Stereotactic biopsy in the diagnosis of pediatric diffuse intrinsic pontine gliomas

WANG Dengyuan; BAI Mangmang; ZHANG Jianning; ZHANG Leiming; YANG Fan; WU Haoze

Abstract：Objective The clinical value of stereotactic biopsy in the diagnosis of pediatric diffuse intrinsic pontine gliomas (DIPG),the operation methods,technical points and clinical experiences of reducing the surgical complications were investigated.Methods A retrospective study was performed based on thirty-four children who underwent stereotactic biopsy for DIPG,at Beijing Naval General Hospital,from January 2015 to December 2017.The patients comprised 17 males and 17 females,aged from 2 to 16 years (average 6.6 years),who underwent biopsy via either frame-guided (thirteen children) or robot-assisted (twenty-one children) stereotaxis.Results A final histopathological diagnosis was made in thirty-two children with two non-diagnostic cases,with 94.1％ for diagnostic yield.Low-grade glioma was diagnosed in 1 case,diffuse astrocytoma (WHO Ⅱ) in 16,anaplastic astrocytoma (WHO Ⅲ) in 10,glioma (WHO Ⅱ～ Ⅲ) in 1,gangliocytoma (WHO Ⅰ) in 1,anaplastic oligodendrocytoma in 1,primitive neuroectodermal tumor (PNET) and glioblastoma (WHO Ⅳ) were diagnosed in 1 patient respectively.Surgery related with complications occurred in 4 patients (11.8 ％),2 with bleeding in the biopsied area,and 2 with temporary neurological deficits,with no permanent neurological deficits and mortality.Conclusion Stereotactic biopsy for DIPG on pediatric patients allows for a high diagnostic yield,safety and reliability.The identification of histopathology and molecular biology features can pave the new way for individual treatment concepts and the targeted therapy of DIPG.