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Review
. 2020 Oct;31(4):515-526.
doi: 10.1016/j.nec.2020.06.002. Epub 2020 Aug 14.

The Role of Stereotactic Biopsy in Brain Metastases

Kenny K H Yu  1 , Ankur R Patel  1 , Nelson S Moss  2
Affiliations
Review

The Role of Stereotactic Biopsy in Brain Metastases

Kenny K H Yu et al. Neurosurg Clin N Am. 2020 Oct.

Abstract

Brain metastases (BrM) affect up to 20% of patients with cancer and represent an increasing portion of patients with surgical brain tumors owing to improving prognoses of cancer patients in general and in many cases even of those with brain metastases. With advances in molecular biology and targeted therapy, the indications for neurosurgical sampling and specifically stereotactic biopsy are likely to change in the future. In this review the authors address some of the scientific advances in BrM biology, the clinical rationale and range of techniques currently used to perform stereotactic biopsy, and how the advent of molecular interrogation may potentially alter the way patients with BrM are managed in the future.

Keywords: Brain metastasis; Image-guided biopsy; Stereotactic techniques.

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Conflict of interest statement

Disclosure NM has consulted for AstraZeneca. KY has consulted for BrainLab AG.

Figures

Figure 1:
Figure 1:
(A) Navigus brain biopsy bone anchor. (Reprinted with the permission of Medtronic, Inc. ©). (B) Varioguide biopsy arm. (Courtesy of Brainlab AG).
Figure 1:
Figure 1:
(A) Navigus brain biopsy bone anchor. (Reprinted with the permission of Medtronic, Inc. ©). (B) Varioguide biopsy arm. (Courtesy of Brainlab AG).
Figure 2:
Figure 2:
Axial T1 weighted post-contrast (A) and diffusion weight images (DWI, B) MRIs of the brain demonstrating a ring enhancing mass in the left internal capsule without restricted diffusion. Two month post-treatment axial T1 weighted post-contrast MRI of the brain (C) reveals a resolving cystic lesion.
Figure 3:
Figure 3:
(A) Axial T1 weighted post-contrast MRI of the brain displaying a right medial occipital enhancing mass. (B) Axial T1 weighted post-contrast MRI of the brain demonstrates a multicystic peripherally enhancing mass in the right parietal lobe. (C) Axial T1 weighted post-contrast MRI of the brain demonstrates a ring enhancing mass in the right posterior frontal lobe.
See this image and copyright information in PMC

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