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Fakhry M, Elayadi M, Elzayat MG, Samir O, Maher E, Taha H, El-Beltagy M, Refaat A, Zamzam M, Abdelbaki MS, Sayed AA, Kieran M, Elhaddad A. Plasma miRNA expression profile in pediatric pineal pure germinomas. Front Oncol 2024; 14:1219796. [PMID: 38665953 PMCID: PMC11043570 DOI: 10.3389/fonc.2024.1219796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background Pure germinomas account for 40% of pineal tumors and are characterized by the lack of appreciable tumor markers, thus requiring a tumor biopsy for diagnosis. MicroRNAs (miRNA) have emerged as potential non-invasive biomarkers for germ cell tumors and may facilitate the non-invasive diagnosis of pure pineal germinomas. Material and methods A retrospective chart review was performed on all patients treated at the Children's Cancer Hospital Egypt diagnosed with a pineal region tumor between June 2013 and March 2021 for whom a research blood sample was available. Plasma samples were profiled for miRNA expression, and DESeq2 was used to compare between pure germinoma and other tumor types. Differentially expressed miRNAs were identified. The area under the curve of the receive;r operating characteristic curve was constructed to evaluate diagnostic performance. Results Samples from 39 pediatric patients were available consisting of 12 pure germinomas and 27 pineal region tumors of other pathologies, including pineal origin tumors [n = 17; pineoblastoma (n = 13) and pineal parenchymal tumors of intermediate differentiation (n = 4)] and others [n = 10; low-grade glioma (n = 6) and atypical teratoid rhabdoid tumor (n = 4)]. Using an adjusted p-value <0.05, three miRNAs showed differential expression (miR-143-3p, miR-320c, miR-320d; adjusted p = 0.0058, p = 0.0478, and p = 0.0366, respectively) and good discriminatory power between the two groups (AUC 90.7%, p < 0.001) with a sensitivity of 25% and a specificity of 100%. Conclusion Our results suggest that a three-plasma miRNA signature has the potential to non-invasively identify pineal body pure germinomas which may allow selected patients to avoid the potential surgical complications.
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Affiliation(s)
- Mona Fakhry
- Department of Pediatric Oncology, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Moatasem Elayadi
- Department of Pediatric Oncology, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Mariam G. Elzayat
- Genomics and Epigenomics Program, Research Department, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Omar Samir
- Genomics and Epigenomics Program, Research Department, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Eslam Maher
- Clinical Research Department, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Hala Taha
- Department of Pathology, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital (CCHE-57357), Cairo, Egypt
| | - Mohamed El-Beltagy
- Department of Neurosurgery, Children’s Cancer Hospital Egypt (CCHE-57357) and Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amal Refaat
- Radio-Diagnosis Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital (CCHE-57357), Cairo, Egypt
| | - Manal Zamzam
- Department of Pediatric Oncology, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Mohamed S. Abdelbaki
- The Division of Hematology and Oncology, St. Louis Children’s Hospital, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Ahmed A. Sayed
- Genomics and Epigenomics Program, Research Department, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
- Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Mark Kieran
- Department of Pediatric Oncology, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
| | - Alaa Elhaddad
- Department of Pediatric Oncology, Children’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
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Kaes M, Beynon C, Kiening K, Neumann JO, Jakobs M. Stereotactic frame-based biopsy of infratentorial lesions via the suboccipital-transcerebellar approach with the Zamorano-Duchovny stereotactic system-a retrospective analysis of 79 consecutive cases. Acta Neurochir (Wien) 2024; 166:147. [PMID: 38520537 PMCID: PMC10960772 DOI: 10.1007/s00701-024-06036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Lesions of the posterior fossa (brainstem and cerebellum) are challenging in diagnosis and treatment due to the fact that they are often located eloquently and total resection is rarely possible. Therefore, frame-based stereotactic biopsies are commonly used to asservate tissue for neuropathological diagnosis and further treatment determination. The aim of our study was to assess the safety and diagnostic success rate of frame-based stereotactic biopsies for lesions in the posterior fossa via the suboccipital-transcerebellar approach. METHODS We performed a retrospective database analysis of all frame-based stereotactic biopsy cases at our institution since 2007. The aim was to identify all surgical cases for infratentorial lesion biopsies via the suboccipital-transcerebellar approach. We collected clinical data regarding outcomes, complications, diagnostic success, radiological appearances, and stereotactic trajectories. RESULTS A total of n = 79 cases of stereotactic biopsies for posterior fossa lesions via the suboccipital-transcerebellar approach (41 female and 38 male) utilizing the Zamorano-Duchovny stereotactic system were identified. The mean age at the time of surgery was 42.5 years (± 23.3; range, 1-87 years). All patients were operated with intraoperative stereotactic imaging (n = 62 MRI, n = 17 CT). The absolute diagnostic success rate was 87.3%. The most common diagnoses were glioma, lymphoma, and inflammatory disease. The overall complication rate was 8.7% (seven cases). All patients with complications showed new neurological deficits; of those, three were permanent. Hemorrhage was detected in five of the cases having complications. The 30-day mortality rate was 7.6%, and 1-year survival rate was 70%. CONCLUSIONS Our data suggests that frame-based stereotactic biopsies with the Zamorano-Duchovny stereotactic system via the suboccipital-transcerebellar approach are safe and reliable for infratentorial lesions bearing a high diagnostic yield and an acceptable complication rate. Further research should focus on the planning of safe trajectories and a careful case selection with the goal of minimizing complications and maximizing diagnostic success.
