Aim: To compare diagnostic accuracy of frame based vs frameless stereotactic brain biopsy in patients with deep seated brain lesion. Material and Methods: The present prospective comparative study was conducted in the Department of Neurosurgery, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Kolkata, after approval of the research review board, including 50 radiologically confirmed brain tumour subjects, after considering the inclusion and exclusion criteria. Study subjects were divided into two groups: 25 in Frame-Based stereotactic biopsy group and 25 in Frameless stereotactic biopsy group. After enrolment into the study, patient’s information regarding their age, gender and history of present illness was taken and clinical examination was done. Diagnostic yield and complications of the two procedures performed was also recoded. Data was collected in a pretested and predesigned porforma. Results: There was predominance of male subjects in both study groups. There were non-diagnostic sample in two cases (8%) with diagnostic yield 92%, in each group. There was statistically significant less days of hospitalization for the patients who underwent Frame-based biopsy compared to those who underwent frameless biopsy (P<0.01). There was a statistically significant decrease in total operating room time in frameless group in comparison to frame-based group (P < 0.01). Regarding the diagnostic yield, diagnostic agreement between initial and final tissue, mean number of specimens and mean number of trajectories, no significant difference was found among groups. Conclusion: The frame-based biopsy treatment was easily conducted with local anaesthesia and a moderate sedative and seldom required general anaesthesia, but the frameless approach frequently required general anaesthesia because to Mayfield head fixation. The frameless surgery took much less time in the operating room, throughout the intraoperative set-up, and from the incision to the closure. Patients who underwent frame-based biopsy had considerably shorter hospital stays than those who had frameless image-guided biopsy.

Brain Lesion, Diagnostic Accuracy, Stereotactic, Brain Biopsy, Frame, Frameless