Frameless image-guided stereotaxy with real-time visual feedback for brain biopsy

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• 作者：Jens Gempt (1)
  Niels Buchmann (1)
  Yu-Mi Ryang (1)
  Sandro Krieg (1)
  Jürgen Kreutzer (1)
  Bernhard Meyer (1)
  Florian Ringel (1)
  
• 关键词：Frameless stereotaxy ; Image guidance ; Brain biopsy ; Brain tumour
• 刊名：Acta Neurochirurgica
• 出版年：2012
• 出版时间：September 2012
• 年：2012
• 卷：154
• 期：9
• 页码：1663-1667
• 全文大小：300KB
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• 作者单位：Jens Gempt (1)
  Niels Buchmann (1)
  Yu-Mi Ryang (1)
  Sandro Krieg (1)
  Jürgen Kreutzer (1)
  Bernhard Meyer (1)
  Florian Ringel (1)
  
  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universit?t München, Ismaningerstr. 22, 81675, München, Germany
  

文摘

Background Frame-based stereotaxy remains the “gold standard-for cerebral biopsies and functional neurosurgery though new frameless stereotactic systems are evolving continually. As the technique of frameless stereotaxy gains increasing acceptance among neurosurgeons, this study assesses the feasibility of a system for frameless image-guided stereotaxy. Methods All patients biopsied for intracranial lesions between February 2007 and August 2010 using the BrainLAB VarioGuide frameless stereotactic system were evaluated prospectively. Prior to surgery, patients underwent magnetic resonance (MR) imaging; additionally, fluoroethyl-tyrosine (FET)-positron emission tomography (PET) images were acquired and fused to MR images in selected cases. Biopsy trajectory length, lesion volume, procedure duration, and diagnostic yield were assessed. Results Ninety-six diagnostic biopsies in 91 patients were evaluated. Lesion volume ranged from 0.17 to 121.8?cm3; trajectory length from 25.3 to 101.9?mm. Diagnostic yield was 93.8%. Mean operation time from skin incision to wound closure was 42?min; in the operating room, it was 99?min. Conclusions Clinical experience indicates VarioGuide to be safe and accurate. Reachable range of lesion localisation appears to be comparable to a frame-based stereotaxy system. Operation times are brief. The unique design of this frameless stereotactic system allows real-time visual feedback of needle positioning.