Efficacy, Safety, and Impact of Fluorescein in Frameless Stereotactic Needle Biopsies – A Case Series

Author:

Dellaretti Marcos1,Lima Franklin Bernardes Faraj1,de Sena Pedro Henrique Velasco Pondé1,Figueiredo Hian P. G.1,Gomes Fernando Cotrim2,Faria Barbara Caroline Dias2,Almeida Julio César1

Affiliation:

1. Santa Casa de BH e Faculdade Santa Casa BH

2. Universidade Federal de Minas Gerais (UFMG)

Abstract

Abstract

Introduction: Stereotactic needle biopsy stands as a crucial method for diagnosing intracranial lesions unsuitable for surgical intervention. Nonetheless, the potential for sampling errors necessitates 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. Materials and Methods: 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. Results: 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 (Odds Ratio = 5.67; 95% Confidence Interval: 1.59-20.24; p=0.0074). The rate of complications was statistically similar across both cohorts. Discussion: Despite its established value, stereotactic needle biopsy is susceptible to inaccuracies and complications. The application of fluorescence-based adjuncts like 5-ALA and fluorescein has been investigated to improve diagnostic fidelity and reduce risks. These technologies potentially minimize the necessity for multiple biopsies, decrease surgical duration, and provide immediate verification of tumor presence. Conclusion: Fluorescein-assisted stereotactic biopsy emerges as an effective, secure alternative to conventional methods.

Publisher

Springer Science and Business Media LLC

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