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Results for “Image-guided diagnosis”

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At least 19 recordsLinked to original sources

PubMed1991

[Imaging procedures in the evaluation of tumors of the thoracic wall].

Modern sectional imaging methods supplement the clinical examination of chest wall tumors ideally by demonstrating their deeper components and relation to neighbouring structures. Imaging methods are still limited in demonstrating detail anatomy, a disadvantage that is caused by limited soft tissue contrast and motion artifacts. In certain cases, a specific diagnosis is made by the specific behaviour of the tissue, whereas much more often morphological criteria and the topographic location and relation of the tumor help get the specific diagnosis. Image-guided percutaneous biopsy of the chest wall is an easy, relatively non invasive way of getting the definitive diagnosis.

Humans↗

PubMed2026

Optimizing prostate biopsy decision making - (MUSIC-screen): A 1:1 randomized controlled trial comparing micro-ultrasound versus multiparametric magnetic resonance imaging for prostate cancer diagnosis.

BACKGROUND: Micro-ultrasound (microUS) represents a potential alternative to multiparametric magnetic resonance (mpMRI) in guiding prostate biopsy, with level 1 evidence demonstrating non-inferiority to detect Grade Group ≥2 (GG ≥ 2) prostate cancer in biopsy-naïve men. However, a critical gap remains in the screening pathway, in which imaging is needed to identify men at risk and determine whether biopsy is warranted. METHODS: MUSIC-Screen is a phase 3, open-label, noninferiority 1:1 randomized controlled trial evaluating microUS as an alternative imaging compared to mpMRI for determining the need for prostate biopsy in biopsy- and imaging- naïve men at risk for GG ≥ 2. A total of 1284 men will be randomized to undergo either microUS or mpMRI. Men with PRI-MUS 3-5 or PI-RADS 3-5 lesion will undergo targeted and systematic biopsy. Men with negative imaging and PSA density ≥ 0.15 will undergo systematic biopsy, while those with PSA density < 0.15 will defer biopsy. RESULTS: The primary outcome is GG ≥ 2 detection in each study arm. The primary hypothesis is that microUS is non-inferior to mpMRI for screening and detection of GG ≥ 2. Secondary objectives include comparison of GG ≥ 2 detection rates in targeted cores among patients with PRI-MUS or PI-RADS scores of 3-5, proportion of men who defer biopsy but are diagnosed with GG ≥ 2 within 8 years, assessment of the negative predictive value of each imaging modality, and health economic analyses. CONCLUSION: MUSIC-Screen will determine whether microUS can be used as an imaging modality to inform biopsy decision making that is non-inferior to mpMRI for GG ≥ 2 prostate cancer detection. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06626022.

Humans↗

PubMed1991

Cytologic diagnosis of cavernous hemangioma of the liver with fine-needle biopsy.

We present the cytopathologic findings in seven cases of cavernous hemangiomas of the liver diagnosed by direct "squash" smears made on tissue obtained through image-guided fine-needle biopsy. The diagnosis in each case was confirmed histologically. Utilizing this simple cytologic technique, the morphologic findings in these common hepatic lesions are as accurate and diagnostic as histologic examination.

Biopsy, Needle↗

PubMed1992

Diagnostic and therapeutic use of chest sonography: value in critically ill patients.

OBJECTIVE: Portable chest radiography, used for critically ill patients, often fails to depict thoracic disease clearly. Chest sonography allows good characterization of pleural diseases, mediastinal lesions, and pulmonary consolidations, and provides accurate and safe guidance for interventional procedures. Accordingly, we evaluated its usefulness in the diagnosis and management of critically ill patients. SUBJECTS AND METHODS: Sonography was used prospectively to evaluate 41 critically ill patients, when portable chest radiographs were difficult to interpret and failed to explain the clinical findings. An initial diagnosis was made on the basis of clinical and radiologic information. The final diagnosis was confirmed by thoracentesis (n = 15), image-guided aspiration biopsy (n = 7), surgery (n = 3), and clinical follow-up (n = 16). All 41 sonographic examinations were performed by a sonographer who had no knowledge of the initial diagnosis. The sonographic findings were recorded and analyzed. The usefulness of sonography in diagnosis and management was then evaluated according to the following criteria: diagnostic value--(1) made diagnosis, (2) changed diagnosis, (3) additional information, (4) no benefit; and management aid--(1) affected decision, (2) affected decision and guided thoracentesis, (3) affected diagnosis and guided aspiration, (4) no benefit. RESULTS: Chest sonography was helpful in diagnosis in 27 (66%) of 41 patients and in treatment in 37 (90%) of 41 patients. A significant influence on treatment planning occurred in 17 (41%) of 41 patients. A diagnostic aspiration biopsy under sonographic detected sonographically. Thoracentesis were attempted in 25 of 29 patients with pleural effusion and were successful in 24 patients (96%); a minimal pneumothorax developed in one patient (4%). CONCLUSION: Chest sonography is a useful diagnostic tool for critically ill patients with chest diseases. This technique can be particularly helpful when CT is not available or when critically ill patients cannot be moved.

