy for 32 patients; 2-5 biopsies were needed for others.
• Biopsies of the enhancing rim of RELs yielded the best diagnostic accuracy.
• Transient neurological deficits (hemiparesis, decreased consciousness) occurred in a small percentage of patients.

Conclusions:

• The Gildenberg technique is a safe and effective method for CT-guided stereotactic biopsies.
• Targeting the enhancing rim of lesions improves diagnostic yield.
• The technique provides accurate histopathological diagnoses, guiding subsequent patient management.