Accuracy and Diagnostic Yield of the New AW stereotactic Frame and Its Comparison with The CRW Frame for Brain Biopsy.

Objective: The Albert-Wong (AW) stereotactic frame for brain biopsy was created by a Malaysian neurosurgeon in 2015. A phantom-based accuracy study demonstrated that its accuracy was non-inferior to well-established stereotactic frames. The objective of our study is to compare the diagnostic yield and accuracy between two stereotactic frame systems: the CRW and AW frame.

Methods: This was a retrospective cross-sectional study. All patients who had undergone frame-based biopsy for intracranial lesions using the CRW or AW frame from the year 2014 to 2022 were included in this study. Sociodemographic details, biopsy characteristics, and histopathological reports were collected, tabulated, and analyzed. A p-value of < 0.05 was regarded as statistically significant.

Results: A total of 38 patients underwent frame-based stereotactic biopsy from January 2014 to January 2022. The CRW frame was used for 19 (50%) of the patients, and the remaining utilized the AW frame. Deep lesions were biopsied in 27 (71%) of the patients, and the overall diagnostic yield was 89.5%. When comparing sociodemography and lesion characteristics between the CRW and AW frame groups, no statistically significant differences were found. The diagnostic yield and accuracy of these frames were 100% vs 84% and 100% vs 90% (AW vs CRW), respectively, with no statistical difference between them (p > 0.05).

Conclusion: This study found that biopsies with the AW frame demonstrated diagnostic yield and accuracy which were non-inferior to the older more established frame (CRW).