Aortic Aneurysm↗

PubMed1991

[Image-guided thin needle puncture of tumors of the gastrointestinal system. Puncture technique and handling of materials].

The image-guided fine-needle aspiration biopsy in the diagnosis of gastro-intestinal tumors has reached a very high value out of other diagnostic tools. The results of this method depend directly on the technical performance (aspirator, technicians, cytologist) of the punction and processing of the obtained cytological material. The following paper is a brief communication on technical methods and experience in performing the image-guided fine-needle aspiration biopsy at the university hospital of Zurich.

Adenoma↗

PubMed1992

Metabolic disorders of the brain in chronic hepatic encephalopathy detected with H-1 MR spectroscopy.

Proton magnetic resonance (MR) spectroscopy of the brain was performed in 11 patients with chronic hepatic encephalopathy (CHE), and the results were compared with those of patients with liver disease but without CHE; clinical control subjects with diabetes, uremia, or cortical atrophy; and healthy subjects. The technique of water-suppressed stimulated-echo hydrogen-1 MR spectroscopy for detection of cerebral glutamate, glutamine, glucose, N-acetylaspartate, choline metabolites, (phospho)creatine, and myo-inositol is described. Specific changes in the brain of CHE patients included the anticipated elevation in cerebral glutamine levels (P less than or equal to .0001), a 23% reduction in choline metabolite levels (P less than or equal to .0001), and a more than 50% reduction in cerebral myo-inositol levels (P less than or equal to .0001). In four of the 15 patients with liver disease but without clinical CHE, a significant reduction in the myo-inositol level was detected, and in two of these patients an elevation in the glutamine concentration was also observed. These findings indicate a role for image-guided H-1 MR spectroscopy in the diagnosis and monitoring of both overt and preclinical CHE.

Aspartic Acid↗

PubMed1992

The efficacy of image-guided stereotactic brain biopsy in neurologically symptomatic acquired immunodeficiency syndrome patients.

A prospective series of 50 neurologically symptomatic human immunodeficiency infected patients with intracranial lesions who underwent image-guided stereotactic brain biopsy is presented. Patients were diagnosed with primary central nervous system lymphoma (14 patients), progressive multifocal leukoencephalopathy (14 patients), toxoplasmosis (13 patients), human immunodeficiency virus encephalitis (3 patients), infarction (2 patients), and 1 patient each with metastatic adenocarcinoma, metastatic melanoma, cryptococcoma, and atypical mycobacterial infection. Two of the patients with toxoplasmosis had a second intracranial abnormality. Two biopsies resulted in either descriptive diagnosis only or were nondiagnostic; the definitive diagnostic efficacy of image-guided stereotactic biopsy was thus 96%. No deaths were incurred as a result of biopsy. Four intraoperative or postoperative hemorrhages occurred; in only 1 patient was there a residual neurological deficit related to the surgery. Image-guided stereotactic biopsy may thus be considered both safe and effective in this patient population.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Liver transplant biopsies with a biopsy gun.

The authors evaluated the safety and efficacy of a biopsy gun for performance of image-guided percutaneous biopsy of hepatic allografts in liver transplant recipients. Two hundred fifty-two liver biopsies were performed in 58 transplant recipients over a 27-month period by using this instrument with an 18-gauge needle. Major complications occurred in two of the 252 biopsies (0.8%): One hemopneumothorax necessitated drainage with a chest tube, and one hemorrhage necessitated transfusion. No patient required surgical exploration because of a complication of the biopsy. Specimens were adequate for accurate histopathologic diagnosis in 248 of 252 procedures (98.4%). The authors conclude that image-guided percutaneous biopsy of hepatic allografts with use of the biopsy gun is a safe and accurate method of obtaining hepatic tissue from liver transplant recipients for histopathologic analysis.

