[Significance of stereotactic biopsy for the management of WHO grade II supratentorial glioma].
OBJECTIVE
The aim of this prospective study was to compare the diagnostic value of magnetic resonance imaging (MRI) and stereotactic biopsy in patients harboring WHO grade II gliomas.


METHODS
Stereotactic biopsy was performed in 62 adult patients with low-signal, nonenhancing, space-occupying lesions on T1 MR imaging between 1998 and 2001. The results of histological analysis were compared to the preoperative imaging diagnoses. Any adverse perioperative sequel was considered as morbidity. Applied treatment strategies are described.


RESULTS
Transient perioperative morbidity for the stereotactic approach was 4.8% (three patients), and there was no mortality or permanent morbidity. In four patients, neoplastic lesions could be excluded (gliosis: three patients, encephalitis: one), and WHO grade III gliomas were seen in five patients (14.8.% false positive rate of neurodiagnostic imaging). The diagnostic reliability of stereotactic biopsy was 96.8%. The following treatment strategies were initiated: microsurgery (17 patients), interstitial radiosurgery (12 patients), combination of microsurgery and interstitial radiosurgery (21 patients), external beam irradiation (six patients),and chemotherapy (two patients). Four patients were initially not treated.


CONCLUSIONS
Diagnostic neuroimaging is not sufficient for the planning of rational treatment strategies in patients harboring WHO grade II gliomas. Frame-based stereotactic biopsy is a prerequisite for individualized treatment strategies.
Muacevic
A
A
Neurochirurgische Klinik, Klinikum Grosshadern, Munich.
Kreth
F W
FW
D000328:Adult; D001706:Biopsy / Q000009:adverse effects; D001921:Brain / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D005910:Glioma / Q000145:classification / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016634:Radiosurgery; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000145:classification; D015173:Supratentorial Neoplasms / Q000145:classification / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed
Der Stellenwert der stereotaktischen Hirnbiopsie für das Management von Patienten mit supratentoriellen Gliomen WHO-Grad-II.