ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1544613
Diagnostic yield of intraoperative frozen sections obtained through robot-assisted stereotactic biopsy of brain lesions Running Head: Intraoperative frozen in stereotactic biopsy
Provisionally accepted- 1Guangdong 999 Brain Hospital, Guangzhou, China
- 2The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To evaluate the diagnostic yield and diagnostic accuracy of intraoperative frozen sections obtained through robot-assisted stereotactic biopsy of brain lesions Methods: The medical records of 87 patients who underwent 89 robot-assisted stereotactic biopsies of brain lesions at our institution between June 2015 and January 2024 were retrospectively reviewed. All patients were assessed using hematoxylin/eosin (HE) staining of intraoperative frozen sections, and intraoperative immunohistochemical examination when necessary. A final diagnosis derived from integrated diagnostics (neoplastic diseases) or final histopathologic examination (non-neoplastic diseases) was the 'gold standard'. Intraoperative frozen section results were divided into 3 categories: confirmed diagnosis, tentative diagnosis, and misdiagnosis. Subgroup analyses of negative intraoperative frozen section Results: Mean turn-around time for intraoperative frozen sections was 26 ± 5.6 minutes (range, 20 -62 minutes). One (FS-1) to 4 (FS-N) (median, 1) intraoperative frozen sections were evaluated per patient. There was a significant increase in positive results from FS-1 (79.77%; n=71/89) to FS-N (92.13%; n=82/89) (P = 0.018). FS-1 results were negative in 18 (20.22%) patients. Among these, FS-N results were positive after adjusting the puncture depth or changing the target in 11 patients. The overall concordance rate of intraoperative frozen section to final diagnosis was 91.1% (confirmed diagnosis, n=73; tentative diagnosis, n=8). Intraoperative immunohistochemistry was performed on the frozen sections of 38 patients (42.7%). Among the patients with negative FS-1 results, tentative diagnoses or misdiagnoses, there were 12, 6 and 7 patients with medium sized lesions, respectively. Eight patients with negative FS-1 results had high-grade glioma.Conclusions: The diagnostic yield of intraoperative frozen sections obtained through robotassisted stereotactic biopsy of brain lesions is high. If the first frozen section result is negative, additional specimens should be obtained after adjusting the puncture depth or the target. Lesions that are difficult to distinguish morphologically on HE staining may be examined using intraoperative immunohistochemistry. High-grade glioma may be more prone to tentative or misdiagnosis due to heterogeneity of the lesion.
Keywords: brain tumor, Stereotactic Biopsy, Robotics, Frozen section, diagnostic yield
Received: 13 Dec 2024; Accepted: 26 May 2025.
Copyright: © 2025 Chen, Luo, Lin, Deng, Zhang, Zeng, Lin and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tao Lin, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
Da Liu, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.