Adolescent↗

PubMed1992

Stereotactic diagnosis and treatment of pineal region tumours and vascular malformations.

Diagnosis and treatment of tumours and vascular malformations in the region of the pineal gland continue to challenge the neurosurgeon's skill. Due to vital vascular and brain structures in the region, microsurgical removal of such masses is often impossible. During the past nine years, we have managed 47 patients with pineal region mass lesions using stereotactic techniques for diagnosis and treatment. In order to determine further therapeutic options, 15 patients underwent stereotactic biopsy of pineal region tumours. In all patients, the histologic diagnosis obtained served to direct further therapy. Thirty-two patients were treated with stereotactic radio-surgery for pineal region tumours or vascular malformations. During the follow-up period, one patient underwent delayed microsurgical resection of a midbrain angiographically occult vascular malformation. No other patient required microsurgical intervention after a stereotactic procedure. In all 47 patients, no significant morbidity or mortality occurred after stereotactic biopsy or radiosurgery. Empiric treatment of pineal region tumours with fractionated radiation therapy is no longer warranted. Image-guided stereotactic technology provides a safe method to accurately diagnose and effectively treat selected pineal region masses. After definitive histologic diagnosis is established, proper treatment may be instituted. Options for treatment include stereotactic radiosurgery for selected tumours and vascular malformations, microsurgical resection of benign tumours or fractionated external beam radiation therapy for malignant germ cell and glial tumours. Stereotactic surgery should be the first option in the diagnosis and therapy of pineal region masses.

Adolescent↗

PubMedDate not supplied

Carcinoembryonic antigen content in fine needle aspirates of the lung. A diagnostic adjunct to cytology.

Carcinoembryonic Antigen (CEA) was measured in 59 consecutive fine needle aspirates (FNAs) of the lung from 58 patients to determine if the CEA content would enhance the sensitivity of the cytologic diagnosis. Twenty-eight males and 30 females with tumors 1-40 cm in diameter were studied. Final diagnoses were correlated with the clinical history, radiologic studies, tissue (when available) and follow-up. Image-guided FNAs were performed by radiologists using a 22-gauge Chiba needle and 20-mL syringe with one to four passes per specimen. Cytologic examination included rapid assessment in the radiology suite and a final diagnosis in 24 hours. CEA was measured by enzyme immunoassay using monoclonal antibody. Nine benign aspirates and 50 malignant aspirates were diagnosed. The sensitivity of cytology was 86% and specificity, 100%. Using 5 ng/mL as the cutoff, the sensitivity of CEA for malignant aspirates was 50% and specificity, 90%. The combined sensitivity of CEA and cytology was 95%. The mean CEA in malignant aspirates was 131 ng/mL and in benign aspirates, 2.41. The highest mean CEA was seen in adenocarcinoma, 402.6 ng/mL. Lower CEA content was seen in epidermoid carcinoma (58.6 ng/mL), large cell carcinoma (8.09), oat cell carcinoma, metastatic carcinoma of the kidney and breast, thymoma and lymphoma (each less than 1 ng/mL). Elevated CEA alone was diagnostic in two aspirates of bronchioloalveolar carcinoma; carcinoma with an unknown primary source, three; and large cell carcinoma, one. The adjunctive use of CEA in FNAs of the lung enhances the sensitivity of the cytologic diagnosis.

Adult↗

PubMed2025

Image-guided biopsy of breast lesions-when to use what biopsy technique.

In recent years, minimally invasive diagnostic options for breast lesions have expanded, but consensus on optimal biopsy techniques and imaging combinations remains lacking. This study, driven by an adapted RAND-UCLA Appropriateness Method and insights from eight experts in breast biopsy from across the world, aims to create consensus for selecting biopsy techniques. Highlighted findings suggest Vacuum-Assisted Biopsy (VAB) for lesions visible exclusively at mammography/tomosynthesis (with or without contrast enhancement) or MRI. Core-needle biopsy (CNB) takes precedence for masses over 5 mm visible under US. The selection of other biopsy techniques during US-guided procedures depends on lesion type, size, and sampling indication. VAB is preferred for smaller masses (< 5 mm), complex cystic and solid lesions with small solid parts, small intraductal masses, architectural distortions, and calcifications visible on US. In re-biopsy scenarios for inconclusive findings or high-risk lesions, the panel suggests two VAB extensions: Extended Vacuum-Assisted Biopsy (EVAB) for unambiguous lesion classification and Vacuum-Assisted Excision (VAE) for complete lesion removal. Furthermore, the panel provides detailed input on how to handle specific cases, such as re-biopsy for lobular neoplasia, flat epithelial atypia and atypical ductal hyperplasia. Surgical excision is advised for DCIS and benign or borderline phyllodes tumors found through initial CNB or VAB. In conclusion, an international expert group formulated recommendations on diagnostic breast biopsies under image guidance, aiming to ensure accurate diagnosis worldwide by providing practical advice on needle selection and biopsy approach. KEY POINTS: Evidence-based literature on the preferred biopsy technique and imaging combination for the diagnosis of breast lesions is sparse, and a general consensus is not available. The selection of biopsy technique for different image-guided procedures depends on lesion type, size, and sampling indication. This international expert panel consensus statement addresses standard approaches for varying biopsy indications.

