Evaluation of frame based versus frameless stereotactic biopsy technique in the diagnosis of deep seated brain lesions.

Abstract

Stereotactic brain biopsy has been established as an indispensable tool for modern neurosurgeons. This technique provides a relatively straightforward, very accurate, and fairly safe method of obtaining diagnostic tissue, particularly for lesions that are deeply situated or located in eloquent regions of the brain .

The Cartesian coordinate system, X (lateral), Y (anterior posterior), Z (cranial-caudal), was born and remains the basis of stereotactic surgery .

Frame-based stereotaxis (FB) is a well-established technique for performing three-dimensional point stereotactic needle procedures such as diagnostic biopsies, lesion aspirations, and brachytherapy instillation. It has proved a safe and effective tool since it was first coupled with computed planar imaging nearly three decades ago.

Frame‑based stereotactic biopsy is still regarded as an important diagnostic tool. It requires less anesthesia resources, less operating room time, and shorter hospital stays than the frame‑less stereotactic navigation.

The development of frameless stereotaxis (FL) has been rapidly embraced by most neurosurgeons to the extent that it is rapidly supplanting FB techniques in general neurosurgical practice. Some early reports have suggested that FL techniques are as good as or better than the traditional frame- based approach.