Efficacy, safety, and impact of fluorescein in frameless stereotactic needle biopsies – a case series

• Published in: Neurosurgical review 2024-09, Vol.47 (1), p.523, Article 523
• Main Authors: Dellaretti, Marcos, de Lima, Franklin Bernardes Faraj, de Sena, Pedro Henrique Velasco Pondé, Figueiredo, Hian Penna Gavazza, Albuquerque, João Pedro Santos, Gomes, Fernando Cotrim, Dias Faria, Barbara Caroline, de Almeida, Júlio César
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy, Needle - adverse effects; Biopsy, Needle - methods; Brain Neoplasms - diagnosis; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Female; Fluorescein; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Prospective Studies; Retrospective Studies; Stereotaxic Techniques
• ISSN: 1437-2320; 1437-2320
• DOI: 10.1007/s10143-024-02758-6

Stereotactic needle biopsy stands as a crucial method for diagnosing intracranial lesions unsuitable for surgical intervention. Nonetheless, the potential for sampling errors lead to innovative approaches to enhance diagnostic precision. This study contrasts the outcomes of patients undergoing fluorescein-assisted frameless stereotactic needle biopsy with those receiving traditional biopsies to evaluate the impact on diagnostic accuracy and safety. This study included patients with contrast-enhancing intracranial lesions, comprising a prospective group undergoing fluorescein-assisted biopsies and a retrospective group undergoing conventional biopsies at the same institution. We’ve collected data on demographics, procedural specifics, diagnostic outcomes, and postoperative events. A comparative analysis involved 43 patients who received fluorescein-assisted biopsies against 77 patients who underwent conventional biopsies. The average age was 60.5 years. The fluorescein group exhibited a 93% success rate in diagnosis, markedly higher than the 70.1% in the non-fluorescein group (OR = 5.67; 95%IC: 1.59–20.24; p