Intraparenchymal brain lesion biopsy guided by a rigid endoscope and navigation system.
BACKGROUND
The authors report a continuous case series of navigation-guided rigid endoscopic biopsy via the transcortical route for intraparenchymal brain lesions to assess the feasibility and efficacy of the method.


METHODS
Thirty-four patients with intraparenchymal brain lesions found on neurovisualization underwent navigation-guided rigid endoscopic biopsy. Most of the preoperative diagnoses were glioma WHO Grade II-IV (16 cases) or malignant lymphoma (15 cases). Intraoperative photodynamic diagnosis and intraoperative pathological diagnosis were used in 28 and 29 cases, respectively. In 2 cases with small and deep lesions, intraoperative magnetic resonance imaging was used for confirming the accuracy of the biopsy point.


RESULTS
The sampling accuracy determined by postoperative imaging and the definitive diagnosis ratio were 94% (32 out of 34 cases) and 97% (33 out of 34 cases), respectively. There was no postoperative mortality. In 2 patients, mild postoperative permanent morbidity (5.9%), presumably related to this technique, was observed in the early cases in the current group (34 case series).


CONCLUSIONS
The method was estimated as safe and feasible for diagnostic tissue sampling of intraparenchymal brain lesions.
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Eiichi
E
Ishikawa
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Tetsuya
T
Yamamoto
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Masahide
M
Matsuda
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Hiroyoshi
H
Akutsu
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Alexander
A
Zaboronok
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Hidehiro
H
Kohzuki
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Shunichiro
S
Miki
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Shingo
S
Takano
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Akira
A
Matsumura
Endoscopic biopsy; high-grade glioma; malignant lymphoma; needle biopsy