Diagnosis and Stereotactic Biopsy for Glioblastoma (brain Cancer)
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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, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery provides a full range of services in its areas of expertise. The department's doctors operate on patients with brain and spinal cord tumors, central nervous system malformations, epilepsy, traumatic brain injuries, degenerative disc diseases, spinal stenosis, spinal cord injuries, and peripheral nervous system pathologies. Neurosurgeons specialize in treating patients of all ages, including children and adolescents. Pediatricians, pediatric oncologists, radiologists, and neuroradiologists are involved in the treatment of young patients. Surgical procedures to treat pathologies of the nervous system are performed by highly qualified surgeons with extensive clinical experience. The physicians use state-of-the-art equipment in their work: intraoperative imaging systems, neuronavigation devices, and fluorescence imaging. Advanced technologies are key to effective and safe treatment, as damage to vital anatomical structures of the brain or spinal cord may cause severe neurological deficits. More than 2,000 operations are performed annually in the department's state-of-the-art operating rooms, the majority of which are for brain tumors. The department treats more than 11,000 patients each year. For many years, it has been one of the leading neurosurgical centers in Germany that treats patients from many European countries.
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 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.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery specializes in performing surgical procedures of any complexity on the brain, spinal cord, spine, and peripheral nervous system in patients of all ages. The department's operating rooms are equipped with the latest technology to ensure the most effective and safe treatment of neurosurgical pathologies. During surgery, the department's specialists use innovative intraoperative neuromonitoring systems, neuronavigation devices, and continuous electrophysiologic monitoring systems. The department employs skilled neurosurgeons with extensive clinical experience and in-depth expertise, who prioritize effective treatment according to each patient's individual needs. The physicians strictly follow current clinical protocols and recommendations of the German Society of Neurosurgery (DGNC). It should be noted that the department is part of the Center for Neuro-Oncology certified by the German Cancer Society (DKG), has the status of a Center for Spine Surgery certified by the German Spine Society (DWG), and a Center for Skull Base Surgery certified by the German Society for Skull Base Surgery (GSB).
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.
The statistics demonstrates the constant growth of oncological pathology in recent years. The same is observed with brain tumors, which require specific measures for the precise diagnosis making.
First symptoms
The first symptoms of the tumor in the central nervous system do not give a clear picture, as they are very similar to the symptoms of many other types of brain cancer.
If general symptoms of brain tumors are manifested due to damage of the entire central nervous system and affect the general well-being, then glioblastoma symptoms depend on the lesion area.
Each part of the brain is responsible for certain functions. Depending on the location of the tumor, various brain regions are affected. Therefore, the diagnosis can cause various symptoms.
Symptoms can indicate where the tumor is located within the brain. Paralysis and convulsions are characteristic of tumor in the frontal lobes; loss of vision and hallucinations indicate the tumor in the occipital one. An affected cerebellum will result in coordination disorders, while a tumor in the temporal lobe will lead to hearing loss and memory loss.
Typical symptoms of tumor presence in the central nervous system are:
- Headache. Headache is the most frequent and early symptom of a brain tumor.
- Vomiting. Vomiting is also a typical symptom of the diagnosis and often occurs in the morning.
- Dizziness. Usually, this symptom appears at the advanced stages of brain cancer.
- Mental disorders. Clear consciousness, memory, thinking, perception, and ability to concentrate are usually impaired.
- Vision impairment
The speed and intensity of the development of the symptoms depend on the location of the tumor and the characteristics of its growth. Tumors can press on some parts of the brain, which leads to a clear manifestation of symptoms.
In the presence of at least a few of the listed symptoms, it is necessary to start a treatment.
Diagnostics
Glioblastoma is the most aggressive form of primary brain tumors, among other tumors of the central nervous system. For a long time, doctors have tried to develop new treatments for glioblastoma diagnosis, but only recently progress has been made.
Conventional imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), cannot illustrate what is happening in the brain and inside a tumor effectively enough.
An imaging technique that is used to evaluate how patients with glioblastoma respond to therapy is magnetic resonance spectroscopy. Unlike standard MRI, which only sees structural features of the tumor, magnetic resonance spectroscopy can identify the changes in the tumor that indicate how quickly the tumor grows.
MRI is the most widely used technique for detecting brain tumors. However, conventional MRI is not able to detect changes in cell density, cell type transformation, or biochemical composition of the tumor. All of this can be detected with magnetic resonance spectroscopy.
Besides, the tumors of different physiology often look the same on MRI. Therefore, MRI and magnetic resonance spectroscopy are complementary methods in diagnosis, monitoring of diagnosis progression, and response to therapy.
The ability to provide early non-invasive detection of diagnosis is highly valued by both patients and doctors. Hence, the number of hospitals that include magnetic resonance spectroscopy into their clinical practice is growing constantly.
Unlike the conventional MRI imaging, which scans the entire brain, magnetic resonance spectroscopy works like a virtual biopsy and allows clinicians to assess the peculiarities of the targeted tumor.
There’s also a positron emission tomography, which is a modern, highly sensitive method of diagnostics. This examination helps to determine the presence of cancerous tissues after surgery, identify cancer recurrence, cancer metastasis to bone tissues and other organs. Positron emission tomography and computed tomography include dual imaging with the use of positron emission tomography and computed tomography equipment.
