Comparison Meta-analysis of Intraoperative MRI-guided Needle Biopsy Versus Conventional Stereotactic Needle Biopsies

Overview

Journal Neurooncol Adv

Publisher Oxford University Press

Date 2024 Jan 8

PMID 38187873

Authors

Sanjay Dhawan

Clark C Chen

Affiliations

Soon will be listed here.

Abstract

Background: MRI-guided needle biopsy (INB) is an emerging alternative to conventional frame-based or frameless stereotactic needle biopsy (SNB). Studies of INB have been limited to select case series, and comparative studies between INB and SNB remain a missing gap in the literature. We performed a meta-analysis to compare INB and SNB literature in terms of diagnostic yield, surgical morbidity and mortality, tumor size, and procedural time.

Methods: We identified 36 separate cohorts in 26 studies of SNB (including both frameless and frame-based biopsies, 3374 patients) and 27 studies of INB (977 patients). Meta-regression and meta-analysis by proportions were performed.

Results: Relative to publications that studied SNB, publications studying INB more likely involved brain tumors located in the eloquent cerebrum (79.4% versus 62.6%, = 0.004) or are smaller in maximal diameter (2.7 cm in INB group versus 3.6 cm in the SNB group, = .032). Despite these differences, the pooled estimate of diagnostic yield for INB was higher than SNB (95.4% versus 92.3%, = .026). The pooled estimate of surgical morbidity was higher in the SNB group (12.0%) relative to the INB group (6.1%) ( = .004). Mortality after the procedure was comparable between INB and SNB (1.7% versus 2.3%, = .288). Procedural time was statistically comparable at 90.3 min (INB) and 103.7 min (SNB), respectively ( = .526).

Conclusions: Our meta-analysis indicates that, relative to SNB, INB is more often performed for the challenging, smaller-sized brain tumors located in the eloquent cerebrum. INB is associated with lower surgical morbidity and improved diagnostic yield.

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