Eshagh Bahrami1, Mansour Parvaresh2, Mahsa Bahrami1, Arash Fattahi1. 1. Neurosurgery, Iran University of Medical Sciences, Tehran, Iran. 2. Neurosurgery, Iran University of Medical Sciences, Tehran, Iran. Electronic address: parvareshrizi.m@iums.ac.ir.
Abstract
BACKGROUND: Tissue diagnosis for lesions in the posterior fossa, such as the brainstem, cerebellar peduncle, and cerebellum, is an important determinant of the next treatment option. Herein, we present our 10-year experience with magnetic resonance imaging (MRI)-guided frame-based stereotactic biopsy for 39 patients with posterior fossa lesions, the largest case series in this matter. METHODS: We performed a retrospective cross-sectional study on all patients with posterior fossa lesion admitted to 2 referral centers between 2006 and 2016. We used Leksell Frame G for stereotactic biopsy of all patients. MRI systems of both hospitals were 1.5 T. RESULTS: We performed analysis on the 39 cases (21 men and 18 women). Age of the patients ranged between 9 and 73 years (mean, 35.4 ± 15.7 years). Localization success rate was 100%. For 38 patients (97.4%), tissue sample size was enough for tissue diagnosis. For 1 case, it was insufficient and nondiagnostic. In this series, we had no surgery-related complications. CONCLUSIONS: We present the largest reported series of MRI-guided frame-based stereotactic biopsy of the posterior fossa lesions via a transcerebellar route. We prefer oblique positioning of the frame on the skull and use a transcerebellar route to reduce surgical complications and achieve a greater localization success rate.
BACKGROUND: Tissue diagnosis for lesions in the posterior fossa, such as the brainstem, cerebellar peduncle, and cerebellum, is an important determinant of the next treatment option. Herein, we present our 10-year experience with magnetic resonance imaging (MRI)-guided frame-based stereotactic biopsy for 39 patients with posterior fossa lesions, the largest case series in this matter. METHODS: We performed a retrospective cross-sectional study on all patients with posterior fossa lesion admitted to 2 referral centers between 2006 and 2016. We used Leksell Frame G for stereotactic biopsy of all patients. MRI systems of both hospitals were 1.5 T. RESULTS: We performed analysis on the 39 cases (21 men and 18 women). Age of the patients ranged between 9 and 73 years (mean, 35.4 ± 15.7 years). Localization success rate was 100%. For 38 patients (97.4%), tissue sample size was enough for tissue diagnosis. For 1 case, it was insufficient and nondiagnostic. In this series, we had no surgery-related complications. CONCLUSIONS: We present the largest reported series of MRI-guided frame-based stereotactic biopsy of the posterior fossa lesions via a transcerebellar route. We prefer oblique positioning of the frame on the skull and use a transcerebellar route to reduce surgical complications and achieve a greater localization success rate.