Artikel
Feasibility, risk profile and diagnostic yield of stereotactic biopsy in the pediatric population
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Autoren
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Christina A. Hamisch
- Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie,; Klinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie
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Philipp Kickingereder
- Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie,; Neurologische Klinik, Abteilung für Neuroradiologie, Universitätsklinikum Heidelberg
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Tobias Blau ,Thorsten Simon<SUP>5</SUP>
- Institut für Neuropathologie, Universitätsklinikum Köln
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Maximilian I. Ruge
- Klinik für Stereotaxie und Funktionelle Neurochirurgie, Zentrum für Neurochirurgie
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: While stereotactic biopsies (SB) are widely accepted as routine diagnostic tool for unclear cerebral pathologies in adult patients, there is still a certain reluctance to apply this technique for the pediatric population. Probable reasons might be the localization of pathologies predominantly in highly eloquent regions (posterior fossa/midline structures) and/or a perceived elevation of other peri-operative risks. Here we present feasibility, risk profile and diagnostic yield of SB in one of the largest reported pediatric populations.
Method: All pediatric patients (age<21) who underwent SB in our institution (1994-2013) were analyzed in detail retrospectively regarding success of performing the SB, diagnostic yield, and procedural complications. These parameters were correlated with localization (lobar vs. midline) and amount of biopsy material (1 vs. ≥ 2 probes)
Results: 133 patients (median age 11.0 ± 5.1 range 1-20) underwent 148 SB's located lobar (41) and midline (97) (for baseline characteristics see table 1). Tissue was obtained in all cases (90.6% ≥ 2 probes) and was diagnostic in 93.2%. In 3.4% a second SB procedure was successful. Mortality was zero and procedural morbidity was transient and low (5.4%). These parameters were not influenced by localization or amount of biopsy material.
Conclusions: In the pediatric population SB can be performed safely and with a high diagnostic yield in specialized institutions. Under the aspect of providing tissue for advanced histo-pathological- immunological and molecular information to tailor more individualized treatment this well established technique deserves to be considered more often in the pediatric population.