Breast cancer↗

PubMed1990

Positron emission tomography of fluorine-18-deoxyglucose and image-guided phosphorus-31 magnetic resonance spectroscopy in brain tumors.

Positron emission tomography (PET) of 2(18F)-fluoro-2-deoxy-D-glucose (FDG) and volume-selective phosphorus-31 magnetic resonance spectroscopy (31P-MRS) are methods used to assess the energy metabolism of the brain. Both methods were studied with respect to their contribution to differential diagnosis in 23 patients with various brain tumors. The various neuroectodermal tumors differed with respect to their metabolic rate for glucose (MRGL). Benign and malignant tumors could be better differentiated by using tumor metabolism relative to contralateral brain and by evaluating heterogeneities in tumors. Low-grade gliomas usually showed normal 31P-MR spectra; high-grade gliomas were characterized by reduced and often split phosphodiester peaks and alkaline pH. Meningiomas, which had variable MRGL, typically showed extremely low phosphocreatine levels, reduced phosphodiesters, and alkaline pH. We concluded that FDG-PET and 31P-MRS examine different aspects of tumor metabolism. Therefore, both can contribute independently and complementarily to the differential diagnosis of brain tumors.

Astrocytoma↗

PubMed1989

Diagnostic laparoscopy: a prospective review of 100 cases.

The perceived role of laparoscopy in the management of liver disease has changed because of the widespread use of image-guided biopsy. Laparoscopy, however, permits direct inspection of the liver surface and the abdominal cavity, as well as tissue sampling. In order to assess the utility of laparoscopy, and specifically, the diagnostic value of direct visualization of the liver surface, we prospectively collected information on 100 consecutive patients undergoing laparoscopy. The contribution of the laparoscopic findings to patient management and the predictive value of the laparoscopic diagnosis compared to histology were assessed. Laparoscopy had a 95% diagnostic yield. Liver surface characteristic consistent with malignancy, cirrhosis, or fibrosis were sensitive and specific predictors of histologic findings. We conclude that laparoscopy continues to be a valuable diagnostic procedure, especially in cases where accurate assessment of the liver architecture is required.

Adolescent↗

PubMed2026

PCa Detection in PI-RADS 4 and 5 Lesions: Comparison of [68Ga]Ga-PSMA-11 PET/CT-Guided Robot-Assisted Biopsy Versus mpMRI Cognitive-Fusion TRUS-Guided Prostate Biopsy.

Lesions with a Prostate Imaging-Reporting and Data System (PI-RADS) score of 4 or greater on multiparametric MRI (mpMRI) indicate a high likelihood of prostate cancer (PCa), and guidelines recommend a targeted biopsy. We aimed to compare the diagnostic performance of robotic arm-assisted [68Ga]Ga-PSMA-11 PET/CT-guided prostate biopsy (PGPB) with mpMRI-directed cognitive-fusion transrectal ultrasound-guided biopsy (MCFB) in biopsy-naïve men with clinical findings suggestive of PCa. Methods: This prospective, single-center, randomized clinical trial (NCT05137561) enrolled biopsy-naïve men age 50-90 y with elevated levels of prostate-specific antigen (≥4 ng/mL) and abnormal digital rectal examination findings. All participants underwent mpMRI, and those with a PI-RADS score of 4 or greater were randomized into 2 arms. In arm 1, participants underwent PGPB for a [68Ga]Ga-PSMA-avid lesion, and participants in arm 2 underwent MCFB. Participants in arm 1 with PET-negative findings subsequently underwent MCFB, and participants with negative biopsy results underwent PET and PGPB. The primary outcome was the detection of PCa. Secondary outcomes included complication rates and participant-reported pain. Result: Of the 267 participants enrolled, 81.3% (217) had lesions with a PI-RADS score of 4 or greater and were randomized to either PGPB (n = 112) or MCFB (n = 105). PCa was detected in 97.1% of participants (101/104) in arm 1 and 81.0% (85/105) in arm 2 (P < 0.05). PGPB showed higher diagnostic accuracy for PI-RADS 5 lesions (100% vs. 95.1%, P = 0.09). Major complications were observed in arm 2 only (n = 5). Arm 1 had significantly fewer complications (10.8% vs. 51.4%, P < 0.01), a lower median visual analog scale score for pain (3 vs. 5), and shorter procedure times. The core positivity rate was higher in arm 1 (60% ± 20%), despite obtaining fewer cores. Conclusion: [68Ga]Ga-PSMA-11 PGPB demonstrated higher diagnostic performance, fewer complications, and better tolerability compared with MCFB. This approach enables integrated diagnosis and staging, offering a promising alternative for efficient, safe, and accurate evaluation of prostate cancer.

