Stereotactic Biopsy for Diagnosis of Brain Astrocytoma in the Best Hospitals in the World
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Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of accurate diagnostics and surgical treatment of diseases of the central and peripheral nervous system. The department's surgeons annually perform over 5,000 surgical interventions, which indicates their high professionalism and tremendous experience. The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). The treatment of neurosurgical diseases in children and adolescents is carried out by a specially trained team of experts.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. The department keeps pace with new trends in medicine, as well as contributes significantly to their development. Therefore, the most modern diagnostic and therapeutic methods are available here. An individual approach to each clinical case is crucial to ensure optimal treatment results with the preservation of all neurological functions.
Department of Adult and Pediatric Neurosurgery
According to the Focus magazine, the Department of Adult and Pediatric Neurosurgery ranks among the top German medical facilities specializing in the surgical treatment of brain tumors! The department offers the full range of diagnostics and surgical treatment of diseases of the central and peripheral nervous system. A specially trained team of pediatric neurosurgeons provides treatment for various neurosurgical pathologies in children. During the treatment, the doctors use state-of-the-art equipment, in particular, imaging-guided neuronavigation, functional imaging (fMRI), intraoperative mapping, intraoperative videoangiography, etc.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and treatment of the entire spectrum of neurosurgical diseases. The department specializes in the treatment of brain tumors, vascular diseases and intracerebral hemorrhages, spinal diseases, deep brain stimulation, etc. Special competence lies in the field of pediatric neurosurgery. The department offers the very latest highly accurate and minimally invasive treatment methods.
Department of Neurosurgery
The Department of Neurosurgery offers the full range of surgical treatment of diseases of the nervous system and belongs to the largest medical facilities of this kind at the national level. The department has 4 state-of-art operating rooms where more than 2,700 interventions are performed annually. It has the progressive surgical equipment, for example, intraoperative monitoring, neuronavigation, tools for performing minimally invasive operations, which provide the most effective and reliable therapy. The department has earned the reputation of the Center of Competence in the field of tumor surgery of the nervous system and spine.
Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery offers the full range of diagnostics and surgical treatment of diseases of the brain, spinal cord and peripheral nerves at the highest international level of modern medicine. The department has four high-tech operating rooms, in which more than 2,400 surgical interventions are performed annually. Surgery to treat tumors of the nervous system in childhood and adulthood is of particular interest to the department's specialists. In addition, the department's medical team has unique clinical experience in the surgical treatment of epilepsy, spinal pathologies and deformities, as well as neurovascular pathologies. The department's doctors have a perfect command of advanced surgical techniques, for example, navigational surgery, intraoperative neuromonitoring, hybrid surgical techniques, which are the basis of successful clinical practice. State-of-the-art computer-assisted systems allow neurosurgeons to plan each stage of surgical intervention as accurately as possible, thereby guaranteeing its high efficiency and safety.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers modern diagnostics and effective treatment of the full range of diseases, injuries, inflammatory processes, tumors and malformations of the brain, spinal cord and their meninges, as well as spinal diseases. Spinal surgery is performed in collaboration with doctors from the Department of Adult and Pediatric Traumatology, Orthopedic Surgery. The department admits adults and children with malformations of the nervous system, brain and spinal cord tumors, drug-resistant epilepsy and other diseases. As one of the largest medical facilities of this kind in Germany, the department's doctors annually perform more than 2,500 surgical interventions on the brain and spinal cord, peripheral nerve endings. The department's specialists also perform over 400 spinal surgical procedures annually. To achieve high success rates of the surgical treatment, doctors use the very latest equipment, including neuronavigation systems. Thanks to this, surgeons not only successfully eliminate the pathology, but also guarantee the patient maximum safety. The department has 78 beds, including 14 beds in the Intensive Care Unit. The priority goal of the department's medical team is to provide high-quality treatment focused on the patient's needs.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the diagnostics and comprehensive treatment of neurosurgical pathologies, including tumors of the central and peripheral nervous system. The department is the leading Center of Neurosurgery in Northern Germany and is responsible for the implementation of new algorithms for the treatment of patients with brain tumors. To this end, there is an active participation in the international researches and the development of new surgical methods, for example, operations in the waking state. Close interdisciplinary cooperation also contributes to the achievement of optimal treatment results.