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Affiliation(s)
- Manuel Kaes
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
- Department of Neurosurgery, Division for Stereotactic Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
- Medical Faculty, Heidelberg University, Grabengasse 1, 69117, Heidelberg, Germany.
| | - Christopher Beynon
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Medical Faculty, Heidelberg University, Grabengasse 1, 69117, Heidelberg, Germany
| | - Karl Kiening
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Department of Neurosurgery, Division for Stereotactic Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Medical Faculty, Heidelberg University, Grabengasse 1, 69117, Heidelberg, Germany
| | - Jan-Oliver Neumann
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Department of Neurosurgery, Division for Stereotactic Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Medical Faculty, Heidelberg University, Grabengasse 1, 69117, Heidelberg, Germany
| | - Martin Jakobs
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Department of Neurosurgery, Division for Stereotactic Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Medical Faculty, Heidelberg University, Grabengasse 1, 69117, Heidelberg, Germany
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Feng Y, Yaming W, Yongzhi S, Penghu W, Hong W, Xiaotong F, Changming W, Sichang C, Guoguang Z. Novel application of robot-guided stereotactic technique on biopsy diagnosis of intracranial lesions. Front Neurol 2023; 14:1173776. [PMID: 37576012 PMCID: PMC10421699 DOI: 10.3389/fneur.2023.1173776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/30/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction This study was performed to examine whether there is a link between the application of three types of robot-guided stereotactic biopsy techniques and the diagnostic rate of intracranial lesion biopsy. Methods The study involved 407 patients who underwent robot-guided stereotactic intracranial lesion biopsy at Xuanwu Hospital of Capital Medical University from January 2019 to December 2021. Age, sex, lesion characteristics, lesion distribution, surgical method, and target path depth were assessed for their impact on the biopsy diagnostic rate. Results The patients' mean age was 42.1 years (range, 6 months-82 years). All patients underwent robot-assisted stereotactic brain biopsy using one of three different systems: a ROSA robotic system (n=35), the CAS-R-2 (n=65), or the REMEBOT domestic robotic system (n=307). No significant difference was found in the diagnostic rate of positive histopathological findings or the mean time of surgery among the three biopsy modalities. The diagnostic rate was 93.86%. Multiple linear regression analysis showed that age, sex, and biopsy modality did not affect the diagnostic rate n>0.05), whereas enhancing lesions and smaller-volume lesions (≤l cm3) were significantly correlated with the diagnostic rate (p = 0.01). Lesions located in the suprasellar and pineal regions were significantly associated with the negative diagnostic rate (p<0.05). Conclusion The presence of enhancing lesions, lesion location, and lesion volume significantly affected the diagnostic rate of brain biopsy. Age, sex, lesion depth, and biopsy modality did not significantly affect the diagnostic rate. All three procedures had high safety and effectiveness.
