Evaluation of 311 contemporary cases of stereotactic biopsies in patients with neoplastic and non-neoplastic lesions-diagnostic yield and management of non-diagnostic cases.
Evaluation of 311 contemporary cases of stereotactic biopsies in patients with neoplastic and non-neoplastic lesions-diagnostic yield and management of non-diagnostic cases.
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DOI：
10.1007/s10143-020-01394-0
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发表时间：
2021-10
影响因子：
2.8
通讯作者：
Schipmann S
中科院分区：
文献类型：
--
作者：
Pasternak KA;Schwake M;Warneke N;Masthoff M;Zawy Alsofy S;Suero Molina E;Stummer W;Schipmann S
立体定向活检是一个既定的工具，以获得诊断不明脑病变。然而，非诊断性活检仍然发生。我们的目的是分析立体定向活检的当代诊断率、非诊断性活检的预测因素、结果和非诊断性活检后的随访策略。我们对2012年至2018年期间在我科因新诊断病变接受立体定向活检的311例成人患者进行了一项单中心回顾性研究。获得了关于合并症、症状、影像学特征和非侵入性诊断程序的患者数据。总体诊断率为86.2%，在不同疑似诊断组之间差异显著，与非肿瘤性病变相比，疑似原发性脑肿瘤的诊断率最高（91.2% vs. 73.3%，p > 0.001）。非诊断性活检的预测因素是小病灶大小、缺乏对比增强、存在脓毒症或潜在的血液肿瘤疾病。在非诊断性活检的情况下，在12例病例中进行了再次活检，最终诊断率为75%。在16例病例中，根据疑似基础疾病开始经验性治疗。对其余15例病例进行了密切随访。我们发现，立体定向活检是一个安全的程序，合理的诊断率，即使是非肿瘤性病变，当非侵入性诊断是不确定的。此外，我们还为非诊断性活检病例制定了治疗建议。
Stereotactic biopsies are an established tool for obtaining diagnosis of unclear brain lesions. However, non-diagnostic biopsies still occur. We aimed to analyze the contemporary diagnostic yield of stereotactic biopsies, predictors for non-diagnostic biopsies, outcome, and follow-up strategy after non-diagnostic biopsy. We conducted a single-center retrospective study of 311 adult patients undergoing stereotactic biopsies due to a newly diagnosed lesion at our department between 2012 and 2018. Patient data regarding comorbidities, presenting symptoms, imaging features, and non-invasive diagnostic procedures were obtained. The overall diagnostic yield was 86.2% and differed significantly between the various suspected diagnosis groups and was the highest when suspecting primary brain tumor compared with non-neoplastic lesions (91.2% vs. 73.3%, p > 0.001). Predicators for non-diagnostic biopsies were small lesion size, lack of contrast-enhancement, presence of sepsis, or underlying hemato-oncological disease. In case of non-diagnostic biopsy, a re-biopsy was performed in 12 cases, revealing a final diagnosis in 75%. In 16 cases, empiric therapy was started based on the suspected underlying disease. Close follow-up was performed in the remaining 15 cases. We showed that stereotactic biopsy is a safe procedure with reasonable diagnostic yield even for non-neoplastic lesions, when non-invasive diagnostic was inconclusive. In addition, we developed treatment recommendations for cases of non-diagnostic biopsies.
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影响因子：
1.9
作者：
Aebelo, Andreas M.;Noera, Victor R.;Poulsen, Frantz R.
通讯作者：
Poulsen, Frantz R.
影响因子：
3.3
作者：
Jain, Deepali;Sharma, Mehar Chand;Mahapatra, A. K.
通讯作者：
Mahapatra, A. K.
DOI：
10.1055/s-0038-1676597
发表时间：
2019-05-01
影响因子：
1
作者：
Lara-Almunia, Monica;Hernandez-Vicente, Javier
通讯作者：
Hernandez-Vicente, Javier
影响因子：
4.1
作者：
LEVIVIER, M;GOLDMAN, S;BROTCHI, J
通讯作者：
BROTCHI, J
影响因子：
3
作者：
Kongkham, Paul N.;Knifed, Eva;Bernstein, Mark
通讯作者：
Bernstein, Mark