Robot-Assisted Stereotactic Biopsy of Diffuse Intrinsic Pontine Glioma: A Single-Center Experience

World Neurosurg. 2017 May:101:584-588. doi: 10.1016/j.wneu.2017.02.088. Epub 2017 Feb 27.

Abstract

Background: Diffuse intrinsic pontine glioma (DIPG) is a childhood tumor with a dismal prognosis. Emerging molecular signatures have paved the way for stereotactic biopsy in selected centers. We present our experience in DIPG stereotactic needle biopsy using the Robotic Stereotactic-Assisted system (ROSA) in a series of consecutive pediatric patients.

Methods: All stereotactic biopsy procedures for DIPG performed during the last year at our institution were considered. All procedures were carried out using the ROSA surgical assistant through a precoronary approach. All children underwent a postoperative computed tomography scan to document possible surgical complications and confirm the site of biopsy. Postoperative clinical changes were recorded to test morbidity of the procedure.

Results: In the last year, we performed 7 pontine needle biopsies. Specimens were diagnostic and useful for molecular analysis in all cases. No surgical complications were observed. One child showed a transient neurologic worsening related to the biopsy that resolved within 2 weeks. The combination of the precoronary approach and use of the stereotactic ROSA system allowed single-session surgeries in all cases.

Conclusions: Pontine biopsy for DIPG is a safe procedure in selected centers. The advantages of the single-session procedure we described might be of particular interest in the pediatric setting.

Keywords: Biopsy; Brainstem; DIPG; Pediatric brain tumor; Stereotactic.

MeSH terms

  • Adolescent
  • Brain Stem Neoplasms / diagnostic imaging*
  • Brain Stem Neoplasms / surgery
  • Child
  • Female
  • Glioma / diagnostic imaging*
  • Glioma / surgery
  • Humans
  • Image-Guided Biopsy / methods
  • Imaging, Three-Dimensional / methods
  • Male
  • Pons / diagnostic imaging*
  • Pons / surgery
  • Robotic Surgical Procedures / instrumentation
  • Robotic Surgical Procedures / methods*
  • Stereotaxic Techniques* / instrumentation