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Affiliation(s)
- Yan Feng
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
- Precision Diagnosis and Treatment Center for Nervous System Diseases, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Wang Yaming
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
- Precision Diagnosis and Treatment Center for Nervous System Diseases, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Shan Yongzhi
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
- Precision Diagnosis and Treatment Center for Nervous System Diseases, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Wei Penghu
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
| | - Wang Hong
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Fan Xiaotong
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
| | - Wang Changming
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
| | - Chen Sichang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
| | - Zhao Guoguang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- China National Medical Center for Neurological Diseases, Beijing, China
- Precision Diagnosis and Treatment Center for Nervous System Diseases, Xuanwu Hospital Capital Medical University, Beijing, China
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Li H, Zheng C, Rao W, Sun J, Yu X, Zhang J. The risk factors of hemorrhage in stereotactic needle biopsy for brain lesions in a large cohort: 10 years of experience in a single center. Chin Neurosurg J 2022; 8:40. [PMID: 36494749 PMCID: PMC9732999 DOI: 10.1186/s41016-022-00307-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to identify the risk factors for hemorrhage from a large cohort who underwent stereotactic needle biopsy for brain lesions at a single center over a 10-year period. METHODS We performed a retrospective chart review of consecutive patients who underwent stereotactic biopsy at our institute between January 2010 and December 2019. Demographic characteristics and clinical variables were collected and analyzed to identify risk factors for postbiopsy hemorrhage using the chi-square test and univariable and multivariable logistic regression analyses. RESULTS A total of 3196 patients were included in this study; of these, a histological diagnosis was eventually made for 2938 (91.93%) patients. Hemorrhage occurred in 149 (4.66%) patients, and symptomatic hemorrhage occurred in 46 (1.44%) patients. In multivariable logistic regression analyses, the presence of deep-seated lesions (OR 1.272, p = 0.035), concomitant edema and enhancement on MR imaging scans (OR 1.827, p = 0.002), intraoperative hypertension without a past history (OR 1.012, p = 0.024), and the presence of high-grade glioma (OR 0.306, p = 0.003) were identified as independent predictors of hemorrhage after biopsy. CONCLUSION Stereotactic needle biopsy is a safe and effective way to obtain tissue from brain lesions for histological diagnosis. The presence of deep-seated lesions, concomitant edema, and enhancement on MR imaging scans and the presence of high-grade glioma are independent predictors of hemorrhage after stereotactic biopsy.
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Affiliation(s)
- Hailong Li
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Chunling Zheng
- grid.414252.40000 0004 1761 8894Cardiovascular Medical Department, PLA General Hospital, No. 6, Fucheng Road, Haidian District, 100048 Beijing China
| | - Wei Rao
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Junzhao Sun
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Xin Yu
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
| | - Jianning Zhang
- grid.414252.40000 0004 1761 8894Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853 Beijing China
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Escobar-Vidarte OA, Griswold DP, Orozco-Mera J, Mier-Garcia JF, Peralta Pizza F. A Case Series of Stereotactic Biopsy of Brainstem Lesions through the Transfrontal Approach. J Neurol Surg Rep 2022; 83:e123-e128. [DOI: 10.1055/s-0042-1758696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/24/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background and Importance Brainstem lesions may be unresectable or unapproachable. Regardless, the histopathological diagnosis is fundamental to determine the most appropriate treatment. We present our experience with transfrontal stereotactic biopsy technique for brainstem lesions as a safe and effective surgical route even when contralateral transhemispheric approach is required for preservation of eloquent tissue.
Clinical Presentation Twenty-five patients underwent surgery by transfrontal approach. Medical records were reviewed for establishing the number of patients who had postoperative histopathological diagnosis and postoperative complications. Twenty-four patients (18 adults and 7 children) had histopathological diagnosis. There were 18 astrocytomas documented, of which 12 were high grade and 6 low grade. The other diagnoses included viral encephalitis, post–renal transplant lymphoproliferative disorder, nonspecific chronic inflammation, Langerhans cell histiocytosis, and two metastases. No case was hindered by cerebrospinal fluid loss or ventricular entry. Complications included a case of mesencephalic hemorrhage with upper limb monoparesis and a case of a partially compromised third cranial nerve in another patient without associated bleeding.
Conclusion Stereotactic biopsy of brainstem lesions by transfrontal ipsilateral or transfrontal transhemispheric contralateral approaches is a safe and effective surgical approach in achieving a histopathological diagnosis in both pediatric and adult populations.