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery provides top-class medical care for patients with diseases of the central and peripheral nervous systems. The medical facility performs surgery of any complexity on the brain, spinal cord, spine, and peripheral nerves. The department is the largest healthcare facility of this kind in Germany and has a team of highly professional neurosurgeons with long clinical experience. The department's specialists focus on patients with brain tumors (gliomas, meningiomas, and brain metastases), neurovascular diseases (aneurysms, arteriovenous malformations, and dural arteriovenous fistulas), and traumatic brain injuries. Spinal surgeons operate on patients with herniated discs, spinal canal stenosis, spondylolisthesis, spondylodiscitis, spinal fractures, and spinal tumors. The department extensively uses minimally invasive surgical techniques that allow for good therapeutic results with high safety in surgical manipulations. The medical facility has two hybrid operating rooms with state-of-the-art equipment, including the Zeego® intraoperative robotic angiography system and the intraoperative Brainsuite® MRI.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of diagnostics and treatment of diseases of the central and peripheral nervous system. The medical institution occupies a leading position in this sector in Europe. The neurosurgeons of the department have at their disposal four high-tech operating rooms, in which more than 3,500 interventions are performed annually. Active clinical and experimental research activities, as well as close cooperation with national and international reputable research centers, promote the introduction of innovative treatment techniques that are available only in a few clinics in the world.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the widest range of surgical interventions for the treatment of diseases of the central and peripheral nervous system, including stereotactic surgery and endoscopy. With more than 2,400 operations every year, the department has a unique experience, which allows it to provide the high-quality medical care even in extremely complex clinical cases. The key focus of the department is pediatric neurosurgery. In addition to the high professionalism of doctors, the treatment success is facilitated by exclusively advanced medical equipment, for example, neuronavigation systems and intraoperative fluorescence navigation.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of modern services in this medical field. The high level of technical equipment in the department allows for the performance of all highly specialized surgical interventions to treat pathologies of the central and peripheral nervous system. The clinical practice mainly focuses on the diagnostics and surgical treatment of diseases, injuries of the brain, spine, spinal cord, intervertebral discs, nerve plexuses, functional neurosurgery and the treatment of neurosurgical pathologies in children.
Department of Neurosurgery
The Department of Neurosurgery offers the full range of diagnostics and surgical treatment of diseases of the nervous system. All operating rooms are equipped with the cutting-edge technology, which provides the most reliable and effective treatment of neurosurgical pathology. The department employs competent neurosurgeons with rich clinical experience and deep expert knowledge, who have in their arsenal many modern therapeutic methods.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers all modern surgical interventions for the treatment of pathologies of the nervous system. The clinical focuses include the treatment of oncological diseases of the nervous system (neuro-oncology), skull base surgery, vascular neurosurgery, spinal surgery and functional neurosurgery, including the surgical treatment of epilepsy. As a state-of-the-art medical facility, the department has the advanced systems for deep brain stimulation, multimodal neuronavigation devices, intraoperative neuronavigation using CT, ultrasound systems, fluorescence imaging devices and endoscopy equipment. Thus, the department has all the possibilities to ensure effective treatment according to the international standards.
University Hospital of Ludwig Maximilian University of Munich
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of diagnostic examinations and surgical treatment of diseases of the central and peripheral nervous systems. The team of the department's neurosurgeons successfully performs operations for pathologies of the brain and spinal cord, spine, neurovascular pathologies, pituitary diseases, and epilepsy. The doctors specialize in surgery for malignant brain tumors. The department is part of the Gliome Competence Center Network and the German Cancer Aid. The department uses the latest minimally invasive microsurgical techniques, navigation systems, intraoperative systems, and other advanced technical resources that allow for an optimal therapy result. The department has 84 beds for its patients, 10 of which are intended for intensive care. Medical care is based on an individual approach with due consideration of the patient's specific clinical data and needs. The specialists working at the medical facility always devote enough time to personal communication with their patients and do everything possible so that they receive effective treatment and maintain a decent quality of life.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of services in these fields and specializes in the surgical treatment of diseases of the brain and spinal cord, peripheral nervous system and spine. The important areas of the department's clinical activity also include neuro-oncology, vascular neurosurgery and pediatric neurosurgery. The treatment is provided in four state-of-the-art operating rooms equipped with all the necessary facilities. The department admits about 2,700 inpatients and 4,100 outpatients annually. The team of the department's neurosurgeons is distinguished by high professionalism, and performs many operations using sparing minimally invasive surgical techniques. Navigation systems, intraoperative monitoring devices, 5-ALA fluorescence are successfully used during the surgical treatment. Each operation is carefully planned using advanced navigation devices (under the guidance of CT and MRI scanning). In general, the department's surgeons annually perform more than 4,000 neurosurgical interventions, and therefore they are justifiably proud of their unique clinical experience and treatment results.
