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      Feasibility of freehand CT and 3-T MR guided brain aspiration biopsies with 18/20-gauge coaxial needles

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      Author(s)
      Algın, Oktay
      Ayberk, G.
      Date
      2022-07
      Source Title
      Japanese Journal of Radiology
      Print ISSN
      1867-1071
      Publisher
      Springer
      Volume
      40
      Issue
      7
      Pages
      740 - 748
      Language
      English
      Type
      Article
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      Abstract
      Background and purpose: An accurate histopathological examination with minimal neuronal damage is essential for optimizing treatment strategies of central nervous system lesions. We investigated the feasibility and safety of CT and 3-tesla (3 T) MR-guided freehand brain aspiration biopsies with 18/20-gauge coaxial needles in performing a single imaging unit. Materials and methods: We reviewed CT and 3 T-MR guided freehand aspiration biopsies with 18/20-gauge coaxial needles of 33 patients (11-female and 22-male, mean and median ages: 53 years, min–max 21–79 years) in our tertiary hospital within an 8-year-period were included in this retrospective study. Lesion sizes, diagnostic yield, morbidity, and mortality rates of these biopsies without a scalp incision, surgical burr-hole, or stereotactic-instrumentation/neuro-navigation guidance were assessed. All biopsies were performed with local anesthesia and sedation within a single imaging unit of our radiology department. All free-hand biopsies were done as in-patient procedures and the patients were closely observed after the biopsies. Results: The mean diameter of the lesions was 27 mm (median 25; range 15–46 mm). The diagnostic yield of all free-hand brain biopsies was 88% [one inconclusive result (90%) for 3 T-MR; three inconclusive results (87%) for CT]. There was no major hemorrhage or hematoma, no clinical deterioration, or no infection in our patients on early- and late-phase examinations. Postprocedural minor hemorrhage with a ≤ 2 cm diameter was observed in two patients. The morbidity rate of the study population is 6%. There was no procedure-related infection or mortality in the post-procedural 3 weeks. Conclusions: Freehand CT or 3 T-MR guided aspiration biopsy was a safe and feasible method for pathological diagnosis of intracranial lesions. Biopsy workflow was simplified with this technique. It could be considered a valuable alternative for stereotaxic biopsies, especially for centers that do not have stereotaxic equipment or experience. © 2022, The Author(s) under exclusive licence to Japan Radiological Society.
      Keywords
      3-tesla (3T)
      Brain biopsy
      Central nervous system
      Lymphoma
      MRI
      Tumors
      Permalink
      http://hdl.handle.net/11693/111594
      Published Version (Please cite this version)
      https://doi.org/10.1007/s11604-022-01257-2
      Collections
      • Aysel Sabuncu Brain Research Center (BAM) 249
      • National Magnetic Resonance Research Center (UMRAM) 301
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