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Affiliation(s)
- Oscar Andrés Escobar-Vidarte
- Department of Neurosurgery, University del Valle, Cali, Valle del Cauca, Colombia
- Department of Neurosurgery, University Hospital del Valle, Cali, Valle del Cauca, Colombia
- Department of Neurosurgery, Castellana Clinic, Cali, Valle del Cauca, Colombia
- Department of Neurosurgery, Latin American Institute of Neurology and the Nervous System, Bogota, Colombia
| | - Dylan Paul Griswold
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
- School of Medicine, Stanford Medical School, Stanford, California, United States
| | - Javier Orozco-Mera
- Department of Neurosurgery, University del Valle, Cali, Valle del Cauca, Colombia
- Department of Neurosurgery, University Hospital del Valle, Cali, Valle del Cauca, Colombia
| | - Juan Felipe Mier-Garcia
- Department of Neurosurgery, University del Valle, Cali, Valle del Cauca, Colombia
- Department of Neurosurgery, University Hospital del Valle, Cali, Valle del Cauca, Colombia
| | - Fernando Peralta Pizza
- Department of Neurosurgery, University Hospital Tomas Uribe Uribe of Tuluá, Tuluá, Valle del Cauca Colombia
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Malaizé H, Laigle-Donadey F, Riche M, Marijon P, Mokhtari K, Bielle F, Tran S, Nichelli L, Beccaria K, Idbaih A, Hoang-Xuan K, Touat M, Carpentier A, Mathon B. Roles and outcomes of stereotactic biopsy for adult patients with brainstem lesion. J Neurooncol 2022; 160:159-170. [PMID: 36083426 DOI: 10.1007/s11060-022-04129-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to assess the benefit-risk ratio by determining diagnostic yield and safety of brainstem biopsies in adult patients. The secondary objectives were (i) to compare brainstem biopsy safety and postbiopsy patients' outcomes and survival with those of patients biopsied for a brain or cerebellar lesion, and (ii) to assess the impact of brainstem biopsy on final diagnosis and further therapeutic management. METHODS Among 1784 stereotactic biopsies performed in adult patients at a tertiary center between April 2009 and October 2020, we retrospectively examined 50 consecutive brainstem biopsies. We compared variables regarding diagnostic yield, safety and post-biopsy outcomes between brainstem biopsy patients and brain/cerebellum biopsy patients. RESULTS Brainstem biopsy led to a diagnosis in 86% of patients (94.6% in patients with suspected tumor). Lesion contrast enhancement on imaging was the sole predictor of obtaining a diagnosis. Rates of symptomatic complications and mortality were significantly higher in brainstem biopsy patients compared to brain/cerebellum biopsy patients (20% vs 0%; p < 0.001 and 6% vs 0%; p = 0.01, respectively). Transfrontal trajectory and prebiopsy swallowing disorders were predictors of brainstem biopsy-related symptomatic complications. Brainstem biopsy findings led to diagnostic change in 22% of patients. CONCLUSIONS Stereotactic biopsy in adult patients with brainstem lesion has a high diagnostic yield. Although stereotactic brainstem biopsy is associated with more functional and fatal complications than biopsies targeting the brain/cerebellum, its safety profile appears acceptable. Thus, the benefit-risk ratio of stereotactic biopsy in patients with brainstem lesion is favorable but should nevertheless be carefully weighted on a case-by-case basis.
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Affiliation(s)
- Henri Malaizé
- Department of Neurosurgery, la Pitié-Salpêtrière University Hospital, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Florence Laigle-Donadey
- Department of Neurology, Sorbonne University, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, APHP, La Pitié-Salpêtrière Hospital, 2 - Mazarin, 75013, Paris, France
| | - Maximilien Riche
- Department of Neurosurgery, la Pitié-Salpêtrière University Hospital, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Pauline Marijon
- Department of Neurosurgery, la Pitié-Salpêtrière University Hospital, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Karima Mokhtari
- Department of Neuropathology, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 75013, Paris, France.,Paris Brain Institute, ICM, INSERM U 1127, CNRS, UMR 7225, Sorbonne University, UMRS 1127, Paris, France
| | - Franck Bielle
- Department of Neuropathology, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 75013, Paris, France.,Paris Brain Institute, ICM, INSERM U 1127, CNRS, UMR 7225, Sorbonne University, UMRS 1127, Paris, France
| | - Suzanne Tran
- Department of Neuropathology, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 75013, Paris, France.,Paris Brain Institute, ICM, INSERM U 1127, CNRS, UMR 7225, Sorbonne University, UMRS 1127, Paris, France
| | - Lucia Nichelli
- Department of Neuropathology, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 75013, Paris, France
| | - Kevin Beccaria
- Department of Pediatric Neurosurgery, University of Paris Cité, APHP, Necker - Enfants Malades Hospital, 75015, Paris, France
| | - Ahmed Idbaih
- Department of Neurology, Sorbonne University, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, APHP, La Pitié-Salpêtrière Hospital, 2 - Mazarin, 75013, Paris, France
| | - Khê Hoang-Xuan
- Department of Neurology, Sorbonne University, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, APHP, La Pitié-Salpêtrière Hospital, 2 - Mazarin, 75013, Paris, France
| | - Mehdi Touat
- Department of Neurology, Sorbonne University, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, APHP, La Pitié-Salpêtrière Hospital, 2 - Mazarin, 75013, Paris, France
| | - Alexandre Carpentier
- Department of Neurosurgery, la Pitié-Salpêtrière University Hospital, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Bertrand Mathon
- Department of Neurosurgery, la Pitié-Salpêtrière University Hospital, 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France. .,Paris Brain Institute, ICM, INSERM U 1127, CNRS, UMR 7225, Sorbonne University, UMRS 1127, Paris, France.
