Perfusion MRI as a neurosurgical tool for improved targeting in stereotactic tumor biopsies.
Stereotact Funct Neurosurg
; 90(4): 240-7, 2012.
Article
em En
| MEDLINE
| ID: mdl-22699810
ABSTRACT
OBJECTIVE:
Stereotactic biopsies are subject to sampling errors (essentially due to target selection). The presence of contrast enhancement is not a reliable marker of malignancy. The goal of the present study was to determine whether perfusion-weighted imaging can improve target selection in stereotactic biopsies.METHODS:
We studied 21 consecutive stereotactic biopsies between June 2009 and March 2010. Perfusion-weighted magnetic resonance imaging (MRI) was integrated into our neuronavigator. Perfusion-weighted imaging was used as an adjunct to conventional MRI data for target determination. Conventional MRI alone was used to determine the trajectory.RESULTS:
We found a linear correlation between regional cerebral blood volume (rCBV) and vessel density (number of vessels per mm(2); R = 0.64; p < 0.001). Perfusion-weighted imaging facilitated target determination in 11 cases (52.4%), all of which were histopathologically diagnosed as glial tumors. For glial tumors, which presented with contrast enhancement, perfusion-weighted imaging identified a more precisely delimited target in 9 cases, a different target in 1 case, and exactly the same target in 1 other case. In all cases, perfusion-selected sampling provided information on cellular features and tumor grading. rCBV was significantly associated with grading (p < 0.01), endothelial proliferation (p < 0.01), and vessel density (p < 0.01). For lesions with rCBV values ≤1, perfusion-weighted MRI did not help to determine the target but was useful for surgical management.CONCLUSIONS:
For stereotactic biopsies, targeting based on perfusion-weighted imaging is a feasible method for reducing the sampling error and improving target selection in the histopathological diagnosis of tumors with high rCBVs.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Encefálicas
/
Técnicas Estereotáxicas
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Angiografia por Ressonância Magnética
/
Glioma
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Linfoma
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Stereotact Funct Neurosurg
Assunto da revista:
NEUROCIRURGIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
França