The role of biopsy in the management of patients with presumed diffuse low grade glioma

Journal of Neuro-Oncology - Tập 125 - Trang 481-501 - 2015
Brian T. Ragel1, Timothy C. Ryken2, Steven N. Kalkanis3, Mateo Ziu4, Daniel Cahill5, Jeffrey J. Olson6
1Rebound Orthopedics and Neurosurgery, Vancouver, USA
2Department of Neurosurgery, University of Kansas Medical Center, Kansas City, USA
3Department of Neurosurgery, Henry Ford Health System, Detroit, USA
4Department of Neurosurgery, Seton Brain and Spine Institute, Austin, USA
5Massachusetts General Hospital, Boston, USA
6Department of Neurosurgery, Emory University School of Medicine, Atlanta, USA

Tóm tắt

What is the optimal role of biopsy in the initial management of presumptive low-grade glioma in adults? Adult patients with imaging suggestive of a low-grade glioma. Stereotactic biopsy is recommended when definitive surgical resection is limited by lesions that are deep-seated, not resectable, and/or located within eloquent cortex, or in patients unable to undergo craniotomy due to medical co-morbidities to obtain the critical tissue diagnosis needed for targeted treatment planning for patients with low-grade gliomas. What is the best technique for brain biopsy? Adult patients with imaging suggestive of a low-grade glioma. Frameless and frame-based stereotactic brain biopsy for low-grade gliomas are recommended based on clinical circumstances as they provide similar diagnostic yield, diagnostic accuracy, morbidity, and mortality. It is recommended the surgeon consider advanced imaging techniques (e.g., perfusion, spectroscopy, metabolic studies) to target specific regions of interest to potentially improve diagnostic accuracy.

Tài liệu tham khảo

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