Skip to main content
Log in

Frame-based stereotactic biopsy remains an important diagnostic tool with distinct advantages over frameless stereotactic biopsy

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Object: As the availability of image-guided surgical navigation systems has increased, the application of frame-based biopsy has declined at our institution, despite equivalent accuracy and safety. There are several cost issues separating the use of surgical navigation systems and stereotactic frames for simple biopsy which may have implications in this era of health care cost control. We retrospectively reviewed the UCSF experience with stereotactic brain biopsy from a 9 year period. Methods: Data were collected for 213 consecutive stereotactic brain biopsies performed at UCSF (139 frame-based and 74 frameless). There were no significant differences between the frame-based and frameless biopsy groups with regard to patient demographics, overall histopathology, proportion of nondiagnostic biopsies, or incidence of complications. General anesthesia was used for 9 (6%) and 70 (95%) of the frame-based and frameless biopsy cases, respectively. Frame-based biopsies required a mean of 114 ± 3 min of operating room time, while frameless biopsies required 185 ± 6 min (P < 0.0001). For patients admitted to our neurosurgery service who underwent frame-based (n=110) or frameless (n=52) biopsy within 24 h of admission, the mean lengths of hospital stay were 1.8 ± 0.2 and 3.2 ± 0.6 days, respectively (P=0.007). Conclusion: Frame-based and frameless stereotactic biopsy approaches were equally effective at providing a tissue diagnosis with minimum morbidity and mortality. The frame-based approach, however, required significantly less anesthesia resources, less operating room time and shorter hospital stays, and thus should still be considered a first-line approach for stereotactic brain biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. TM Moriarty A Quinones-Hinojosa PS Larson E Alexander Suffix3rd PL Gleason RB Schwartz FA Jolesz PM. Black (2000) ArticleTitleFrameless stereotactic neurosurgery using intraoperative magnetic resonance imaging: stereotactic brain biopsy Neurosurgery 47 1138–1145 Occurrence Handle10.1097/00006123-200011000-00023 Occurrence Handle1:STN:280:DC%2BD3crgvFOmuw%3D%3D Occurrence Handle11063107

    Article  CAS  PubMed  Google Scholar 

  2. J McInerney DW. Roberts (2000) ArticleTitleFrameless stereotaxy of the brain Mt Sinai J Med 67 300–310 Occurrence Handle1:STN:280:DC%2BD3cvmsFymtA%3D%3D Occurrence Handle11021780

    CAS  PubMed  Google Scholar 

  3. DY Wen WA Hall DA Miller EL Seljeskog RE. Maxwell (1993) ArticleTitleTargeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques Neurosurgery, 32 407–412

    Google Scholar 

  4. D Fontaine D Dormont D Hasboun S Clemenceau C Valery C Oppenheim M Sahel C Marsault J Philippon P. Cornu (2000) ArticleTitleMagnetic resonance-guided stereotactic biopsies: results in 100 consecutive cases Acta Neurochir (Wien) 142 249–255 Occurrence Handle10.1007/s007010050032 Occurrence Handle1:STN:280:DC%2BD3c3nslekuw%3D%3D

    Article  CAS  Google Scholar 

  5. GH Barnett DW Miller J. Weisenberger (1999) ArticleTitleFrameless stereotaxy with scalp-applied fiducial markers for brain biopsy procedures: experience in 218 cases J Neurosurg 91 569–576 Occurrence Handle1:STN:280:DyaK1MvjsFaisg%3D%3D Occurrence Handle10507376

    CAS  PubMed  Google Scholar 

  6. IM Germano JV. Queenan (1998) ArticleTitleClinical experience with intracranial brain needle biopsy using frameless surgical navigation Comput Aided Surg 3 33–39 Occurrence Handle10.1002/(SICI)1097-0150(1998)3:1<33::AID-IGS5>3.0.CO;2-M Occurrence Handle1:STN:280:DyaK1czmsVagsQ%3D%3D Occurrence Handle9699077

    Article  CAS  PubMed  Google Scholar 

  7. NL Dorward TS Paleologos O Alberti DG. Thomas (2002) ArticleTitleThe advantages of frameless stereotactic biopsy over frame-based biopsy Br J Neurosurg 16 110–118 Occurrence Handle10.1080/02688690220131705 Occurrence Handle1:STN:280:DC%2BD38zgsFOjtQ%3D%3D Occurrence Handle12046728

    Article  CAS  PubMed  Google Scholar 

  8. NL Dorward O Alberti JD Palmer ND Kitchen DG. Thomas (1999) ArticleTitleAccuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studies Technical note. J Neurosurg 90 160–168 Occurrence Handle1:STN:280:DyaK1MzjvFGiug%3D%3D

    CAS  Google Scholar 

  9. WA. Hall (1998) ArticleTitleThe safety and efficacy of stereotactic biopsy for intracranial lesions Cancer 82 1749–1755 Occurrence Handle10.1002/(SICI)1097-0142(19980501)82:9<1756::AID-CNCR23>3.0.CO;2-2 Occurrence Handle1:STN:280:DyaK1c3jsFygsw%3D%3D Occurrence Handle9576298