Astrocytoma is a group of brain tumors that can be both benign and malignant. The main treatment for any astrocytoma is surgery. A course of radiation therapy may be recommended after it. An MRI scan and stereotactic biopsy of the tumor are of the greatest importance for the diagnosis making.
In order to get better, faster or cheaper astrocytoma diagnosis and treatment, many patients travel abroad. In the best foreign hospitals, you can count on the highly accurate and safe diagnosis of the disease. The precise stereotactic biopsy provides clinicians with enough tumor tissue for the further histological and immunohistochemical examination.
Principles of astrocytoma diagnosis
The biopsy is used to diagnose most types of the malignant tumors. The doctor receives a tissue sample, which is then sent to the laboratory for histological analysis. Sometimes the histological analysis is supplemented by determining the tumor’s genetic structure.
However, brain tumors are an exception. In neurosurgery, stereotactic biopsy is not a routine examination method that is prescribed to all patients without exception. This is because biopsy is an invasive and unsafe procedure that is connected with certain health risks.
The basis for the diagnosis of astrocytoma, like other neoplasms of the central nervous system, is the MRI scan. Nuclear magnetic resonance can be used in different ways:
- Standard MRI with intravenous contrast agent – it allows a doctor to see the tumor in the brain, assess its size, localization, relationship with anatomically important structures, establish the type of the neoplasm
- Magnetic resonance spectroscopy – it is used primarily to determine the tumor grade, metabolic activity of astrocytoma and allows to distinguish a tumor from non-cancerous pathology (brain inflammation, scars and radiation necrosis) reliably
- Functional MRI – it is performed to determine functionally significant areas of the brain so that the doctor does not damage them during a stereotaxic biopsy or surgery to remove an astrocytoma
- MRA and MRV (magnetic resonance angiography and venography) – they are used to assess the peculiarities of the blood supply to the astrocytoma during the surgery planning
Less commonly, PET (positron emission tomography) is used in neurosurgery. It is an alternative to MR spectrography. The study allows assessing metabolic activity, growth rate of astrocytoma, differentiating it from non-neoplastic diseases. PET is the most informative for malignant astrocytomas detection.
When is a stereotactic biopsy required?
As a rule, the doctors can diagnose astrocytoma using the MRI scan. This technique can determine the histological type of the tumor with a fairly high probability.
The histological analysis of the astrocytoma sample is desirable in most patients. However, it can be obtained from the results of surgical treatment of brain astrocytoma. Thus, there is no point in performing a stereotaxic biopsy, because this is an additional surgical procedure that increases the risks for the patient, but does not influence the tactics of astrocytoma treatment. Regardless of the type of neoplasm, it must be removed surgically.
Typically, stereotactic biopsy is performed in the following groups of patients:
- In the case of suspected lymphoma
- Those not eligible for the surgical treatment of brain astrocytoma
- If there is no possibility to reliably distinguish astrocytoma from a non-neoplastic disease at the stage of preoperative diagnostic examination
Lymphoma is the only group of primary tumors of the central nervous system that, if detected, does not require surgery to remove it. The main treatment is chemotherapy. If the doctor sees a neoplasm based on the MRI scan, which may not be astrocytoma, but lymphoma, he will send the patient to the Department of Neurosurgery for performing the stereotaxic biopsy.
Should the MRI scan detect astrocytoma, then, in most cases, surgery will be the first-line treatment option. Nonetheless, sometimes the surgical procedure is not performed. This is possible in the following cases:
- Advanced stage of astrocytoma
- Neoplasm is located in a place inconvenient for surgical removal – deep in the brain tissue, near functionally important areas of the brain, large vessels and nerves
- Patient's refusal from surgery
- Medical contraindications for the surgical intervention
The stereotactic biopsy can rarely be required to distinguish astrocytoma from a scar, an area of radiation necrosis, or brain inflammation. However, in most modern hospitals, the doctors can make differential diagnosis using non-invasive methods, such as the magnetic resonance spectroscopy or positron emission tomography with methionine.
How is the stereotactic biopsy performed?
The stereotactic biopsy, on the basis of which the diagnosis is confirmed, is performed at the Department of Neurosurgery. It is a minor surgery on the brain.
A stereotactic frame is fixed on the patient's head under local anesthesia. It is attached to the periosteum with four screws.
