J Neurol Surg B Skull Base 2025; 86(S 01): S1-S576
DOI: 10.1055/s-0045-1803870
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Revolutionizing Brain Biopsies: The ClearPoint-Guided Technique: Technical Insights and Initial Mayo Clinic Experience

Authors

  • Emiliano Sanchez-Garavito

    1   Mayo Clinic, Florida, United States

  • Harshvardhan Iyer

    1   Mayo Clinic, Florida, United States

  • Carlos Perez-Vega

    1   Mayo Clinic, Florida, United States

  • Juan Pablo Navarro Garcia de Llano

    1   Mayo Clinic, Florida, United States

  • Adrian Safa

    1   Mayo Clinic, Florida, United States

  • Erik Middlebrooks

    1   Mayo Clinic, Florida, United States

  • Rabih Tawk

    1   Mayo Clinic, Florida, United States

  • Kaisorn Chaichan

    1   Mayo Clinic, Florida, United States

  • Alfredo Quinones-Hinojosa

    1   Mayo Clinic, Florida, United States

  • Sanjeet Grewal

    1   Mayo Clinic, Florida, United States
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    Introduction: Midbrain and thalamic tumors are notoriously difficult to biopsy due to their deep location and proximity to critical brain structures. Stereotactic needle biopsy, augmented by image-guided navigation and intraoperative MRI, provides a precise method for diagnosing these challenging lesions. The ClearPoint SmartFrame Array Neuro Navigation System offers three-dimensional surgical planning and real-time trajectory adjustments, enhancing biopsy accuracy and safety.

    Objective: This study aims to evaluate the efficacy and safety of the ClearPoint SmartFrame Array in performing biopsies on midbrain and thalamic tumors.

    Methods: From May 2021 to June 2023, eight patients with thalamic or brainstem lesions underwent stereotactic biopsies using the ClearPoint system. The procedure involved preoperative and intraoperative MRI scans for precise lesion targeting and trajectory planning. Patient demographics, procedural details, pathology results, and postoperative outcomes were documented.

    Results: The study included five male and three female patients, aged 21 to 81 years, with symptoms such as diplopia, dysphagia, tremors, headache, hemiparesis, and hydrocephalus. The average operating room (OR) time was 145 minutes. Pathological diagnoses included: one benign lesion, two astrocytomas, one lymphoma, one glioblastoma, one ganglioglioma, one neuroepithelial neoplasm, and one inconclusive case. Postoperative treatments included radiotherapy, temozolomide, bevacizumab, and methotrexate. There were no intraoperative complications. The ClearPoint system's accuracy allowed for successful first-attempt biopsies in all cases, reducing procedure time and hospital stay.

    Conclusion: The ClearPoint SmartFrame Array is a precise, safe, and efficient tool for stereotactic biopsies of midbrain and thalamic tumors. Its advanced design and real-time MRI guidance significantly improve surgical outcomes, reducing OR time, length of stay, and intraoperative complications. The system demonstrates superiority over traditional stereotactic frames, establishing it as a preferred method to biopsy challenging brain lesions.


     

    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    07 February 2025

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