Abstract
INTRODUCTION: Tissue heterogeneity and rapid tumor progression may decrease the accuracy and prognostic value of stereotactic brain biopsy in the diagnosis of gliomas. Correct tumor grading is therefore dependent on accuracy of biopsy needle placement. The accuracy of frameless and frame-based techniques in the diagnosis and grading of glioma remains unstudied. METHODS: The diagnoses of 21 astrocytic brain tumors were derived using image-guided stereotactic biopsy (12 frame-based, 9 frameless) and followed by open resection of the lesion 1.5 months (0.5–4 mo) later. The histological diagnoses yielded by biopsy were compared with subsequent histological diagnosis from open tumor resection. RESULTS: Stereotactic biopsy histology accurately represented the greater lesion at open resection a median of 45 days later in 16 patients (76%) and correctly guided therapy in 19 (91%). Biopsy accuracy of frameless versus frame-based stereotaxy was similar (89 versus 66%, P = 0.21). In 3 patients (14%), biopsy specimens were adequate...
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