The molecular diagnostic yield of frame-based stereotactic biopsies in the age of precision neuro-oncology: a cross-sectional study.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
09 2023
Historique:
received: 07 06 2023
accepted: 23 07 2023
medline: 5 9 2023
pubmed: 9 8 2023
entrez: 8 8 2023
Statut: ppublish

Résumé

With the increasing role of molecular genetics in the diagnostics of intracranial tumors, delivering sufficient representative tissue for such analyses is of paramount importance. This study explored the rate of successful diagnosis after frame-based stereotactic biopsies of intracranial lesions. Consecutive patients undergoing frame-based stereotactic biopsies in 2020 and 2021 were included in this retrospective analysis. Cases were classified into three groups: conclusive, diagnosis with missing molecular genetics (MG) data, and inconclusive neuropathological diagnosis. Of 145 patients, a conclusive diagnosis was possible in n = 137 cases (94.5%). For 3 cases (2.0%), diagnosis was established with missing MG data. In 5 cases (3.5%), an inconclusive (tumor) diagnosis was met. Diagnoses comprised mainly WHO 4 glioblastomas (n = 73, 56%), CNS lymphomas (n = 23, 16%), inflammatory diseases (n = 14, 10%), and metastases (n = 5, 3%). Methylomics were applied in 49% (n = 44) of tumor cases (panel sequencing in n = 28, 30% of tumors). The average number of specimens used for MG diagnostics was 5, while the average number of specimens provided was 15. In a univariate analysis, insufficient DNA was associated with an inconclusive diagnosis or a diagnosis with missing MG data (p < 0.001). Analyses of planned and implemented trajectories of cases with diagnosis with missing MG data or inconclusive diagnosis (n = 8) revealed that regions of interest were reached in almost all cases (n = 7). Although stereotactic frame-based biopsies deliver a limited amount of tissue, they bear high histopathological and molecular genetic diagnostic yields. Given the proven surgical precision of the planned biopsy trajectories, optimizing surveyed lesion regions could help improve the rate of conclusive diagnoses.

Identifiants

pubmed: 37553446
doi: 10.1007/s00701-023-05742-z
pii: 10.1007/s00701-023-05742-z
pmc: PMC10477138
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2479-2487

Informations de copyright

© 2023. The Author(s).

