Stereotactic computed tomography–guided brain biopsy: diagnostic yield based on a series of 170 patients

• Published in: Surgical neurology Vol. 65; pp. S27 - S32
• Main Authors: Ferreira, Marcelo Paglioli, Ferreira, Nelson Pires, Pereira Filho, Arthur Azambuja, Pereira Filho, Gustavo Azambuja, Franciscatto, André Cerutti
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2006
• Subjects: Adult; Age Factors; Biopsy - methods; Brain biopsy; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; CT-guided stereotaxy; Female; Glioma - diagnostic imaging; Glioma - pathology; Humans; Lymphoma - diagnostic imaging; Lymphoma - pathology; Male; Middle Aged; Predictive Value of Tests; Sex Factors; Stereotactic surgery; Stereotaxic Techniques; Tomography, X-Ray Computed; CT; Brain biopsy; CT-guided stereotaxy; Stereotactic surgery
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2005.11.036

Stereotactic CT-guided biopsy is a valuable and safe procedure for diagnosing intracranial lesions. The objectives of this article are to analyze the diagnostic yield in a series of stereotactic CT-guided brain biopsies and to evaluate whether predictive factors may influence diagnostic yield. The medical records of a series of patients who underwent stereotactic CT-guided brain biopsy from 1993 to 2005 in a neurosurgical center were reviewed. Clinical data were stored and analyzed with Microsoft Access (Microsoft Corp, Seattle, WA) and SPSS V11.0 software (SPSS, Inc, Chicago, IL). The following variables were analyzed: age, sex, anatomopathologic diagnosis, lesion topography and volume, postsurgical complications, and predictive factors that may affect diagnostic yield. One hundred seventy patients (102 males, 68 females; average age, 48.5 years) were analyzed. Stereotactic CT-guided biopsies allowed diagnosis in 157 cases (92%). The most frequent anatomopathologic diagnoses were high-grade glioma (n = 45), low-grade glioma (n = 31), nonspecific inflammatory lesions (n = 19), metastasis (n = 10), and lymphoma (n = 10). The most frequent topographies were frontal (n = 42), basal ganglia (n = 40), and parietal (n = 27) and front-parietal lobes (n = 9). Complications occurred in 5 patients (2.9%). Mortality rate was 1.2% (2 patients). Age had a positive impact, whereas female sex negatively affected diagnostic yield. All other predictive factors analyzed were not significant. Stereotactic CT-guided brain biopsies performed presented acceptable anatomopathologic diagnostic rate. Age had a positive impact, whereas female sex negatively affected diagnostic yield in this series.