Efficacy of a Second Brain Biopsy for Intracranial Lesions after Initial Negativity.
brain tumor
corticosteroids
diagnosis
neoplasms
neuropathology
neurosurgery
Journal
Journal of clinical neurology (Seoul, Korea)
ISSN: 1738-6586
Titre abrégé: J Clin Neurol
Pays: Korea (South)
ID NLM: 101252374
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
19
05
2020
revised:
21
07
2020
accepted:
21
07
2020
entrez:
8
10
2020
pubmed:
9
10
2020
medline:
9
10
2020
Statut:
ppublish
Résumé
The rationale for performing a second brain biopsy after initial negativity is not well evaluated in the literature. This study was designed to 1) assess the efficacy of a second brain biopsy when the first biopsy was nondiagnostic, 2) identify possible factors associated with an increased diagnostic rate in the second biopsy, and 3) analyze additional morbidity induced by the second biopsy. We performed a retrospective cohort study from 2009 to 2019, during which 1,919 patients underwent a brain biopsy, including 30 who were biopsied twice (1.6%). The specific histological diagnosis rate, diagnosis-associated factors, and complication rate were assessed for the 30 twice-biopsied patients. The second biopsy allowed a specific histological diagnosis in 86.7% of the patients who had initially undergone a nondiagnostic brain biopsy [odds ratio (OR)=7.5, 95% confidence interval (CI)=3.0-18.7, Performing a second brain biopsy in patients who have an initial nondiagnostic biopsy is effective in most cases. We advocate that a second biopsy be systematically considered in the diagnosis algorithm of these patients after it has been verified that molecular testing cannot help to obtain a diagnosis. Corticosteroid administration can lead to nondiagnostic biopsies and should be avoided when possible during the prebiopsy period.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
The rationale for performing a second brain biopsy after initial negativity is not well evaluated in the literature. This study was designed to 1) assess the efficacy of a second brain biopsy when the first biopsy was nondiagnostic, 2) identify possible factors associated with an increased diagnostic rate in the second biopsy, and 3) analyze additional morbidity induced by the second biopsy.
METHODS
METHODS
We performed a retrospective cohort study from 2009 to 2019, during which 1,919 patients underwent a brain biopsy, including 30 who were biopsied twice (1.6%). The specific histological diagnosis rate, diagnosis-associated factors, and complication rate were assessed for the 30 twice-biopsied patients.
RESULTS
RESULTS
The second biopsy allowed a specific histological diagnosis in 86.7% of the patients who had initially undergone a nondiagnostic brain biopsy [odds ratio (OR)=7.5, 95% confidence interval (CI)=3.0-18.7,
CONCLUSIONS
CONCLUSIONS
Performing a second brain biopsy in patients who have an initial nondiagnostic biopsy is effective in most cases. We advocate that a second biopsy be systematically considered in the diagnosis algorithm of these patients after it has been verified that molecular testing cannot help to obtain a diagnosis. Corticosteroid administration can lead to nondiagnostic biopsies and should be avoided when possible during the prebiopsy period.
Identifiants
pubmed: 33029973
pii: 16.659
doi: 10.3988/jcn.2020.16.4.659
pmc: PMC7542000
doi:
Types de publication
Journal Article
Langues
eng
Pagination
659-667Informations de copyright
Copyright © 2020 Korean Neurological Association.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
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