This is followed by MRI scanning. The information obtained during the diagnosis making is used to calculate the optimal entry point for the biopsy needle and the trajectory of its movement. The trajectory of needle movement should be short, pass outside functionally significant areas of the brain, large vessels and nerves.
The stereotactic system calculates coordinates in a three-dimensional plane. According to them, the specialists of the Department of Neurosurgery assemble a stereotactic arch. Then the stereotactic biopsy itself is performed: the doctor drills a small hole in the skull (about 4 mm in diameter) under general anesthesia, coagulates the dura mater vessels and inserts a biopsy needle. With its help, he receives a tissue in the volume of about 1 cubic centimeter from 2-3 areas of the brain tumor.
After stereotactic biopsy, the needle is removed, the wound is sutured, and a bandage is applied. To make sure that there are no complications, within 1-2 days after stereotactic biopsy the doctor carries out the diagnosis using computed tomography or nuclear magnetic resonance.
What do the stereotactic biopsy results determine?
Based on stereotactic biopsy results, the doctor receives precise information about the histological type of brain tumor and its grade. The procedure allows him to plan astrocytoma treatment better.
The stereotactic biopsy serves for making important decisions:
- Whether the patient needs surgery (it is required for most brain tumors, but not for lymphoma)
- Whether it makes sense to carry out radiation therapy (whether the tumor is sensitive to irradiation)
- Is it possible to perform the treatment of brain astrocytoma with chemotherapy
- Which radiation mode is it better to choose
- What chemotherapy regimen and what method of drug administration is it better to use
Why is it worth undergoing the stereotactic biopsy abroad?
The popularity of medical tourism in the world is growing every year. Millions of patients leave their native countries in order to undergo diagnosis making and treatment in one of the leading foreign hospitals.
Here are some of the main reasons why people want to receive medical services abroad:
- Possibility of the better diagnosis making or treatment (for this purpose, the residents of developing countries visit countries with a high level of medicine)
- Reduced cost of treatment (e.g. the patients from the developed countries who do not have health insurance often go to Turkey, India or Thailand)
- Desire to get medical help faster, without long waiting in line for treatment
In the best hospitals abroad, you can undergo the stereotactic biopsy of the brain and astrocytoma treatment. The tumor biopsy is not equally successful everywhere. If the procedure is performed by the inexperienced doctor, or the hospital does not have modern equipment, then adverse reactions are possible:
- Complications of the stereotactic biopsy
- Lack of information in the received results of the tumor tissue examination
The reason may be an incorrectly selected target in the brain, displacement of the small tumor during the procedure, or insufficient tissue volume. Sometimes the doctor takes a sample from the necrotic area, which is usually located in the center of the astrocytoma.
In the best hospitals abroad, the prices for the diagnosis making and astrocytoma treatment can be somewhat higher. Nonetheless, the progressive medical centers use cutting-edge stereotactic systems, with which the experienced highly qualified doctors work. Therefore, the procedure is almost always successful, with minimal risk of complications. The needle is directed to the tumor through the shortest distance, bypassing the functionally important areas of the brain and large vessels.
Diagnosis making and treatment abroad with Booking Health
You can undergo the stereotactic biopsy and treatment of brain astrocytoma abroad using the Booking Health services. Website of the company represents the leading specialized foreign hospitals. Here you can find information about prices, doctors and astrocytoma treatment methods. You can also compare the cost of treatment in different hospitals and book a medical program at the best price.
The Booking Health company will help not only reduce the cost of treatment abroad, but also arrange your trip to one of the leading and specialized foreign hospitals. We offer the following services and benefits:
- Selection of the hospital abroad that specializes in the diagnosis making and treatment of brain astrocytoma
- Direct communication with the chosen doctor of the Department of Neurosurgery or Radiation Oncology
- Reduced waiting time for the stereotactic biopsy, and making an appointment with a doctor on the most suitable dates for you
- Reduced cost of astrocytoma treatment – prices are reduced due to avoiding additional coefficients for foreign patients
- Latest information about your expenses, the cost of treatment and the procedures performed, the funds remaining on your account
- Preparation of the medical program without the need to repeat previously performed diagnostic procedures
- Communication with the hospital specializing in neurosurgery after the diagnosis making and treatment of brain astrocytoma
- Buying and forwarding medicines and necessary medical products
- Possibility of additional diagnosis making, treatment or rehabilitation abroad
The Booking Health specialists provide high-quality services. We will book a hotel and airline tickets for you, arrange a transfer from the airport to the hospital and back.