Stereotactic biopsy
Despite all the information on innovative scanning methods, the basis for making an accurate diagnosis can only be information from the study of tumor cells under a microscope. Material for such analysis is obtained with the help of biopsy.
If the tumor is located in the brain, performing the manipulation is fraught with certain difficulties. A stereotactic biopsy allows solving this problem. The essence of the method is to elaborate a safe access scheme to a target area based on coordinates calculated from the results of prior scanning.
Stereotactic biopsy has been used for a long time and is the main method for obtaining clear and reliable results that contribute to surgery success.
The use of this technique allows doctors to obtain biopsy material with guaranteed accuracy and maximum comfort for the patient, minimizing the risk of complications development.
A stereotactic biopsy can be performed in the form of a biopsy with a stereotaxic frame or biopsy with the use of a navigation system.
- Biopsy with stereotaxic frame.
Biopsy with the use of stereotaxic frame (frame-based) is a traditional procedure with high accuracy rate.
Before conducting a biopsy in the clinic, a patient undergoes magnetic resonance imaging with contrast enhancement. Planning of the access point, the trajectory of the instruments introduction, and the target of the biopsy is performed.
The first stage of the biopsy is the installation and fastening of the main ring with special screws, while the patient is under local anesthesia. A localizer with markers is put on the ring and the patient is sent for a scan.
At the workstation, the neurosurgeon compares the obtained information with the results of MRI. The computer analysis of the images is performed immediately, and as a result, the coordinates of the target point are obtained. The patient is transported to the operating room for a stereotaxic procedure.
According to the obtained results, the neurosurgeon makes a small incision. Through it, along a pre-calculated path, a biopsy needle is inserted and the material is harvested.
- Biopsy with the use of a navigation system.
Biopsy with the use of a navigation system without a stereotaxic frame (frameless) takes less time and is more convenient for the patient and the neurosurgeon.
After MRI, the information is transferred to the navigation system. The technique makes it possible to establish the position of the entry point, the site for the biopsy, and the trajectory of the biopsy instrument moving.
In the operating room, under general or local anesthesia, the neurosurgeon touches the patient with a special pointer, and the computer shows the desired point. The tissue is harvested through the hole, using a biopsy needle.
Thanks to modern techniques in the field of brain surgery, stereotactic biopsy has become an outpatient procedure, which is mainly performed under local anesthesia with maximum comfort for the patient. In the absence of complications, a patient is discharged from the hospital on the next day, after performing the control computed tomography scan.
Previously, any intervention on the brain, that included biopsy and surgery, was accompanied by a huge risk of damage to important structures of the brain that are responsible for movement, coordination, sensory perception, etc. Nowadays, practically all surgery types are performed using the stereotactic method.
Goals of stereotactic biopsy:
- To clarify the histological structure of a hard-to-reach tumor before surgery
- To assess the affected brain structures before surgery
- To drain abscesses of the brain
- To drain the ventricles of the brain (in cases of occlusive hydrocephalus and hemorrhagic stroke)
What are the risks?
The biggest risk is bleeding in the tumor and the brain due to the damage of the biopsy needle. The risk of bleeding from a biopsy is around 5%, and the risk of mortality is up to 1%. Additional risks can include headaches on the biopsy site, infections, and seizures.
To minimize risks, the patient's medical condition is assessed and improved after stereotactic biopsy or before beginning stereotactic surgery. Intraoperative antibiotics can prevent bleeding before surgery. It is also beneficial to keep the patient overnight in the hospital, for observation before stereotactic surgery.
Cost of treatment of glioblastoma in the best hospitals in the world
The cost of treatment of glioblastoma in the best-rated hospitals on the Booking Health website is relatively low. You can save up to 40% of the standard hospital prices for foreigners by booking the medical program here.
With Booking Health, you can undergo the treatment of glioblastoma at an affordable price. The cost of treatment varies in different countries, as the prices depend on the hospitals, the diagnosis, and the complexity of treatment. The cost of treatment with stereotactic biopsy abroad goes as follows:
- Germany – from 15,140 EUR to 25,601 EUR
- Austria – approximately 17,500 EUR
- Turkey – approximately 8,300 EUR
- Spain – approximately 8,200 EUR
- India – approximately 6,100 EUR
You can visit the Booking Health website to find out the exact price for the desired treatment.
Where can I undergo the treatment of glioblastoma?
The best hospitals for the treatment of glioblastoma are as follows:
- University Hospital Bergmannsheil Bochum, Germany
- Charite University Hospital Berlin, Germany
- University Hospital HM Monteprincipe Madrid, Spain
- University Hospital for Neurosurgery Salzburg, Austria
- University Hospital Freiburg, Germany
You can check out the full list of hospitals on the Booking Health website.
How can I undergo glioblastoma treatment abroad?
Organizing the treatment of glioblastoma abroad by oneself can be challenging. It is safer, easier, and less stressful to shift some responsibility onto a medical tourism agency that will support you throughout your journey.
We represent the best hospitals in the world, and you can choose which one is right for you. Clinicians of the best hospitals will do everything to make the treatment as comfortable and effective as possible.
If you want to get more information on hospitals, the cost of treatment with surgery, or the cost of diagnostics with biopsy, please leave a request on the Booking Health website. We will contact you as soon as possible, and answer all your questions.
