CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(04): 701-706
DOI: 10.1055/s-0044-1789593
Original Article

Improving Diagnostic Yield and Accuracy of Stereotactic Biopsies through Changes in Practice and Techniques: An 8-Year Single-Center Comparative Study

Kugan Vijian
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
,
Bik Liang Lau
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
,
Davendran Kanesen
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
,
Swee San Lim
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
,
Donald L. Ngian
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
,
Albert S. Hieng Wong
1   Department of Neurosurgery, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
› Author Affiliations
Funding None.

Abstract

Background Stereotactic biopsies are used to aid neurosurgeons in clinching the diagnosis of intracranial lesions that are difficult to access surgically. A published study of stereotactic biopsies in our center demonstrated a diagnostic yield of only 76% for biopsies from the year 2014 to 2019. A set of criteria/prerequisites was applied to increase yield.

Objective The aim of the study was to identify the improvement in accuracy and yield after implementation of a set of criteria/prerequisites.

Materials and Methods This was a retrospective and prospective analysis of all patients who underwent stereotactic biopsies from the year 2014 to 2022. This study was conducted at Sarawak General Hospital, Malaysia. A set of stereotactic criteria/prerequisites was introduced since 2020, which include preoperative careful, meticulous trajectory planning and target selection, regular checking and maintenance of equipment, larger burr holes, and good sampling techniques.

Results A total of 83 patients underwent stereotactic biopsies from the year 2014 to 2022. Frameless and frame-based methods were used for 45 (54%) and 38 (46%) patients, respectively. The overall diagnostic yield of all biopsies was 84%. Fifty patients underwent stereotactic biopsies prior to implementation of good practice guidelines in 2020 with a positive histopathological yield and accuracy of 76 and 88%, respectively. Thirty-three biopsies done postimplementation demonstrated a yield and accuracy of 97% (p < 0.05). There was also a shift of preference toward frame-based methods after 2019, with 85% of these biopsies being frame based.

Conclusion This comparative study shows that adherence to specific stereotactic biopsy guidelines and techniques introduced in our center has successfully improved our biopsy yield and accuracy.

Authors' Contributions

K.V, B.L.L., and A.S.H.W. have given substantial contributions to the conception and the design of the manuscript. S.S.L. and D.L.N. have contributed in providing the samples and designing the methodology. K.V, B.L.L., and D.K. have contributed to acquisition, analysis, and interpretation of the data. All the authors participated in drafting the manuscript, and author A.S.H.W. revised it critically. All the authors contributed equally to the manuscript and read and approved the final version of the manuscript.




Publication History

Article published online:
02 September 2024

© 2024. Asian Congress of Neurological Surgeons. 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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