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Factors affecting diagnostic yield in stereotactic biopsy for brain lesions: a 5-year single-center series

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Abstract

The objective of this study is to determine the factors that are associated with the diagnostic yield of stereotactic brain biopsy. A retrospective analysis was performed on 50 consecutive patients who underwent stereotactic brain biopsies in a single institute from 2014 to 2019. Variables including age, gender, lesion topography and characteristics, biopsy methods, and surgeon’s experience were analyzed along with diagnostic rate. This study included 31 male and 19 female patients with a mean age of 48.4 (range: 1–76). Of these, 25 underwent frameless brain-suite stereotactic biopsies, 15 were frameless Portable Brain-lab® stereotactic biopsies and 10 were frame-based CRW® stereotactic biopsies. There was no statistical difference between the diagnostic yield of the three methods. The diagnostic yield in our series was 76%. Age, gender, and biopsy methods had no impact on diagnostic yield. Periventricular and pineal lesion biopsies were significantly associated with negative diagnostic yield (p = 0.01) whereas larger lesions were significantly associated with a positive yield (p = 0.01) with the mean volume of lesions in the positive yield group (13.6 cc) being higher than the negative yield group (7 cc). The diagnostic yields seen between senior and junior neurosurgeons in the biopsy procedure were 95% and 63%, respectively (p = 0.02). Anatomical location of the lesion, volume of the lesion, and experience of the surgeon have significant impacts on the diagnostic yield in stereotactic brain biopsy. There was no statistical difference between the diagnostic yield of the three methods, age, gender, and depth of lesion.

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Availability of data and material

The data that support the findings of this study are not publicly available on legal or ethical grounds except an approval from hospital director.

Code availability

• Microsoft Excel ©

• SPSS software version 20.0 ® (SPSS Inc., Chicago, IL)

• Radionic Stereocalc®

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Acknowledgements

We would like to acknowledge the support from Dr. Ngian Hie Ung (Director of Sarawak General Hospital), all the participating neurosurgeons in Sarawak General Hospital (SGH), Dr. Peter Tan (neuro-anesthesiology SGH), Dr. Lau Kiew Siong (Head of Radiology, SGH) and his staff, and Dr. Jacqueline Wong (Head of Pathology, SGH) in the conduct of this study. We would like to thank the Datuk Dr. Noor Hisham bin Abdullah (Director General of Health Malaysia) for his permission to publish this article.

Finally, I would like to acknowledge with gratitude the support and love of my family—my sons, Matthew, Marcus, and Martin; and my beloved wife, Hie Chin Wong. They kept me going, and this article writing would not have been possible without them.

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Authors and Affiliations

  1. Department of Neurosurgery, Sarawak General Hospital, Ministry of Health, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia

    Bik Liang Lau, Kugan Vijian, Donald Ngian San Liew & Albert Sii Hieng Wong

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  1. Bik Liang Lau
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  2. Kugan Vijian
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  3. Donald Ngian San Liew
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  4. Albert Sii Hieng Wong
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Contributions

Conception and design: Bik Liang Lau. Acquisition of data: Bik Liang Lau, Kugan Vijian. Analysis and interpretation of data: Bik Liang Lau, Kugan Vijian. Drafting the article: Bik Liang Lau. Critically reviewing the article: Bik Liang Lau, Albert Sii Hieng Wong. Reviewed submitted version of the manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: Bik Liang Lau. Administrative/technical/material support: all authors. Agreement to be accountable for all aspects of work: Bik Liang Lau.

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Correspondence to Bik Liang Lau.

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Ethics approval

This study was registered under the National Medical Research Register, Ministry of Health Malaysia (NMRR ID: NMRR-21–1213-60517). The study complies with the guidelines for human studies and conducted ethically in accordance with World Medical Association Declaration of Helsinki. This is a retrospective data collection study. A hospital director’s consent was granted for data collection. Director’s consent for publication was granted as well.

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Not applicable.

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This study had gained publication approval from National Medical Research Register, National Institute of Health (NIH), Malaysia.

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The authors declare no competing interests.

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Lau, B.L., Vijian, K., Liew, D.N.S. et al. Factors affecting diagnostic yield in stereotactic biopsy for brain lesions: a 5-year single-center series. Neurosurg Rev 45, 1473–1480 (2022). https://doi.org/10.1007/s10143-021-01671-6

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  • DOI: https://doi.org/10.1007/s10143-021-01671-6

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