Accuracy of VarioGuide Frameless Stereotactic System Against Frame-Based Stereotaxy: Prospective, Randomized, Single-Center Study
Accuracy of VarioGuide Frameless Stereotactic System Against Frame-Based Stereotaxy: Prospective, Randomized, Single-Center Study
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DOI：
10.1016/j.wneu.2017.04.104
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发表时间：
2017-08-01
影响因子：
2
通讯作者：
Benes, Vladimir
中科院分区：
文献类型：
--
作者：
Bradac, Ondrej;Steklacova, Anna;Benes, Vladimir
引言：无框架立体定向脑活检系统目前被广泛使用。VarioGuide（VG）是一种相对新颖的无框架系统。其准确性在实验室环境中进行了研究，但尚未在临床环境中进行研究。本研究的目的是确定其准确性和诊断率，并比较这与框架为基础的（FB）stereotaxy.MATERIAL和METHODS：总体而言，53例患者（33名男性和20名女性，60 +/- 15岁）被纳入本前瞻性，随机，单中心研究。26例患者被随机分配到FB组，27例患者被随机分配到VG组。术中磁共振显示真实的轨迹。计算了目标的距离以及规划轨迹与真实的轨迹之间的角度偏差。结果：中位病变体积为5 mL（四分位距[IQR]：2-16 mL）（FB）和16 mL（IQR：2-27 mL）（VG），P [0.133]。目标的平均距离为2.7 +/- 1.1 mm（FB）和2.9 +/- 1.3 mm（VG），P = 0.456。平均角度偏差为2.6 +/- 1.3度（FB）和3.5 +/- 2.1度（VG），P = 0.074。VG和FB的诊断率分别为93%（25/27）和96%（25/26），P = 1.000。平均手术时间为47 +/- 26分钟（FB）和59 +/- 31分钟（VG），P = 0.140。VG组中发生1例轻微出血。FB组的总体患者不适感明显更高（视觉模拟量表评分2.5 +/- 2.1 vs. 1.2 +/- 0.6，P = 0，004）。结论：VG系统在轨迹准确性、并发症发生率和诊断率方面与传统FB立体定位术所代表的“金标准”相当，适用于接受脑活检的患者。VG也更容易被患者接受。
INTRODUCTION: Frameless stereotactic brain biopsy systems are widely used today. VarioGuide (VG) is a relatively novel frameless system. Its accuracy was studied in a laboratory setting but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based (FB) stereotaxy.MATERIAL AND METHODS: Overall, 53 patients (33 males and 20 females, 60 +/- 15 years old) were enrolled into this prospective, randomized, single-center study. Twentysix patients were randomized into the FB group and 27 patients into the VG group. Real trajectory was pointed on intraoperative magnetic resonance. The distance of the targets and angle deviation between the planned and real trajectories were computed. The overall discomfort of the patient was subjectively assessed by the visual analog scale score.RESULTS: The median lesion volume was 5 mL (interquartile range [IQR]: 2-16 mL) (FB) and 16 mL (IQR: 2-27 mL) (VG), P [0.133. The mean distance of the targets was 2.7 +/- 1.1 mm (FB) and 2.9 +/- 1.3 mm (VG), P = 0.456. Mean angle deviation was 2.6 +/- 1.3 deg (FB) and 3.5 +/- 2.1 deg (VG), P = 0.074. Diagnostic yield was 93% (25/27) in VG and 96% (25/26) in FB, P = 1.000. Mean operating time was 47 +/- 26 minutes (FB) and 59 +/- 31 minutes (VG), P = 0.140. One minor bleeding was encountered in the VG group. Overall patient discomfort was significantly higher in the FB group (visual analog scale score 2.5 +/- 2.1 vs. 1.2 +/- 0.6, P = 0,004).CONCLUSIONS: The VG system proved to be comparable in terms of the trajectory accuracy, rate of complications and diagnostic yield compared with the "gold standard" represented by the traditional FB stereotaxy for patients undergoing brain biopsy. VG is also better accepted by patients.