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Vilela-Filho O, Porfírio J, Goulart LC. Indicators of correct targeting in stereotactic biopsy of intracranial lesions. Surg Neurol Int 2022; 13:251. [PMID: 35855128 PMCID: PMC9282734 DOI: 10.25259/sni_246_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/29/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Confirmation of whether a stereotactic biopsy was performed in the correct site is usually dependent on the frozen section or on novel tumor-specific markers that are not widely available. Immediate postoperative computed tomography (CT) or magnetic resonance (MR) is routinely performed in our service after biopsy. In this retrospective study, we have carefully analyzed these images in an attempt to determine the presence of markers that indicate appropriate targeting.
Methods:
Medical records and neuroimages of patients who underwent stereotactic biopsy of intracranial lesions were reviewed. The following variables were assessed: age, sex, anatomopathology, lesion site, complications, diagnostic accuracy, and the presence of image markers.
Results:
Twenty-nine patients were included in this case series. About 96.6% of the biopsies were accurate according to the permanent section. Of the 86.2% of patients with intralesional pneumocephalus on the postoperative images, 51.7% additionally presented petechial hemorrhage. In 13.8% of the cases, no image markers were identified.
Conclusion:
This is the first report of intralesional pneumocephalus and petechial hemorrhage as indicators of appropriate targeting in stereotactic biopsy. In the majority of the cases, an immediate postoperative head CT, which is widely available, can estimate how adequate the targeting is. To use intralesional pneumocephalus/ petechial hemorrhages as not only postoperative but also as intraoperative markers of appropriate targeting, it is advised that the surgical wound should be temporarily closed and dressed after the biopsy so that the patient can undergo a CT/MR scan and be checked for the presence of theses markers before removing the stereotactic frame.
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Jaradat A, Pollo C. Response to letter: "Stereotactic biopsies of brainstem lesions: dilemma on the best trajectory". Acta Neurochir (Wien) 2022; 164:743. [PMID: 34347174 DOI: 10.1007/s00701-021-04925-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Amer Jaradat
- Department of Neurosciences, Jordan University of Science and Technology, Ar Ramtha 3030, Ar-Ramtha, Jordan.
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital, University Hospital Bern, and University of Bern, 3010, Bern, Switzerland
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Mathon B, Malaizé H, Amelot A. Stereotactic biopsies of brainstem lesions: dilemma on the best trajectory. Acta Neurochir (Wien) 2022; 164:745-746. [PMID: 34216253 DOI: 10.1007/s00701-021-04924-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Bertrand Mathon
- Department of Neurosurgery, APHP - Sorbonne University, La Pitié-Salpêtrière Hospital, , 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France.
- INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris Brain Institute, ICM, Paris, France.