Références

Albert NL, Weller M, Suchorska B, Galldiks N, Soffietti R, Kim MM, la Fougère C, Pope W, Law I, Arbizu J, Chamberlain MC, Vogelbaum M, Ellingson BM, Tonn JC (2016) Response assessment in neuro-oncology working group and european association for neuro-oncology recommendations for the clinical use of PET imaging in gliomas. Neuro Oncol 18:1199–1208. https://doi.org/10.1093/neuonc/now058
doi: 10.1093/neuonc/now058 pubmed: 27106405 pmcid: 4999003
Capper D, Jones DTW, Sill M, Hovestadt V, Schrimpf D, Sturm D, Koelsche C, Sahm F, Chavez L, Reuss DE, Kratz A, Wefers AK, Huang K, Pajtler KW, Schweizer L, Stichel D, Olar A, Engel NW, Lindenberg K, Harter PN, Braczynski AK, Plate KH, Dohmen H, Garvalov BK, Coras R, Hölsken A, Hewer E, Bewerunge-Hudler M, Schick M, Fischer R, Beschorner R, Schittenhelm J, Staszewski O, Wani K, Varlet P, Pages M, Temming P, Lohmann D, Selt F, Witt H, Milde T, Witt O, Aronica E, Giangaspero F, Rushing E, Scheurlen W, Geisenberger C, Rodriguez FJ, Becker A, Preusser M, Haberler C, Bjerkvig R, Cryan J, Farrell M, Deckert M, Hench J, Frank S, Serrano J, Kannan K, Tsirigos A, Brück W, Hofer S, Brehmer S, Seiz-Rosenhagen M, Hänggi D, Hans V, Rozsnoki S, Hansford JR, Kohlhof P, Kristensen BW, Lechner M, Lopes B, Mawrin C, Ketter R, Kulozik A, Khatib Z, Heppner F, Koch A, Jouvet A, Keohane C, Mühleisen H, Mueller W, Pohl U, Prinz M, Benner A, Zapatka M, Gottardo NG, Driever PH, Kramm CM, Müller HL, Rutkowski S, von Hoff K, Frühwald MC, Gnekow A, Fleischhack G, Tippelt S, Calaminus G, Monoranu CM, Perry A, Jones C, Jacques TS, Radlwimmer B, Gessi M, Pietsch T, Schramm J, Schackert G, Westphal M, Reifenberger G, Wesseling P, Weller M, Collins VP, Blümcke I, Bendszus M, Debus J, Huang A, Jabado N, Northcott PA, Paulus W, Gajjar A, Robinson GW, Taylor MD, Jaunmuktane Z, Ryzhova M, Platten M, Unterberg A, Wick W, Karajannis MA, Mittelbronn M, Acker T, Hartmann C, Aldape K, Schüller U, Buslei R, Lichter P, Kool M, Herold-Mende C, Ellison DW, Hasselblatt M, Snuderl M, Brandner S, Korshunov A, von Deimling A, Pfister SM (2018) DNA methylation-based classification of central nervous system tumours. Nature 555:469–474. https://doi.org/10.1038/nature26000
doi: 10.1038/nature26000 pubmed: 29539639 pmcid: 6093218
Chang SM, Parney IF, Mcdermott M, Barker FG, Schmidt MH, Huang W, Laws ER, Lillehei KO, Bernstein M, Brem H, Sloan AE, Berger M (2003) Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project. J Neurosurg 98:1175–1181. https://doi.org/10.3171/jns.2003.98.6.1175
doi: 10.3171/jns.2003.98.6.1175 pubmed: 12816260
Chen CC, Hsu PW, Erich Wu TW, Lee ST, Chang CN, Wei KC, Chuang CC, Wu CT, Lui TN, Hsu YH, Lin TK, Lee SC, Huang YC (2009) Stereotactic brain biopsy: single center retrospective analysis of complications. Clin Neurol Neurosurg 111:835–839. https://doi.org/10.1016/j.clineuro.2009.08.013
doi: 10.1016/j.clineuro.2009.08.013 pubmed: 19765887
Ghiaseddin A, Hoang Minh LB, Janiszewska M, Shin D, Wick W, Mitchell DA, Wen PY, Grossman SA (2020) Adult precision medicine: learning from the past to enhance the future. Neuro-Oncol Adv 3. https://doi.org/10.1093/noajnl/vdaa145
Hall WA (1998) The safety and efficacy of stereotactic biopsy for intracranial lesions. Cancer 82:1749–1755. https://doi.org/10.1002/(sici)1097-0142(19980501)82:9%3c1756::aid-cncr23%3e3.0.co;2-2
doi: 10.1002/(sici)1097-0142(19980501)82:9<1756::aid-cncr23>3.0.co;2-2 pubmed: 9576298
Jian J, Li Y, Xia W, He Z, Zhang R, Li H, Zhao X, Zhao S, Zhang J, Cai S, Wu X, Gao X, Qiang J (2022) MRI-based multiple instance convolutional neural network for increased accuracy in the differentiation of borderline and malignant epithelial ovarian tumors. J Magn Reson Imaging 56:173–181. https://doi.org/10.1002/jmri.28008
doi: 10.1002/jmri.28008 pubmed: 34842320
Katzendobler S, Do A, Weller J, Dorostkar MM, Albert NL, Forbrig R, Niyazi M, Egensperger R, Thon N, Tonn JC, Quach S (2022) Diagnostic yield and complication rate of stereotactic biopsies in precision medicine of gliomas. Front Neurol 13:822362. https://doi.org/10.3389/fneur.2022.822362
doi: 10.3389/fneur.2022.822362 pubmed: 35432168 pmcid: 9005817
