Endoscopic biopsy for lesions located in the parenchyma of the brain: Preoperative planning based on stereotactic methods -technical note-

Abstract

Endoscope biopsy guided navigation for intra-parenchymal lesions is safe and effective, but determination of the entry point and trajectory of the endoscopic biopsy is less clear. We describe preoperative planning based on stereotactic methods, and achieving the plan using several techniques. The preoperative planning was based on stereotactic methods such as determining target, entry point, and trajectory. A transparent sheath was advanced under guidance of the navigation system and specimens collected under visual endoscopic monitoring. After collecting specimens, intraoperative magnetic resonance imaging was performed for confirming accurate sampling. Correct specimens were obtained in 6 cases as confirmed by intraoperative magnetic resonance imaging. The histological diagnoses were diffuse large B-cell type malignant lymphoma (n = 3), astrocytoma (n = 1), glioblastoma (n = 1), and inflammatory changes without neoplastic cells (n = 1). No postoperative intracranial hemorrhage or other operative complications occurred. Preoperative planning based on stereotactic methods and procedures guided by navigation systems can achieve endoscopic biopsy for intraparenchymal lesions safely and accurately.