The clinical utility of multimodal MR image-guided needle biopsy in cerebral gliomas

Abstract

Purpose: Our aim was to evaluate the diagnostic value of multimodal Magnetic Resonance (MR) Image in the stereotactic biopsy of cerebral gliomas, and investigate its implications. Materials and Methods: Twenty-four patients with cerebral gliomas underwent ¹H Magnetic Resonance Spectroscopy (¹H-MRS)- and intraoperative Magnetic Resonance Imaging (iMRI)-supported stereotactic biopsy, and 23 patients underwent only the preoperative MRI-guided biopsy. The diagnostic yield, morbidity and mortality rates were analyzed. In addition, 20 patients underwent subsequent tumor resection, thus the diagnostic accuracy of the biopsy was further evaluated. Results: The diagnostic accuracies of biopsies evaluated by tumor resection in the trial groups were better than control groups (92.3% and 42.9%, respectively, p = 0.031). The diagnostic yield in the trial groups was better than the control groups, but the difference was not statistically significant (100% and 82.6%, respectively, p = 0.05). The morbidity and mortality rates were similar in both groups. Conclusions: Multimodal MR image-guided glioma biopsy is practical and valuable. This technique can increase the diagnostic accuracy in the stereotactic biopsy of cerebral gliomas. Besides, it is likely to increase the diagnostic yield but requires further validation.

KEYWORDS:

• MRS
• intraoperative MRI
• biopsy
• glioma

Acknowledgments

The authors would like to thank the nurses (Qiuyue Wu, Chunmei Li and Ye Wang) and the iMRI technician (Zhong Yang) on our team for their cooperation during the complex procedures. We would also like to thank Jianbing Shi for providing wonderful technical support in neuronavigation, and Jie Zhang for performing MRI date processing.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

This work was supported by the National Natural Science Foundation of China (Nos. 81271517 and 81171295), Shanghai Municipal Health Bureau (XBR2011022) and the National Key Technology R&D Program of China (No. 2014BAI04B05).