Journal of Neurosurgical Sciences 2021 May 03

DOI: 10.23736/S0390-5616.21.05291-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Sodium Fluorescein application in brain tumour biopsy: case series

Alessandro NARDUCCI ¹ ✉, Gabriele RONCHETTI ¹, Massimiliano MINARDI ², Giovanni G. VERCELLI ¹, Raffaele NUNZIATA ³, Christian F. CARLINO ¹, Federico NANNUCCI ¹, Chiara NURISSO ¹, Pier F. PRETTI ¹, Federico GRIVA ¹

¹ Neurosurgery Unit, San Giovanni Bosco Hospital, Turin, Italy; ² Neurosurgery Unit, Department of Neurosciences, University of Torino, Turin, Italy; ³ Pathology Unit, San Giovanni Bosco Hospital, Turin, Italy

BACKGROUND: Needle biopsy is a routinely, relatively safe, and effective tool for patients with brain tumours not suitable for surgical resection. Despite technical advancements, missed diagnosis is still reported in up to 24% of cases. The aim of this study is to investigate the role of sodium fluorescein (NaFL), a cheap and safe fluorophore, in the biopsy setting mainly with the perspective of an enhancement of the sampling accuracy.
METHODS: Between January 2018 and March 2020, we prospectively enrolled 48 consecutive patients with suspicion of high-grade glioma to receive NaFL-guided brain tumour biopsy. We compared results between NaFL-group and our historical cohort of patients that underwent biopsy without any dye administration (n=58).
RESULTS: In the NaFL-guided biopsy group, there was a statistically significant increase in diagnostic accuracy compared to the historical cohort (100% vs. 86.2% - p<.05). The mean number of samples was significantly reduced, (3.3 instead of 4.4 of the control group - p<.05). Differences in terms of complications related to the procedure, hospital stay, and surgical time were not significant (p=0.49).
CONCLUSIONS: To the authors' knowledge, this is the largest published series supporting the usefulness of NaFL during biopsy procedure, with improved diagnostic accuracy. This also allows a reduction in the number of samples needed for diagnosis, and subsequent risks of procedurerelated complications, without adding risks related to the drug itself.

KEY WORDS: Glioma; Brain biopsy; Sodium fluorescein; Brain tumours; Neuro-oncology