| | - Henri Malaizé
- Department of Neurosurgery, APHP - Sorbonne University, La Pitié-Salpêtrière Hospital, , 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
| | - Aymeric Amelot
- Department of Neurosurgery, APHP - Sorbonne University, La Pitié-Salpêtrière Hospital, , 47-83, Boulevard de L'Hôpital, 75651, Paris Cedex 13, France
- Department of Neurosurgery, Bretonneau Hospital, Tours, France
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Taha BR, Osswald CR, Rabon M, Garcia CS, Guillaume DJ, Wong X, Venteicher AS, Darrow DP, Park MC, McGovern RA, Lam CH, Chen CC. Learning Curve Associated with ClearPoint Neuronavigation System: A Case Series. World Neurosurg X 2022; 13:100115. [PMID: 35028557 DOI: 10.1016/j.wnsx.2021.100115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The ClearPoint neuronavigation system affords real-time magnetic resonance imaging (MRI) guidance during stereotactic procedures. While such information confers potential clinical benefits, additional operative time may be needed. METHODS We conducted a retrospective analysis of procedural time associated with ClearPoint Stereotaxis, with hypothesis that this procedural time is comparable with that associated with frame-based biopsy. RESULTS Of the 52 patients evaluated, the total procedural time for ClearPoint stereotactic biopsy averaged 150.0 (±40.4) minutes, of which 111.5 (±16.5) minutes were dedicated to real-time MRI acquisition and trajectory adjustment. This procedural time is within the range of those reported for frame-based needle biopsies. Approximately 5 minutes of the procedural time is related to the mounting of the MRI-compatible stereotactic frame. Based on the procedural time, we estimate that four cases are required in the learning curve to achieve this efficiency. Efficient algorithms for distortion corrections and isocenter localization are keys to ClearPoint stereotaxis. Routine quality assurance/control after each MRI software update and institutional information technology maintenance also contribute to efficiency. Real-time MRI is essential for definitive diagnosis in select cases. CONCLUSIONS ClearPoint stereotactic needle biopsy can be achieved in time frames comparable to frame-based stereotaxis. However, procedural efficiency requires 4 "learning curve" cases as well as vigilance in terms of MR distortion correction and information technology maintenance.
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11
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He L, He D, Qi Y, Zhou J, Yuan C, Chang H, Wang Q, Li G, Shao Q. Stereotactic Biopsy for Brainstem Lesions: A Meta-analysis with Noncomparative Binary Data. Cancer Control 2021; 28:10732748211059858. [PMID: 34875878 PMCID: PMC8670786 DOI: 10.1177/10732748211059858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objectives To evaluate the diagnostic yield and safety of brainstem stereotactic biopsy
for brainstem lesions. Methods We performed a meta-analysis of English articles retrieved from the PubMed,
Web of Science, Cochrane Library, and APA psycInfo databases up to May 12,
2021. A binary fixed-effect model, the inverse variance method, or a binary
random-effect model, the Dersimonian Laird method, were utilized for pooling
the data. This meta-analysis was registered with INPLASY,
INPLASY202190034. Findings A total of 41 eligible studies with 2792 participants were included. The
weighted average diagnostic yield was 97.0% (95% confidential interval [CI],
96.0-97.9%). The weighted average proportions of temporary complications,
permanent deficits, and deaths were 6.2% (95% CI, 4.5–7.9%), .5% (95% CI,
.2–.8%), and .3% (95% CI, .1–.5%), respectively. The subgroup analysis
indicated a nearly identical weighted average diagnostic yield between
MRI-guided stereotactic biopsy and CT-guided stereotactic biopsy (95.9% vs
95.8%) but slightly increased proportions of temporary complications (7.9%
vs 6.0%), permanent deficits (1.9% vs .2%), and deaths (1.1% vs .4%) in the
former compared to the latter. Moreover, a greater weighted average
diagnostic yield (99.2% vs 97.6%) and lower proportions of temporary
complications (5.1% vs 6.8%) and deaths (.7% vs 1.5%) were shown in the
pediatric patient population than in the adult patient population. Conclusions Brainstem stereotactic biopsy demonstrates striking accuracy plus satisfying
safety in the diagnosis of brainstem lesions. The diagnostic yield,
morbidity, and mortality mildly vary based on the diversity of assistant
techniques and subject populations.
