Ignite Creation Date:
2024-05-06 @ 8:14 PM
Last Modification Date:
2024-10-26 @ 3:23 PM
Study NCT ID:
NCT06306118
Status:
RECRUITING
Last Update Posted:
2024-03-12
First Post:
2023-11-07
Brief Title:
Autoguide Positioning Device for Multiple Stereotactic Biopsies
Sponsor:
Medical University of Graz
Organization:
Medical University of Graz
Study Overview
Official Title:
Application of the Autoguide Positioning Device for Multiple Stereotactic Tumor Biopsies During a Brain Tumor Resection
Status:
RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
AMB
Brief Summary:
The purpose of this clinical study should be that in the context of planned resections of glial brain tumors pieces of tissue biopsies are removed from the tumor at several specific locations before the actual tumor resection takes place
The aim of these biopsies in advance to the actual tumor resection will be to receive tumor tissue samples not altered in such a way that it is no longer adequate for further treatment If not adequate a so-called undergrading could occur which means that the biological structure of the tumor is misjudged and further therapy does not achieve the desired effect in the patient
On the one hand certain tumor regions can drift due to a brain shift which leads to inaccurate tissue removal and on the other hand samples are not altered by pressure or bleeding
To carry out these biopsies a robot positioning device AutoGuide will be used that has already been approved and tested for this type of intervention The use of the AutoGuide is intended to ensure that the tumor sample is taken with the greatest possible precision
The aim of these biopsies in advance to the actual tumor resection will be to receive tumor tissue samples not altered in such a way that it is no longer adequate for further treatment If not adequate a so-called undergrading could occur which means that the biological structure of the tumor is misjudged and further therapy does not achieve the desired effect in the patient
On the one hand certain tumor regions can drift due to a brain shift which leads to inaccurate tissue removal and on the other hand samples are not altered by pressure or bleeding
To carry out these biopsies a robot positioning device AutoGuide will be used that has already been approved and tested for this type of intervention The use of the AutoGuide is intended to ensure that the tumor sample is taken with the greatest possible precision
Detailed Description:
Operations involving positioning of needles and catheters are amongst the most common procedures in cranial neurosurgery One of the most important matters that have to be considered is that submillimetric 01 mm precision is essential for the success of these procedures However many biopsy needle procedures for obtaining tissue specimens are currently performed with limited accuracy ie using a mechanical arm This could potentially lead to procedural failure such as inconclusive tissue sampling and even major complications eg cerebral hemorrhage with consecutive neurologic deficits
Therefore navigation-guidance was implemented and established over the last two decades Using preoperatively compiled anatomical patient data from radiological images Computerized Tomography CT or Magnetic Resonance Imaging MRI scans a trajectory from entry to target point can be defined and matched intraoperatively on the patients head
In case of stereotactic needle biopsies inaccuracy is associated with the acquisition of non-diagnostic samples in up to 24 of stereotactic biopsy series or non-representative tumor samples in up to 64 of biopsies Therefore serial biopsies could be performed to overcome this drawback - associated with an increased risk of intracranial hemorrhages which have been reported in 03 - 598 of the cases and contribute considerably to the reported morbidity of 0-161 of this procedure
The Autoguide system is a modular guidance system for surgical invasive tools which provides a precise submillimetric trajectory alignment according to the predefined navigation data
After the development of this miniaturized robotic guidance system for neurosurgery was successfully finalized AutoGuide a robot for clinical application in neurosurgery is now commercially available from the Medtronic company
Precision medicine requires highly accurate tissue sampling from radiologic targets Thereby multiple targets on molecular imaging eg MR-spectroscopy PET are of interest in many cases On the basis of the pathologists diagnosis of these tissue samples the oncologist can provide patient-specific targeted therapy - a current standard practice in modern cancer treatment
The aim of this study is to perform a clinical series of multiple stereotactic needle biopsies with the AutoGuide system previous of brain tumor resection to achieve a more accurate diagnosis of a possible hotspot within the tumor
Prior to oncologic treatment neurosurgical resection for maximum reduction of tumor cell load is still the basis of brain tumor treatment During surgery tissue sampling is performed manually by removing tumor tissue from hotspots as shown on the navigation system screen This method of tissue harvesting however is prone to considerable inaccuracy due to the brain shift that occurs as soon as the craniotomy has been performed High precision targeting is therefore required for highly accurate tissue sampling from radiologic targets to ensure correct postoperative therapy allocation
A robotic system such as AutoGuide has the potential to provide highly accurate tissue samples from hotspots of interest prior to craniotomy This allows to send a highly relevant tumor sample to pathology for frozen section right at the very beginning of surgery for decisions about further resection
The major advantage in AutoGuide performed surgeries lies in its rapid re-alignment if multiple areas have to be targeted Such pre-resection biopsies could be routinely performed before brain tumor surgery with only minimal additional time expenditure and a more accurate diagnosis of a hotspot area of the tumor
Therefore navigation-guidance was implemented and established over the last two decades Using preoperatively compiled anatomical patient data from radiological images Computerized Tomography CT or Magnetic Resonance Imaging MRI scans a trajectory from entry to target point can be defined and matched intraoperatively on the patients head
In case of stereotactic needle biopsies inaccuracy is associated with the acquisition of non-diagnostic samples in up to 24 of stereotactic biopsy series or non-representative tumor samples in up to 64 of biopsies Therefore serial biopsies could be performed to overcome this drawback - associated with an increased risk of intracranial hemorrhages which have been reported in 03 - 598 of the cases and contribute considerably to the reported morbidity of 0-161 of this procedure
The Autoguide system is a modular guidance system for surgical invasive tools which provides a precise submillimetric trajectory alignment according to the predefined navigation data
After the development of this miniaturized robotic guidance system for neurosurgery was successfully finalized AutoGuide a robot for clinical application in neurosurgery is now commercially available from the Medtronic company
Precision medicine requires highly accurate tissue sampling from radiologic targets Thereby multiple targets on molecular imaging eg MR-spectroscopy PET are of interest in many cases On the basis of the pathologists diagnosis of these tissue samples the oncologist can provide patient-specific targeted therapy - a current standard practice in modern cancer treatment
The aim of this study is to perform a clinical series of multiple stereotactic needle biopsies with the AutoGuide system previous of brain tumor resection to achieve a more accurate diagnosis of a possible hotspot within the tumor
Prior to oncologic treatment neurosurgical resection for maximum reduction of tumor cell load is still the basis of brain tumor treatment During surgery tissue sampling is performed manually by removing tumor tissue from hotspots as shown on the navigation system screen This method of tissue harvesting however is prone to considerable inaccuracy due to the brain shift that occurs as soon as the craniotomy has been performed High precision targeting is therefore required for highly accurate tissue sampling from radiologic targets to ensure correct postoperative therapy allocation
A robotic system such as AutoGuide has the potential to provide highly accurate tissue samples from hotspots of interest prior to craniotomy This allows to send a highly relevant tumor sample to pathology for frozen section right at the very beginning of surgery for decisions about further resection
The major advantage in AutoGuide performed surgeries lies in its rapid re-alignment if multiple areas have to be targeted Such pre-resection biopsies could be routinely performed before brain tumor surgery with only minimal additional time expenditure and a more accurate diagnosis of a hotspot area of the tumor
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
True
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None