gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Intraoperative low-field MR-guided frameless stereotactic biopsy for intracerebral lesions

Meeting Abstract

  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Christoph M. Woernle - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Marian C. Neidert - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • René-Ludwig Bernays - Klinik für Neurochirurgie, Hirslanden Klinik, Zürich, Schweiz
  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.14.03

doi: 10.3205/13dgnc119, urn:nbn:de:0183-13dgnc1193

Published: May 21, 2013

© 2013 Burkhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To present our intraoperative low-field magnetic resonance imaging (ioMRI) technique for stereotactic brain biopsy in various intracerebral lesions.

Method: Seventy-eight consecutive patients underwent stereotactic biopsies with the PoleStar N-20/N-30 ioMRI system and data were evaluated retrospectively. Biopsy technique included ioMRI before surgery, followed by insertion of the biopsy cannula in the lesion based on the calculated trajectory. IoMRI confirmed accurate placement before biopsy and after surgery to exclude intraoperative complications. Statistical analysis was performed to compare subgroups using Excel and SPSS statistic software.

Results: In all patients stereotactic biopsy was possible with a mean intraoperative surgery time of 86.2 ± 28.6 minutes and a mean hospital stay of 11.6 ± 4.6 days. In 97.4% (n=76) histology was conclusive representing 58 brain tumors and 18 other pathologies. 5 patients were biopsied before without conclusive diagnosis and all biopsies were conclusive this time. Mean cross-sectional lesion size in MRI T1 with contrast (n=64) was 6.9 ± 5.7 cm2 and in lesions without T1 contrast enhancement (n=14) T2 mean cross-sectional lesion size was 5.5 ± 3.9 cm2. Mean distance from the cortex surface to the lesion was 3.4 ± 1.2cm. One patient suffered from a postoperative wound dehiscence, neither clinically or radiologically significant hemorrhage after surgery nor intraoperative complications occurred.

Conclusions: Low-field ioMR-guided frameless stereotactic biopsy accurately diagnosed different intracerebral lesions with rare complications for the patient and within an acceptable surgery time and hospital stay. In repeated non-conclusive biopsies in particular, low-field ioMRI offers a technique for arriving at a diagnosis.