Combined magnetic resonance imaging- and positron emission tomography-guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients.

Details

Serval ID
serval:BIB_DADBF0FDF643
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Combined magnetic resonance imaging- and positron emission tomography-guided stereotactic biopsy in brainstem mass lesions: diagnostic yield in a series of 30 patients.
Journal
Journal of Neurosurgery
Author(s)
Massager N., David P., Goldman S., Pirotte B., Wikler D., Salmon I., Nagy N., Brotchi J., Levivier M.
ISSN
0022-3085 (Print)
ISSN-L
0022-3085
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
93
Number
6
Pages
951-957
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
OBJECT: In the management of brainstem lesions, the place of stereotactic biopsy sampling remains debatable. The authors compared the results of magnetic resonance (MR) imaging, positron emission tomography (PET) scanning, and histological studies obtained in 30 patients who underwent MR imaging- and PET-guided stereotactic biopsy procedures for a brainstem mass lesion.
METHODS: Between July 1991 and December 1998, 30 patients harboring brainstem mass lesions underwent a stereotactic procedure in which combined MR imaging and PET scanning guidance were used. Positron emission tomography scanning was performed using [18F]fluorodeoxyglucose in 16 patients, methionine in two patients, and both tracers in 12 patients. Definite diagnosis was established on histological examination of the biopsy samples. Interpretation of MR imaging findings only or PET findings only was in agreement with the histological diagnosis in 63% and 73% of cases, respectively. Magnetic resonance imaging and PET findings were concordant in 19 of the 30 cases; in those cases, imaging data correlated with histological findings in 79%. Treatment based on information derived from MR imaging was concordant with therapy based on histological findings in only 17 patients (57%). Combining MR imaging and PET scanning data, the concordance between the neuroimaging-based treatment and treatments based on histological findings increased to 19 patients (63%). In seven patients who underwent biopsy procedures with one PET-defined and one MR imaging-defined trajectory, at histological examination the PET-guided samples were more representative of the tumor's nature and grade than the MR imaging-guided samples in four cases (57%). In 18 patients PET scanning was used to define a biopsy target and provided a diagnostic yield in 100% of the cases.
CONCLUSIONS: Although the use of combined PET and MR imaging improves radiological interpretation of a mass lesion in the brainstem, it does not accurately replace histological diagnosis that is provided by a stereotactically obtained biopsy sample. Combining information provided by MR imaging and PET scanning in stereotactic conditions improves the accuracy of targeting and the diagnostic yield of the biopsy sample; an MR imaging- and PET-guided stereotactic biopsy procedure is a safe and efficient modality for the management of mass lesions of the brainstem.
Keywords
Adolescent, Adult, Aged, Biopsy, Brain Stem/pathology, Brain Stem Neoplasms/pathology, Brain Stem Neoplasms/surgery, Child, Child, Preschool, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Stereotaxic Techniques, Tomography, Emission-Computed
Pubmed
Web of science
Create date
20/01/2008 17:35
Last modification date
20/08/2019 16:00
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