Narrow band imaging-guided endoscopic biopsy for intraventricular and paraventricular brain tumors: clinical experience with 14 cases.
BACKGROUND
Narrow-band imaging (NBI) has been confirmed as a useful endoscopic technique to distinguish neoplasm from normal tissue, on the basis of the enhanced neovascularity of tumor tissue. NBI-guided tissue biopsy for laryngopharyngeal and digestive lesions is a novel methodology, but the feasibility for central nervous system tumors remains unclear. The aim of our study was to evaluate the feasibility of NBI-guided biopsy for intraventricular and paraventricular tumor.


METHODS
Fourteen patients with intraventricular or paraventricular tumors underwent neuroendoscopic biopsy using a videoscope with NBI. Ventricular walls and tumors were observed using conventional imaging, followed by NBI. Colors of ventricle walls and tumors visualized using NBI were compared to those visualized under conventional imaging. Extracted specimens were stained using CD31 antibody and numbers of microvessels in each specimen were counted for analyzing vascular density.


RESULTS
Normal ventricle walls were a similar color under conventional imaging and NBI. Tumor surfaces appeared to be cyan in color under NBI. Vessels on the tumor were more clearly visualized with NBI than with conventional imaging. NBI was able to identify tumor surfaces that were not perceptible on conventional imaging. All specimens in the lesion surfaces from cyan-colored areas under NBI contained tumor cells. Specimens extracted from regions that appeared cyan in color under NBI (51.0 vessels/mm(2)) had significantly greater vascular density than regions that appeared a normal color (17.4 vessels/mm(2); p = 0.039).


CONCLUSIONS
NBI-guided biopsy of intraventricular and paraventricular tumors is feasible for visualizing tumor surface-enhancing neovascularities. NBI would contribute to accurate histological diagnosis while minimizing injury to surrounding structures.
Department of Neurosurgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, 920-0293, Japan, yacchan1218@yahoo.co.jp.
Yasuo
Y
Sasagawa
Takuya
T
Akai
Satoko
S
Nakada
Hiroshi
H
Minato
Osamu
O
Tachibana
Takayuki
T
Nojima
Hideaki
H
Iizuka
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001932:Brain Neoplasms / Q000098:blood supply / Q000473:pathology*; D002551:Cerebral Ventricle Neoplasms / Q000098:blood supply / Q000473:pathology*; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D009389:Neovascularization, Pathologic / Q000473:pathology; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods; D055815:Young Adult