Accuracy of Varioguide frameless stereotactic system against Frame based stereotaxy: Prospective randomized single-centre study.

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Accuracy of Varioguide frameless stereotactic system against Frame based stereotaxy: Prospective randomized single-centre study.

World Neurosurg. 2017 Apr 25;:

Authors: Bradac O, Steklacova A, Nebrenska K, Vrana J, de Lacy P, Benes V

Abstract
INTRODUCTION: Frameless stereotactic brain biopsy systems became widely used nowadays. Varioguide is a relatively novel frameless system. Its accuracy was studied in laboratory setting, but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based stereotaxy.
MATERIAL AND METHODS: Overall 53 patients (33M and 20F,age 60±15y) were enrolled into this prospective randomized single-centre study. Twenty-six patients were randomized into the frame-based (FB) and 27 patients into the Varioguide (VG) group. Real trajectory was pointed on intra-op MR. The distance of the targets and angle deviation between the planned and the real trajectories were computed. The overall discomfort of the patient was subjectively assessed on VAS scale.
RESULTS: The median lesion volume was 5ml [IQR:2-16ml] (FB) and 16ml [IQR:2-27ml] (VG),p=0.133. The mean distance of the targets was 2.7±1.1mm (FB) and 2.9±1.3mm (VG),p=0.456. Mean angle deviation was 2.6±1.3deg (FB) and 3.5±2.1deg (VG), p=0.074. Diagnostic yield was 93% (25/27) in VG and 96% (25/26) in FB, p=1.000. Mean operating time was 47±26min (FB) and 59±31min (VG),p=0.140. One minor bleeding was encountered in the VG group. Overall patient discomfort was significantly higher in the FB group at VAS of 2.5±2.1 vs. 1.2±0.6,p=0,004.
CONCLUSIONS: The Varioguide system proved to be comparable in means of the trajectory accuracy, rate of complications and diagnostic yield compared to the "gold standard" represented by the traditional frame-based stereotaxy for patients undergoing brain biopsy. The Varioguide system is better accepted by patients.

PMID: 28454992 [PubMed - as supplied by publisher]

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