An Experience with Frame-Based Stereotactic Biopsy of Posterior Fossa Lesions via Transcerebellar Route

World Neurosurg. 2020 Apr:136:e380-e385. doi: 10.1016/j.wneu.2020.01.003. Epub 2020 Jan 10.

Abstract

Background: Tissue diagnosis for lesions in the posterior fossa, such as the brainstem, cerebellar peduncle, and cerebellum, is an important determinant of the next treatment option. Herein, we present our 10-year experience with magnetic resonance imaging (MRI)-guided frame-based stereotactic biopsy for 39 patients with posterior fossa lesions, the largest case series in this matter.

Methods: We performed a retrospective cross-sectional study on all patients with posterior fossa lesion admitted to 2 referral centers between 2006 and 2016. We used Leksell Frame G for stereotactic biopsy of all patients. MRI systems of both hospitals were 1.5 T.

Results: We performed analysis on the 39 cases (21 men and 18 women). Age of the patients ranged between 9 and 73 years (mean, 35.4 ± 15.7 years). Localization success rate was 100%. For 38 patients (97.4%), tissue sample size was enough for tissue diagnosis. For 1 case, it was insufficient and nondiagnostic. In this series, we had no surgery-related complications.

Conclusions: We present the largest reported series of MRI-guided frame-based stereotactic biopsy of the posterior fossa lesions via a transcerebellar route. We prefer oblique positioning of the frame on the skull and use a transcerebellar route to reduce surgical complications and achieve a greater localization success rate.

Keywords: Complication; Magnetic resonance imaging; Oblique; Posterior fossa; Stereotactic biopsy; Transcerebellar; Transfrontal.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Diseases / pathology*
  • Brain Stem / pathology*
  • Case-Control Studies
  • Cerebellum / pathology*
  • Child
  • Cranial Fossa, Posterior
  • Equipment Design
  • Female
  • Humans
  • Image-Guided Biopsy / instrumentation
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prospective Studies
  • Stereotaxic Techniques / instrumentation*
  • Young Adult