Katzendobler S, Do A, Weller J, Rejeski K, Dorostkar MM, Albert NL, Forbrig R, Niyazi M, Egensperger R, Tonn JC, von Baumgarten L, Quach S, Thon N (2022) The value of stereotactic biopsy of primary and recurrent brain metastases in the era of precision medicine. Front Oncol 12:1014711. https://doi.org/10.3389/fonc.2022.1014711
doi: 10.3389/fonc.2022.1014711 pubmed: 36605448 pmcid: 9808072
Krieger MD, Chandrasoma PT, Zee CS, Apuzzo ML (1998) Role of stereotactic biopsy in the diagnosis and management of brain tumors. Semin Surg Oncol 14:13–25. https://doi.org/10.1002/(sici)1098-2388(199801/02)14:1%3c13::aid-ssu3%3e3.0.co;2-5
doi: 10.1002/(sici)1098-2388(199801/02)14:1<13::aid-ssu3>3.0.co;2-5 pubmed: 9407627
Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW (2021) The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol 23:1231–1251. https://doi.org/10.1093/neuonc/noab106
doi: 10.1093/neuonc/noab106 pubmed: 34185076 pmcid: 8328013
Malikova H, Koubska E, Weichet J, Klener J, Rulseh A, Liscak R, Vojtech Z (2016) Can morphological MRI differentiate between primary central nervous system lymphoma and glioblastoma? Cancer Imaging 16:40. https://doi.org/10.1186/s40644-016-0098-9
doi: 10.1186/s40644-016-0098-9 pubmed: 27894359 pmcid: 5126849
McAvoy M, Prieto PC, Kaczmarzyk JR, Fernández IS, McNulty J, Smith T, Yu K-H, Gormley WB, Arnaout O (2021) Classification of glioblastoma versus primary central nervous system lymphoma using convolutional neural networks. Sci Rep 11:15219. https://doi.org/10.1038/s41598-021-94733-0
doi: 10.1038/s41598-021-94733-0 pubmed: 34312463 pmcid: 8313677
Mimosa ML, Al-Ameri W, Simpson JT, Nakhla M, Boissinot K, Munoz DG, Das S, Feilotter H, Fattouh R, Saleeb RM (2022) A novel approach to detect IDH point mutations in gliomas using nanopore sequencing: test validation for the clinical laboratory. J Mol Diagn. https://doi.org/10.1016/j.jmoldx.2022.12.001
doi: 10.1016/j.jmoldx.2022.12.001 pubmed: 36565986
Neumann JO, Campos B, Younes B, Jakobs M, Jungk C, Beynon C, Deimling AV, Unterberg A, Kiening K (2018) Frame-based stereotactic biopsies using an intraoperative MR-scanner are as safe and effective as conventional stereotactic procedures. PLoS One 13:e0205772. https://doi.org/10.1371/journal.pone.0205772
doi: 10.1371/journal.pone.0205772 pubmed: 30352066 pmcid: 6198960
Önder E, Arıkök AT, Önder S, Han Ü, Sorar M, Kertmen H, Yılmaz ED, Fesli R, Alper M (2015) Corticosteroid pre-treated primary CNS lymphoma: a detailed analysis of stereotactic biopsy findings and consideration of interobserver variability. Int J Clin Exp Pathol 8:7798–7808
pubmed: 26339344 pmcid: 4555672
Patel A, Dogan H, Payne A, Krause E, Sievers P, Schoebe N, Schrimpf D, Blume C, Stichel D, Holmes N, Euskirchen P, Hench J, Frank S, Rosenstiel-Goidts V, Ratliff M, Etminan N, Unterberg A, Dieterich C, Herold-Mende C, Pfister SM, Wick W, Loose M, von Deimling A, Sill M, Jones DTW, Schlesner M, Sahm F (2022) Rapid-CNS(2): rapid comprehensive adaptive nanopore-sequencing of CNS tumors, a proof-of-concept study. Acta Neuropathol 143:609–612. https://doi.org/10.1007/s00401-022-02415-6
doi: 10.1007/s00401-022-02415-6 pubmed: 35357562 pmcid: 9038836
Pfaff E, El Damaty A, Balasubramanian GP, Blattner-Johnson M, Worst BC, Stark S, Witt H, Pajtler KW, van Tilburg CM, Witt R, Milde T, Jakobs M, Fiesel P, Frühwald MC, Hernáiz Driever P, Thomale UW, Schuhmann MU, Metzler M, Bochennek K, Simon T, Dürken M, Karremann M, Knirsch S, Ebinger M, von Bueren AO, Pietsch T, Herold-Mende C, Reuss DE, Kiening K, Lichter P, Eggert A, Kramm CM, Pfister SM, Jones DTW, Bächli H, Witt O (2019) Brainstem biopsy in pediatric diffuse intrinsic pontine glioma in the era of precision medicine: the INFORM study experience. Eur J Cancer 114:27–35. https://doi.org/10.1016/j.ejca.2019.03.019
doi: 10.1016/j.ejca.2019.03.019 pubmed: 31022591
Pirotte B, Goldman S, Brucher JM, Zomosa G, Baleriaux D, Brotchi J, Levivier M (1994) PET in stereotactic conditions increases the diagnostic yield of brain biopsy. Stereotact Funct Neurosurg 63:144–149. https://doi.org/10.1159/000100306
doi: 10.1159/000100306 pubmed: 7624625
