Accuracy of VarioGuide Frameless Stereotactic System Against Frame-Based Stereotaxy: Prospective, Randomized, Single-Center Study
Language English Country United States Media print-electronic
Document type Journal Article, Randomized Controlled Trial
PubMed
28454992
DOI
10.1016/j.wneu.2017.04.104
PII: S1878-8750(17)30612-5
Knihovny.cz E-resources
- Keywords
- Accuracy, Brain biopsy, Clinical outcome, Diagnostic yield, Frame-based stereotaxy, Frameless stereotaxy, Intraoperative magnetic resonance,
- MeSH
- Biopsy instrumentation MeSH
- Equipment Design MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Image Interpretation, Computer-Assisted instrumentation MeSH
- Cohort Studies MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging instrumentation MeSH
- Brain pathology MeSH
- Brain Neoplasms pathology secondary surgery MeSH
- Neuronavigation instrumentation MeSH
- Observer Variation MeSH
- Tomography, X-Ray Computed MeSH
- Aged MeSH
- Sensitivity and Specificity MeSH
- Imaging, Three-Dimensional MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
INTRODUCTION: Frameless stereotactic brain biopsy systems are widely used today. VarioGuide (VG) is a relatively novel frameless system. Its accuracy was studied in a laboratory setting but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based (FB) stereotaxy. MATERIAL AND METHODS: Overall, 53 patients (33 males and 20 females, 60 ± 15 years old) were enrolled into this prospective, randomized, single-center study. Twenty-six patients were randomized into the FB group and 27 patients into the VG group. Real trajectory was pointed on intraoperative magnetic resonance. The distance of the targets and angle deviation between the planned and real trajectories were computed. The overall discomfort of the patient was subjectively assessed by the visual analog scale score. RESULTS: The median lesion volume was 5 mL (interquartile range [IQR]: 2-16 mL) (FB) and 16 mL (IQR: 2-27 mL) (VG), P = 0.133. The mean distance of the targets was 2.7 ± 1.1 mm (FB) and 2.9 ± 1.3 mm (VG), P = 0.456. Mean angle deviation was 2.6 ± 1.3 deg (FB) and 3.5 ± 2.1 deg (VG), P = 0.074. Diagnostic yield was 93% (25/27) in VG and 96% (25/26) in FB, P = 1.000. Mean operating time was 47 ± 26 minutes (FB) and 59 ± 31 minutes (VG), P = 0.140. One minor bleeding was encountered in the VG group. Overall patient discomfort was significantly higher in the FB group (visual analog scale score 2.5 ± 2.1 vs. 1.2 ± 0.6, P = 0,004). CONCLUSIONS: The VG system proved to be comparable in terms of the trajectory accuracy, rate of complications and diagnostic yield compared with the "gold standard" represented by the traditional FB stereotaxy for patients undergoing brain biopsy. VG is also better accepted by patients.
Department of Neuroradiology Military University Hospital Prague The Czech Republic
Department of Neurosurgery Royal Hallamshire Hospital Sheffield United Kingdom
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