PDF(Pubmed)
Abstract：
Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes.
摘要：
背景和目的：由于脑部病变存在复杂的诊断挑战，通过活检进行准确的组织采样对于有效的治疗计划至关重要。传统的基于框架的立体定向活检已得到导航活检技术的补充。利用成像和导航技术的进步。本研究旨在在临床环境中比较导航和基于框架的立体定向活检方法，评估它们的功效，安全,和诊断结果，以确定精确的脑部病变靶向的最佳方法。材料和方法：回顾性分析2017年1月至2023年8月在学术医学中心接受脑活检的患者。患者人口统计数据，临床特征,活检技术(导航与基于框架)，结果包括准确性，并发症,并对住院时间进行分析。结果：该队列包括112例患者，组间年龄或性别差异无统计学意义。导致活检的症状主要是肌肉力量减弱（42.0％），认知问题（28.6%），失语症(24.1%)。肿瘤最常见于深半球(24.1%)。中位住院时间为5天,再住院率为27.7%。4.47%的患者出现并发症,活检方法之间没有显着差异。然而,导航活检导致样本较少(p<0.001),但与基于帧的活检具有相当的诊断准确性.结论：导航和基于框架的立体定向活检既有效又安全，具有可比的准确性和并发症发生率。技术的选择应考虑病变的具体情况，外科医生偏好，和技术可用性。研究结果强调了先进的神经外科技术在增强患者护理和预后方面的重要性。
