title: [Integration of metabolism images into multimodal neuronavigation for frameless stereotaxy].
abstract: OBJECTIVE
  To evaluate the efficacy of integration of metabolism images into multimodal neuronavigation for frameless stereotactic biopsy.
  
  
  METHODS
  From January to December 2012, 32 patients with brain lesions underwent frameless stereotactic biopsy guided by positron emission tomograph (PET) and proton magnetic resonance spectroscopy ((1)H-MRS)-based multimodal neuronavigation and intraoperative magnetic resonance imaging (iMRI). The cohort consisted of 16 male and 16 female patients, with a mean age of 45 years (range: 7 - 62 years). Biopsy targets were identified according to PET and (1)H-MRS. Biopsy was performed with Varioguide frameless biopsy system. Diagnostic yield and complications were assessed.
  
  
  RESULTS
  Metabolism images-based multimodal neuronavigation and iMRI were successfully implemented in all cases. iMRI confirmed accuracy of biopsy targets. All the specimens obtained pathological diagnosis, the diagnostic yield was 100%. In 1 patient, iMRI found small hematoma (< 5 ml), surgical evacuation wasn't needed with intraoperative complication rate 3.1%. With the help of multimodal neuronavigation, no patients had new or worsened neurologic deficits.
  
  
  CONCLUSIONS
  Integration of metabolism images into multimodal neuronavigation provide not only anatomical, but also metabolic and functional information for frameless stereotaxy, increasing diagnostic yield and avoiding postoperative neurologic deficits.
authors.affiliation: Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Fang-ye
authors.initials: FY
authors.lastname: Li
authors.forename: Xiao-lei
authors.initials: XL
authors.lastname: Chen
authors.forename: Ting-ting
authors.initials: TT
authors.lastname: He
authors.forename: Jia-shu
authors.initials: JS
authors.lastname: Zhang
authors.forename: Zhi-jun
authors.initials: ZJ
authors.lastname: Song
authors.forename: Jin-jiang
authors.initials: JJ
authors.lastname: Li
authors.forename: Gang
authors.initials: G
authors.lastname: Zheng
authors.forename: Shen
authors.initials: S
authors.lastname: Hu
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.forename: Bai-nan
authors.initials: BN
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000379:methods*; D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation; D049268:Positron-Emission Tomography; D013238:Stereotaxic Techniques; D055815:Young Adult