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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2023; 42(03): e233-e238
DOI: 10.1055/s-0043-1775556
Original Article

Accuracy Comparison between Frameless Biopsy and Frame-Based Biopsy: A Retrospective Study of a Case Series

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Abstract

Objective To compare the efficacy and safety of frameless and frame-based techniques for biopsies of intracranial lesions in an exclusive assistance service at a public health center in Brazil (SUS).

Method A review of 65 medical records of patients with brain lesions who underwent a frame-based or frameless biopsy from September 2017 to July 2019 was performed.

Results Among the 65 patients who underwent biopsy, 42 were male, and 23 were female. The mean age was 53.1 years. Most patients (49; 75.4%) presented hemispheric lesions, and, of these, 27 were in the frontal lobe (41,5%). The diagnostic rate was 78.5% (51 of 65 patients), and glial neoplasia was the most common diagnosis. In addition to glial neoplasia, a wide range of pathologies were diagnosed, such as toxoplasmosis, metastasis, lymphoma, inflammatory lesions, and abscesses. Among the 14 patients (21.5%) with inconclusive results, 8 had gliosis without neoplasia (12.3%), 4 had necrosis (6.1%), and 2 had insufficient samples (3%).

The morbidity rate was 9.2%, with 4 cases of hemorrhage, 1 case of infection, and 1 case of worsening of neurological deficits. The mortality rate was 6.1% and occurred in all cases with hemorrhage.

There were no significant differences in the diagnosis or complication (morbidity and mortality) rates between the frame-based and frameless groups.

Conclusion The frame-based and frameless techniques for stereotactic biopsy present similar efficacy and safety.

Resumo

Objetivo Comparar a eficácia e a segurança das técnicas frameless e frame-based para biópsias de lesões intracranianas em um serviço de atendimento exclusivo de um centro de saúde público do Brasil (SUS).

Método Foi realizada uma revisão de 65 prontuários de pacientes com lesões cerebrais submetidos a biópsia com ou sem moldura no período de setembro de 2017 a julho de 2019.

Resultados Dos 65 pacientes submetidos à biópsia, 42 eram do sexo masculino e 23 do sexo feminino. A média de idade foi de 53,1 anos. A maioria dos pacientes (49; 75,4%) apresentava lesões hemisféricas e, destes, 27 eram no lobo frontal (41,5%). A taxa de diagnóstico foi de 78,5% (51 de 65 pacientes), e a neoplasia glial foi o diagnóstico mais comum. Além da neoplasia glial, foram diagnosticadas diversas patologias, como toxoplasmose, metástase, linfoma, lesões inflamatórias e abscessos. Dos 14 pacientes (21,5%) com resultados inconclusivos, 8 apresentavam gliose sem neoplasia (12,3%), 4 apresentavam necrose (6,1%) e 2 apresentavam amostras insuficientes (3%). A taxa de morbidade foi de 9,2%, com 4 casos de hemorragia, 1 caso de infecção e 1 caso de agravamento de déficits neurológicos. A taxa de mortalidade foi de 6,1% e ocorreu em todos os casos com hemorragia. Não houve diferenças significativas nas taxas de diagnóstico ou complicações (morbidade e mortalidade) entre os grupos frame-based e frameless.

Conclusão As técnicas frame-based e frameless para biópsia estereotáxica apresentam eficácia e segurança semelhantes.

Keywords

neurosurgery - biopsy - frameless - frame-based - intracranial - lesions

Palavras-chave

neurocirurgia - biópsia - frameless - frame-based - intracraniana - lesões


Publication History

Received: 16 March 2022

Accepted: 21 June 2022

Article published online:
29 September 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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