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Affiliation(s)
- Lin He
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Dongjie He
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Yuhong Qi
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Jiejing Zhou
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Canliang Yuan
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Hao Chang
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Qiming Wang
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Gaiyan Li
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
| | - Qiuju Shao
- Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China
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12
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Riche M, Marijon P, Amelot A, Bielle F, Mokhtari K, Chambrun MPD, Joncour AL, Idbaih A, Touat M, Do CH, Deme M, Pasqualotto R, Jacquens A, Degos V, Shotar E, Chougar L, Carpentier A, Mathon B. Severity, timeline, and management of complications after stereotactic brain biopsy. J Neurosurg 2021; 136:867-876. [PMID: 34507289 DOI: 10.3171/2021.3.jns21134] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/12/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The literature shows discrepancies in stereotactic brain biopsy complication rates, severities, and outcomes. Little is known about the timeline of postbiopsy complications. This study aimed to analyze 1) complications following brain biopsies, using a graded severity scale, and 2) a timeline of complication occurrence. The secondary objectives were to determine factors associated with an increased risk of complications and to assess complication-related management and extra costs. METHODS The authors retrospectively examined 1500 consecutive stereotactic brain biopsies performed in adult patients at their tertiary medical center between April 2009 and April 2019. RESULTS Three hundred eighty-one biopsies (25.4%) were followed by a complication, including 88.2% of asymptomatic hemorrhages. Symptomatic complications involved 3.0% of the biopsies, and 0.8% of the biopsies were fatal. The severity grading scale had a 97.6% interobserver reproducibility. Twenty-three (51.1%) of the 45 symptomatic complications occurred within the 1st hour following the biopsy, while 75.6% occurred within the first 6 hours. Age ≥ 65 years, second biopsy procedures, gadolinium-enhanced lesions, glioblastomas, and lymphomas were predictors of biopsy-related complications. Brainstem biopsy-targeted lesions and cerebral toxoplasmosis were predictive of mortality. Asymptomatic hemorrhage was associated with delayed (> 6 hours) symptomatic complications. Symptomatic complications led to extended hospitalization in 86.7% of patients. The average extra cost for management of a patient with postbiopsy symptomatic complication was $35,702. CONCLUSIONS Symptomatic complications from brain biopsies are infrequent but associated with substantial adverse effects and cost implications for the healthcare system. The use of a severity grading scale, as the authors propose in this article, helps to classify complications according to the therapeutic consequences and the patient's outcome. Because this study indicates that most complications occur within the first few hours following the biopsy, postbiopsy monitoring can be tailored accordingly. The authors therefore recommend systematic monitoring for 2 hours in the recovery unit and a CT scan 2 hours after the end of the biopsy procedure. In addition, they propose a modern algorithm for optimal postoperative management of patients undergoing stereotactic biopsy.
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Affiliation(s)
- Maximilien Riche
- Departments of1Neurosurgery.,2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM
| | - Pauline Marijon
- Departments of1Neurosurgery.,2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM
| | | | - Franck Bielle
- 2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM.,3Neuropathology
| | - Karima Mokhtari
- 2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM.,3Neuropathology
| | - Marc Pineton de Chambrun
- 4Internal Medicine 2.,5Intensive Care Medicine.,6INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition
| | | | - Ahmed Idbaih
- 2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM.,8Neurology Mazarin
| | - Mehdi Touat
- 2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM.,8Neurology Mazarin
| | - Chung-Hi Do
- 9Anesthesia, Critical Care, and Perioperative Medicine, and
| | - Mamadou Deme
- 9Anesthesia, Critical Care, and Perioperative Medicine, and
| | | | - Alice Jacquens
- 9Anesthesia, Critical Care, and Perioperative Medicine, and
| | - Vincent Degos
- 9Anesthesia, Critical Care, and Perioperative Medicine, and.,10Clinical Research Group ARPE, Sorbonne University.,11INSERM UMR 1141, PROTECT, Paris, France
| | - Eimad Shotar
- 12Neuroradiology, APHP, Sorbonne University, La Pitié-Salpêtrière Hospital
| | - Lydia Chougar
- 2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM.,12Neuroradiology, APHP, Sorbonne University, La Pitié-Salpêtrière Hospital
| | - Alexandre Carpentier
- Departments of1Neurosurgery.,2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM
| | - Bertrand Mathon
- Departments of1Neurosurgery.,2INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM
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13
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Chen P, Mei J, Cheng W, Jiang X, Lin S, Wei X, Qian R, Niu C. Application of multimodal MRI and radiologic features for stereotactic brain biopsy: insights from a series of 208 patients. Br J Neurosurg 2021; 35:611-618. [PMID: 34002649 DOI: 10.1080/02688697.2021.1926922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We reviewed our institutional experience during a 10-year period for improvement of safety and efficacy of stereotactic biopsy procedures. METHODS We performed a retrospective review of inpatient summaries, stereotactic worksheets and radiologic investigations of 208 consecutive patients, who underwent MRI-guided stereotactic biopsies between March 2010 and March 2020. RESULTS The overall diagnostic yield was 96.2%. CT-confirmed intracranial hemorrhage occurred in 17 patients (8.2%), and the overall mortality rate was 0.5%. Combined MRS and PWI helped target selection in 27 cases (13.0%), the diagnostic yield was 100%. The results of the regression analysis revealed that non-diagnostic biopsy specimen significantly correlated with the cystic trait (p<.01) and edema of lesions (p<.05). Enhancement (p<.01) is shown to be an important factor for obtaining a diagnostic biopsy. Furthermore, the edema trait of lesions (p<.01) showed the important factors of hemorrhage. CONCLUSIONS The radiological features of lesions and use of the most suitable MRI sequences during biopsy planning are recommended ways to improve the diagnostic yield and safety of this technique.
