ARISE-The Accuracy Evaluation of a Patient-Specific 3D-Printed Biopsy System Based on MRI Data: A Cadaveric Study.

Background: Brain biopsy is required for the accurate specification and further diagnosis of intracranial findings. The conventional stereotactic frames are used clinically for biopsies and offer the highest possible precision. Unfortunately, they come with some insurmountable technical and logistical limitations. The aim of the present work is to determine the clinical precision in the needle biopsy of the human brain using a new patient-specific stereotactic navigation device based on 3D printing.

Methods: MRI data sets of human cadaver heads were used to plan 32 intracranial virtual biopsy targets located in different brain regions. Based on these data, 16 individualized stereotactic frames were 3D-printed. After the intraoperative application of the stereotactic device to the cadaver's head, the actual needle position was verified by postoperative CT.

Results: Thirty-two brain areas were successfully biopsied. The target point accuracy was 1.05 ± 0.63 mm, which represents the difference between the planned and real target points. The largest target point deviation was in the coronal plane at 0.60 mm; the smallest was in the transverse plane (0.45 mm).

Conclusions: Three-dimensional-printed, personalized stereotactic frames or platforms are an alternative to the commonly used frame-based and frameless stereotactic systems. They are particularly advantageous in terms of accuracy, reduced medical imaging, and significantly simplified intraoperative handling.