Prevalence and risk factors of nonyield brain biopsy: a 21-year experience with robot-assisted stereotactic biopsies.

IF 3.6 2区医学 Q1 CLINICAL NEUROLOGY

Journal of neurosurgery Pub Date : 2025-09-12 DOI:10.3171/2025.2.JNS242273

Xavier Schumacher, Benoit Hudelist, Luca Paun, Joseph Benzakoun, Marco Demasi, Meissa Hamza, Alexandre Roux, Alessandro Moiraghi, Angela Elia, Eduardo Parraga, Edouard Dezamis, Fabrice Chretien, Pascale Varlet, Catherine Oppenheim, Johan Pallud, Marc Zanello

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引用次数: 0

Abstract

Objective: Magnetic resonance imaging-based, robot-assisted stereotactic brain biopsy is increasingly used worldwide. However, large series reporting nonyield biopsy rates of robot-assisted biopsies are lacking in the literature. The aim of this study was to report a 21-year-long experience on MRI-based, robot-assisted stereotactic biopsy for brain lesions.

Methods: The records from a single-center, retrospective, and consecutive collection of all adult patients undergoing MRI-based, robot-assisted stereotactic biopsy for a brain lesion in a tertiary neurosurgical center from December 2002 to January 2024 were reviewed.

Results: A total of 911 patients (377 females, mean age at surgery 61.1 ± 16.7 years) were included. Of these patients, 15 (1.6%) had a nonyield biopsy. The nonyield biopsy rate remained stable over the 21-year-long study period (p = 0.224). The nonyield biopsy rate was significantly higher for neurological diseases (4/19, 21.5%) than infectious diseases (1/20, 5.0%) and tumors (10/872, 1.1%) (p < 0.001). There were significantly more nonyield biopsies for deep-seated lesions (8/261, 3.1%) than for superficial lesions (6/612, 1.0%) (p = 0.025) and non-contrast-enhanced lesions (6/99, 6.1%) than in contrast-enhanced lesions (9/797, 1.1%) (p < 0.001). Patients in the nonyield biopsy group had significantly smaller lesions on both contrast-enhanced 3D T1-weighted sequences (1.9 ± 2.2 vs 27.1 ± 29.5 cm3, p = 0.046) and FLAIR sequences (14.0 ± 17.0 vs 80.7 ± 73.3 cm3, p < 0.001). Preoperative corticosteroid administration (407/911, 44.7%; with the bias that corticosteroids were avoided in patients with suspected lymphoma), number of biopsy samples (mean 4.9 ± 2.4), neurosurgeon experience, and WHO classification versions were not associated with a higher risk of nonyield biopsy (p = 0.274, p = 0.053, p = 0.968, and p = 0.366, respectively).

Conclusions: MRI-based, robot-assisted stereotactic biopsy led to a low rate of nonyield biopsy. Neurological disease, non-contrast-enhanced lesions, and deep-seated lesions were more at risk of nonyield biopsy.

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脑活检无效的患病率和危险因素：21年机器人辅助立体定向活检的经验。

目的：基于磁共振成像的机器人辅助立体定向脑活检在世界范围内的应用越来越广泛。然而，文献中缺乏大量报道机器人辅助活检的无产活检率。本研究的目的是报告21年来基于mri的机器人辅助立体定向脑病变活检的经验。方法：回顾2002年12月至2024年1月在三级神经外科中心接受基于mri的机器人辅助立体定向脑病变活检的所有成年患者的单中心、回顾性和连续收集的记录。结果：共纳入患者911例（女性377例，平均手术年龄61.1±16.7岁）。在这些患者中，15例（1.6%）进行了无产性活检。在21年的研究期间，非产率活检保持稳定（p = 0.224）。神经系统疾病（4/19,21.5%）的无产活检率显著高于感染性疾病（1/20,5.0%）和肿瘤（10/872,1.1%）（p < 0.001）。深层病变（8/261,3.1%）明显多于浅表病变（6/612,1.0%）（p = 0.025），非对比增强病变（6/99,6.1%）明显多于对比增强病变（9/797,1.1%）（p < 0.001）。非产性活检组患者在增强3D t1加权序列（1.9±2.2 vs 27.1±29.5 cm3, p = 0.046）和FLAIR序列（14.0±17.0 vs 80.7±73.3 cm3, p < 0.001）上的病变明显较小。术前皮质类固醇给药（407/911,44.7%，疑似淋巴瘤患者避免使用皮质类固醇）、活检样本数量（平均4.9±2.4）、神经外科医生经验和WHO分类版本与活检无效的高风险无关（p = 0.274, p = 0.053, p = 0.968, p = 0.366）。结论：以mri为基础，机器人辅助的立体定向活检导致低率的无良活检。神经系统疾病、非对比增强病变和深部病变更容易发生无果性活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of neurosurgery 医学-临床神经学

CiteScore

7.20

自引率

7.30%

发文量

1003

审稿时长

1 months

期刊介绍： The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.