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Affiliation(s)
- Peng Chen
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.,Anhui Provincial Key Laboratory of Brain Function and Brain Disease, Hefei, China
| | - Jiaming Mei
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Wei Cheng
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Xiaofeng Jiang
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Shiying Lin
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.,Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China
| | - Xiangpin Wei
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.,Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China
| | - Ruobing Qian
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.,Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China
| | - Chaoshi Niu
- Department of Neurosurgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.,Anhui Provincial Key Laboratory of Brain Function and Brain Disease, Hefei, China.,Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China
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14
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Abramov I, Zhao X, Belykh E, Lawton MT, Pitskhelauri D, Preul MC. Supracerebellar infratentorial inverted subchoroidal approach to lateral ventricle lesions: Anatomical study and illustrative case. Surg Neurol Int 2021; 12:39. [PMID: 33598355 PMCID: PMC7881503 DOI: 10.25259/sni_909_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
Background: This study provides an anatomical description of a novel supracerebellar infratentorial inverted subchoroidal (SIIS) approach to the lateral ventricle. An illustrative case is presented in which this approach was used to simultaneously resect two tumors residing in the posterior fossa and lateral ventricle. Methods: The SIIS approach was performed on five cadaveric heads using microsurgical and endoscopic techniques. Target points were defined in the lateral ventricle, and quantitative analysis was performed to assess limits of exposure within the lateral ventricle. Two coronal reference planes corresponding to the anterior and posterior margins of the lateral ventricle body were defined. Distances from target points to reference planes were measured, and an imaging-based predicting system was provided according to obtained measurements to guide preoperative approach selection. Results: Mean (standard deviation) distances between the predefined target points indicating the anterior limits and the anterior plane were 9 (7.0) mm, 11 (5.8) mm, and 7 (5.1) mm; posterior limits had distances of 8 (3.0) mm, 17 (9.2) mm, 15 (9.2) mm, and 9 (7.2) mm to the posterior plane. Limiting factors of the choroidal fissure dissection were the venous angle anteriorly and thalamocaudate vein posteriorly. The position of the venous angle had a high negative correlation with the anterior exposure limit (r = –0.87, P < 0.001; r = –0.92, P < 0.001). Conclusion: A step-by-step anatomical description of a new SIIS approach is given, and a quantitative description of the limits of the exposure is provided to evaluate the application of this approach.
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Affiliation(s)
- Irakliy Abramov
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
| | - Xiaochun Zhao
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
| | - Evgenii Belykh
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
| | - David Pitskhelauri
- Department of Neuro-oncology, Burdenko Neurosurgery Center, Moscow, Russian Federation
| | - Mark C Preul
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States
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15
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Xia W, Hu B, Li H, Geng C, Wu Q, Yang L, Yin B, Gao X, Li Y, Geng D. Multiparametric‐MRI
‐Based Radiomics Model for Differentiating Primary Central Nervous System Lymphoma From Glioblastoma: Development and Cross‐Vendor Validation. J Magn Reson Imaging 2020; 53:242-250. [PMID: 32864825 DOI: 10.1002/jmri.27344] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2022] Open
Affiliation(s)
- Wei Xia
- Academy for Engineering and Technology Fudan University Shanghai China
- Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Sciences Suzhou China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Bin Hu
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Haiqing Li
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Chen Geng
- Academy for Engineering and Technology Fudan University Shanghai China
- Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Sciences Suzhou China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Qiuwen Wu
- Academy for Engineering and Technology Fudan University Shanghai China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Liqin Yang
- Academy for Engineering and Technology Fudan University Shanghai China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Bo Yin
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Xin Gao
- Suzhou Institute of Biomedical Engineering and Technology Chinese Academy of Sciences Suzhou China
| | - Yuxin Li
- Academy for Engineering and Technology Fudan University Shanghai China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
| | - Daoying Geng
- Academy for Engineering and Technology Fudan University Shanghai China
- Department of Radiology, Huashan Hospital Fudan University Shanghai China
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