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Evaluation of minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs

Rebecca A. Packer MS, DVM1,2, Lynetta J. Freeman DVM, MS3, Margaret A. Miller DVM, PhD4, Amy E. Fauber DVM, MS5, and Wallace B. Morrison DVM, MS6
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  • 1 Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 2 Basic Medical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 3 Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 4 Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 5 Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 6 Departments of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

Abstract

Objective—To evaluate a technique for minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs.

Animals—5 healthy adult female dogs.

Procedures—Computed tomographic guidance was used to plan a biopsy trajectory to a selected area of brain with reference to a localizer grid. The procedure was performed through a 1-cm skin incision and 6-mm burr hole by use of a 9-gauge biopsy device. Five cylindrical samples (3 to 4 mm in diameter and 7 to 12 mm in length) were removed over 5 cycles of the vacuum-assisted tissue excision system, leaving approximately a 2-cm3 resection cavity. A balloon-tipped intracranial brachytherapy catheter was placed through the burr hole into the resection cavity, expanded with saline (0.9% NaCl) solution, and explanted 7 days later.

Results—4 of 5 dogs survived the procedure. The fifth died because of iatrogenic brain damage. Neurologic deficits were unilateral and focal. Twenty-four hours after surgery, all surviving dogs were ambulatory, 2 dogs exhibited ipsiversive circling, 4 had contralateral proprioceptive deficits, 3 had contralateral menace response deficits, 2 had a reduced contralateral response to noxious nasal stimulation, and 1 had dull mentation with intermittent horizontal nystagmus and ventrolateral strabismus. Neurologic status improved throughout the study period. Histologic quality of biopsy specimens was excellent.

Conclusions and Clinical Relevance—This technique enabled histologic diagnosis from high-quality biopsy specimens obtained through a minimally invasive technique and has potential applications for multimodal treatment of deep brain tumors in dogs.

Contributor Notes

Supported by the Purdue University School of Veterinary Medicine Small Animal Disease Research Grant, with technical support and material donations from Hologic Incorporated, and material donations from Cytyc Corporation.

Presented in abstract form at the 26th Annual Forum of the American College of Veterinary Internal Medicine, San Antonio, Tex, June 2008.

The authors thank Kris L. Davis, Jason T. Pavloff, and Gerald L. Carpenter for technical support and Natasha J. Olby for technical assistance.

Address correspondence to Dr. Packer (rpacker@purdue.edu).