Stereotactically inserted tube-guided brain biopsy using positron emission tomography and magnetic resonance coregistered images--case report.
A 53-year-old man presented with malignant lymphoma manifesting as disturbances of walking and standing. Magnetic resonance (MR) imaging showed multifocal bifrontal lesions which were enhanced by gadolinium-diethylenetriaminepenta-acetic acid. Positron emission tomography (PET) with [18F]fluorodeoxyglucose showed high uptake of tracer in the lesion. The PET-MR coregistered image was used to determine the biopsy target. After right frontal craniotomy, a sterilized probe controlled by a neuronavigation system was directly passed into the tumor, and a guide tube was inserted along the same track. After dura opening, a small corticotomy was performed along the guide tube track and the tumor was biopsied. Histological examination revealed malignant lymphoma. The stereotactically inserted tube-guided brain biopsy was less invasive and provided an accurate diagnosis. The PET-MR coregistered image was helpful for determining the most active lesion of the brain tumor.
Masada
Tetsuya
T
Department of Neurological Surgery, Kagawa Medical University, Kita-gun, Kagawa, Japan. tmasada@kms.ac.jp
Takayama
Kazuhiro
K
Kunishio
Katsuzo
K
Nagao
Seigo
S
D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology*; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation; D025321:Surgery, Computer-Assisted; D014055:Tomography, Emission-Computed