Monocentric clinical experience with frameless biopsy of supratentorial intraaxial lesions

Abstract

Neuronavigated biopsy is a type of minimally invasive neurosurgical technique that allows careful planning and selection of one or more biopsy trajectories while preserving eloquent parenchymal areas by real-time tracking of the biopsy needle’s window. The aim of this study is to evaluate the technical and diаgnоstic efficacy of neuronavigated (frameless) biopsy in patients with supratentorial intraaxial lesions and to present the surgical technique used in these biopsies. A retrospective study has been conducted which includes the medical documentation of patients with intracranial lesions in whom neuronavigated frameless biopsy under general anesthesia was performed at the Clinic of Neurosurgery of University Hospital – “St. Marina” in Varna in the period from 2019 to 2021 year. 40 patients were included in the study. In 15 of the cases an isolated biopsy of the intraaxial lesion has been performed. In 25 of the cases a biopsy followed by an open excision of the intraaxial lesion has been performed. Dаtа were anаlyzed with SPSS versiоn 24. The reported diagnostic yield was 95%. Final intraoperative histological diagnosis was reached in 38 patients. In one patient (2.5%) the histological diagnosis was changed after immunohistochemical examination. In one patient (2.5%) the histological diagnosis was changed after excision of the lesion. One microbiological diagnosis was reached. No clinically significant complications or fatalities associated with the surgical technique were reported. Frаmeless biopsy in patients with suprаtentorial intraaxial lesions is a safe and effective procedure with high diagnostic value.