An experience with frame-based stereotactic biopsy of posterior fossa lesions via Transcerebellar route

Abstract Background Tissue diagnosis for lesions in posterior fossa such as brain stem, cerebellar peduncle and cerebellum, is important determinant of the next treatment option. Herein, we present our 10-year period experience with MRI-guided Leksell frame-based stereotactic biopsy for 39 patients with posterior fossa lesions, as a largest case series in this matter. Methods We performed a retrospective cross-sectional study on all patients with posterior fossa lesion admitted in two referral centers between 2006 and 2016. We used Leksell frame-G for stereotactic biopsy of all patients. MRI systems of both hospitals were 1.5 Tesla. Results We performed analysis on remaining 39 cases (21 male and 18 female). Age of the patients ranged between 9 and 73 with mean 35.4±15.7. Localization success rate was 100% and for 38 patients (97.4%), tissue sample size was enough to tissue diagnosis; for one case was insufficient and non-diagnostic. In this series we had no surgery related complications. Conclusion We present largest reported series of MRI-guided frame based stereotactic biopsy of the posterior fossa lesions via transcerebellar route. We preferred oblique positioning of the frame on the skull and use transcerebellar route, for reducing surgical complications and to achieve greater localization success rate.