Riche M, Amelot A, Peyre M, Capelle L, Carpentier A, Mathon B (2021) Complications after frame-based stereotactic brain biopsy: a systematic review. Neurosurg Rev 44:301–307. https://doi.org/10.1007/s10143-019-01234-w
doi: 10.1007/s10143-019-01234-w pubmed: 31900737
Sahm F, Schrimpf D, Jones DT, Meyer J, Kratz A, Reuss D, Capper D, Koelsche C, Korshunov A, Wiestler B, Buchhalter I, Milde T, Selt F, Sturm D, Kool M, Hummel M, Bewerunge-Hudler M, Mawrin C, Schüller U, Jungk C, Wick A, Witt O, Platten M, Herold-Mende C, Unterberg A, Pfister SM, Wick W, von Deimling A (2016) Next-generation sequencing in routine brain tumor diagnostics enables an integrated diagnosis and identifies actionable targets. Acta Neuropathol 131:903–910. https://doi.org/10.1007/s00401-015-1519-8
doi: 10.1007/s00401-015-1519-8 pubmed: 26671409
Scheichel F, Marhold F, Pinggera D, Kiesel B, Rossmann T, Popadic B, Woehrer A, Weber M, Kitzwoegerer M, Geissler K, Dopita A, Oberndorfer S, Pfisterer W, Freyschlag CF, Widhalm G, Ungersboeck K, Roessler K (2021) Influence of preoperative corticosteroid treatment on rate of diagnostic surgeries in primary central nervous system lymphoma: a multicenter retrospective study. BMC Cancer 21:754. https://doi.org/10.1186/s12885-021-08515-y
doi: 10.1186/s12885-021-08515-y pubmed: 34187419 pmcid: 8243818
Scheichel F, Pinggera D, Popadic B, Sherif C, Marhold F, Freyschlag CF (2022) An update on neurosurgical management of primary CNS lymphoma in immunocompetent patients. Front Oncol 12. https://doi.org/10.3389/fonc.2022.884724
Stichel D, Schrimpf D, Casalini B, Meyer J, Wefers AK, Sievers P, Korshunov A, Koelsche C, Reuss DE, Reinhardt A, Ebrahimi A, Fernández-Klett F, Kessler T, Sturm D, Ecker J, Milde T, Herold-Mende C, Witt O, Pfister SM, Wick W, Jones DTW, von Deimling A, Sahm F (2019) Routine RNA sequencing of formalin-fixed paraffin-embedded specimens in neuropathology diagnostics identifies diagnostically and therapeutically relevant gene fusions. Acta Neuropathol 138:827–835. https://doi.org/10.1007/s00401-019-02039-3
doi: 10.1007/s00401-019-02039-3 pubmed: 31278449
Tanji M, Mineharu Y, Sakata A, Okuchi S, Fushimi Y, Oishi M, Terada Y, Sano N, Yamao Y, Arakawa Y, Yoshida K, Miyamoto S (2023) High intratumoral susceptibility signal grade on susceptibility-weighted imaging: a risk factor for hemorrhage after stereotactic biopsy. J Neurosurg 138:120–127. https://doi.org/10.3171/2022.4.Jns212505
doi: 10.3171/2022.4.Jns212505 pubmed: 35561695
Torp SH, Solheim O, Skjulsvik AJ (2022) The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know-a minireview. Acta Neurochir (Wien) 164:2453–2464. https://doi.org/10.1007/s00701-022-05301-y
doi: 10.1007/s00701-022-05301-y pubmed: 35879477
Weller M, van den Bent M, Preusser M, Le Rhun E, Tonn JC, Minniti G, Bendszus M, Balana C, Chinot O, Dirven L, French P, Hegi ME, Jakola AS, Platten M, Roth P, Rudà R, Short S, Smits M, Taphoorn MJB, von Deimling A, Westphal M, Soffietti R, Reifenberger G, Wick W (2021) EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. Nat Rev Clin Oncol 18:170–186. https://doi.org/10.1038/s41571-020-00447-z
doi: 10.1038/s41571-020-00447-z pubmed: 33293629
Yang K, Ellenbogen Y, Martyniuk A, Sourour M, Takroni R, Somji M, Gardiner E, Hui K, Odedra D, Larrazabal R, Algird A, Kachur E, Reddy K, Murty N, Farrokhyar F, Singh SK (2022) Reoperation in adult patients with recurrent glioblastoma: a matched cohort analysis. Neurooncol Adv 4:vdac115. https://doi.org/10.1093/noajnl/vdac115
doi: 10.1093/noajnl/vdac115 pubmed: 35990706 pmcid: 9389419

Auteurs

Obada T Alhalabi (OT)

Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany.

Felix Sahm (F)

Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.

Andreas W Unterberg (AW)

Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany.

Martin Jakobs (M)

Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany. Martin.jakobs@med.uni-heidelberg.de.
Division of Stereotactic Neurosurgery, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany. Martin.jakobs@med.uni-heidelberg.de.

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