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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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"Two are never enough"- Impact of the number of tissue samples taken in stereotactic biopsy

Meeting Abstract

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  • Johanna Quick - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Julia Tichy - Neuroonkologie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Patrick Harter - Edinger Institut für Neurologie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Stephanie Tritt - Institut für Neuroradiologie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Nazife Dinc - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Volker Seifert - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Gerhard Marquardt - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.17.08

doi: 10.3205/17dgnc483, urn:nbn:de:0183-17dgnc4839

Published: June 9, 2017

© 2017 Quick et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Stereotactic procedures are performed in many neurosurgical departments in order to obtain tumor tissues from brain lesions for histopathological evaluation. It is still unclear how many tissue samples have to be taken to establish a final diagnosis based on histopathological and genetic examinations. Only histopathological diagnosis results in adequate therapy.

Methods: We included 43 consecutive patients who underwent stereotactic biopsy of a suspected glioblastoma between 02/2013 and 07/2015. All patients showed contrast enhancing tumors in the MRI. The patients underwent stereotactic biopsy with the Leksell frame attached to their head. Target and Entry Points were calculated with BrainLab iplan software (BrainLab iplan 1.0, Feldkirchen, Germany). First the two samples 5mm before the Target (pre-target) and the “Targetpoint” itself were analyzed (group 1), then a histopathological evaluation of all samples was performed (group 2).

Results: Regarding all patients, a median of 14 samples were taken. Using hematoxilin-eosin staining a correct histopathological diagnosis was made in only 30 cases of group 1. In detail a correct diagnosis was made in 73% of the glioblastoma patients, in none of the anaplastic astrocytoma patients, in 100% of diffuse glioma patients, and in 100% of the carcinoma patients. In 3 cases of group 1 only necrosis was found. Contrariwise a final diagnosis was made in 100% of the patients of group 2.

Conclusion: For patients with suspected glioblastoma, a minimum sample number of ten (4-6 samples for hematoxilin-eosin staining and 4 for molecular diagnosis) should be taken for histopathologic and genetic examination in order to establish a final diagnosis.