Clinical application of multimodal image fusion in stereotactic biopsy of intracranial lesions

Abstract

Objective To explore the clinical application of multimodal image fusion in stereotactic biopsy of intracranial lesions. Methods A total of 34 patients underwent multimodal image-guided stereotactic biopsy and were enrolled into this study from January to December 2016 at Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University. Images including PET/CT, 1H-MRS, BOLD-fMRI, DTI were fused with structural MRI for target confirmation and trajectory design. Framed stereotactic biopsy was performed in 14 patients and frameless stereotactic biopsy was performed in the other 20 patients. The diagnostic yield and complications of biopsy were assessed. Results Stereotactic biopsy was successfully performed in all cases including 32 with supratentorial lesions and 2 with infratentoria lesions. Post-biopsy pathology revealed glioma in 14 patients, lymphoma in 12, metastatic tumors in 6 and inflammatory demyelinating diseases in 2. The diagnostic yield was 100%. Post-biopsy CT confirmed the accuracy of biopsy targets. A small hematoma (< 5 ml) in target area was found in 1(2.9%, 1/34) patient without severe complications and no further operation was performed. There was no bleeding in any trajectory or newly-occurred neurological deficits. Conclusion Multimodal image fusion could provide anatomical, metabolic and functional information for stereotactic biopsy, increase diagnostic yield and reduce complications. Key words: Brain diseases; Biopsy; Stereotactic technology; Multimodal image fusion technique