    Article  CAS  PubMed  Google Scholar 

  10. ML Apuzzo PT Chandrasoma D Cohen CS Zee V. Zelman (1987) ArticleTitleComputed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses Neurosurgery 20 930–937

    Google Scholar 

  11. Quinones-Hinojosa A, Sanai N, McDermott MW. (1999). Assessment of image guided accuracy using two types of disposable biopsy guides as compared to frame-based localization. American Association of Neurological Surgeons Abstract Archive (http: //www.aans.org/Library/Article.aspx?ArticleId = 12387), 2002

  12. MF Pell DG. Thomas (1991) ArticleTitleThe initial experience with the Cosman-Roberts-Wells stereotactic system Br J Neurosurg 5 123–128 Occurrence Handle1:STN:280:By6A387ns1U%3D Occurrence Handle1863372

    CAS  PubMed  Google Scholar 

  13. IR Whittle SW Denholm K. Elshunnar (1991) ArticleTitleCT-guided stereotactic neurosurgery using the Brown-Roberts-Wells system: experience with 125 procedures Aust N Z J Surg 61 919–928 Occurrence Handle1:STN:280:By2D1Mroslw%3D Occurrence Handle1755773

    CAS  PubMed  Google Scholar 

  14. HK Gumprecht DC Widenka Lumenta CB. (1999) ArticleTitleBrainLab VectorVision Neuronavigation System: technology and clinical experiences in 131 cases Neurosurgery 44 97–104 Occurrence Handle10.1097/00006123-199901000-00056 Occurrence Handle1:STN:280:DyaK1M7htValsg%3D%3D Occurrence Handle9894969

    Article  CAS  PubMed  Google Scholar 

  15. EP Sipos SA Tebo SJ Zinreich DM Long Brem H. (1996) ArticleTitleIn vivo accuracy testing and clinical experience with the ISG Viewing Wand Neurosurgery 39 194–202 Occurrence Handle10.1097/00006123-199607000-00048 Occurrence Handle1:STN:280:BymA1Mfjt1Y%3D Occurrence Handle8805161

    Article  CAS  PubMed  Google Scholar 

  16. M Kaus R Steinmeier T Sporer O Ganslandt R. Fahlbusch (1997) ArticleTitleTechnical accuracy of a neuronavigation system measured with a high-precision mechanical micromanipulator Neurosurgery 41 1431–1436 Occurrence Handle10.1097/00006123-199712000-00046 Occurrence Handle1:STN:280:DyaK1c%2Fms1aiuw%3D%3D Occurrence Handle9402599

    Article  CAS  PubMed  Google Scholar 

  17. MD Krieger PT Chandrasoma CS Zee ML. Apuzzo (1998) ArticleTitleRole of stereotactic biopsy in the diagnosis and management of brain tumors Semin Surg Oncol 14 13–25 Occurrence Handle10.1002/(SICI)1098-2388(199801/02)14:1<13::AID-SSU3>3.0.CO;2-5 Occurrence Handle1:STN:280:DyaK1c%2FntFGmsQ%3D%3D Occurrence Handle9407627

    Article  CAS  PubMed  Google Scholar 

  18. PD Sawin PW Hitchon KA Follett JC. Torner (1998) ArticleTitleComputed imaging-assisted stereotactic brain biopsy: a risk analysis of 225 consecutive cases Surg Neurol 49 640–649 Occurrence Handle1:STN:280:DyaK1c3pvFOgug%3D%3D Occurrence Handle9637625

    CAS  PubMed  Google Scholar 

  19. M Field TF Witham JC Flickinger D Kondziolka LD. Lunsford (2001) ArticleTitleComprehensive assessment of hemorrhage risks and outcomes after stereotactic brain biopsy J Neurosurg 94 545–551 Occurrence Handle1:STN:280:DC%2BD3M3jslCqsw%3D%3D Occurrence Handle11302651

    CAS  PubMed  Google Scholar 

  20. M Bernstein AG. Parrent (1994) ArticleTitleComplications of CT-guided stereotactic biopsy of intra-axial brain lesions J Neurosurg 81 165–168 Occurrence Handle1:STN:280:ByuA3c%2Fjs10%3D Occurrence Handle8027795

    CAS  PubMed  Google Scholar 

  21. TM Soo M Bernstein J Provias R Tasker A Lozano A. Guha (1995) ArticleTitleFailed stereotactic biopsy in a series of 518 cases Stereotact Funct Neurosurg 64 183–196 Occurrence Handle1:STN:280:BymH3MvotVA%3D Occurrence Handle8817805

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Justin S. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, J.S., Quiñones-Hinojosa, A., Barbaro, N.M. et al. Frame-based stereotactic biopsy remains an important diagnostic tool with distinct advantages over frameless stereotactic biopsy. J Neurooncol 73, 173–179 (2005). https://doi.org/10.1007/s11060-004-4208-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-004-4208-3

Keywords

Navigation