Humans↗

PubMed1989

[Metabolic studies of gliomas with positron emission tomography and phosphorus 31 MR spectroscopy in diagnosis and treatment planning].

Glioma are often histologically heterogenous. As many of these tumors are not removable in toto, due to their localisation, the most malignant part of the tumor may be missed and information for optimum therapeutic management is incomplete. Furthermore, low grade gliomas tend to become more malignant in their development; additional surgical intervention is often not possible. Non-invasive measurement of tumor glucose metabolism with (F-18)-2-fluoro-2-deoxyglucose (FDG) and positron-emission-tomography (PET) may be used to evaluate tumor malignancy. Malignant gliomas (astrocytoma III degree and glioblastoma) frequently showed increased peak metabolic rates (in comparison with normal white matter) and uncoupling of FDG transport and phosphorylation. Preliminary experiences with image-guided localized phosphorus-31 MR spectroscopy (P-31 MRS) demonstrated a decrease of phosphodiesters in malignant gliomas, whereas the phosphomonoesters showed an increase in several cases. The phosphocreatine peak was often reduced. A more active therapy of low grade gliomas might be indicated when signs of hypermetabolism in FDG-PET and alteration of energy-rich phosphates or membrane-phosphates in P-31 MRS are found.

Adenosine Triphosphate↗

PubMed1992

Combined magnetic resonance imaging and proton magnetic resonance spectroscopy of patients with acute stroke.

BACKGROUND AND PURPOSE: The prospect for a therapeutic window for treatment of ischemic stroke encourages the noninvasive investigation of metabolic changes in acute ischemia. Recently, localized proton spectroscopy became available at 1.5-T magnetic resonance systems. In this study we evaluated the usefulness of combined magnetic resonance imaging and spectroscopy on the diagnosis of acute and chronic infarctions. METHODS: Combined magnetic resonance imaging and spectroscopy investigations were carried out with a 1.5-T system in 16 volunteers, eight patients with chronic infarction (greater than 8 months), and 10 patients with acute ischemic stroke (less than 8 hours). We used a stimulated echo sequence to acquire localized spectra from image-guided volumes of interest (16-27 ml). RESULTS: There were no significant interindividual differences of choline, creatine, phosphocreatine, and N-acetyl aspartate resonances in the spectra from volunteers. In chronic infarctions, N-acetyl aspartate was decreased in relation to choline. Acute ischemic infarctions were characterized by decreased N-acetyl aspartate resonances and elevation of lactate. CONCLUSIONS: The study demonstrates the feasibility of proton spectroscopy in stroke patients. Metabolic alterations in ischemic tissue can be monitored and can distinguish acute from chronic lesions.

Aged↗

PubMed2026

Computed tomography-guided precision biopsy combined with metagenomic next-generation sequencing for etiological diagnosis in patients with blood culture-negative systemic infections.

ObjectiveTo evaluate the diagnostic efficacy of computed tomography-guided percutaneous biopsy combined with metagenomic next-generation sequencing in patients with blood culture-negative systemic infections and to assess the clinical impact of using this combined strategy for etiological confirmation and guidance of targeted antimicrobial therapy.MethodsThis single-center retrospective observational cohort study enrolled 78 patients who met the Sepsis-3 consensus criteria for suspected systemic infection and had negative conventional microbiological work-ups (at least two sets of blood cultures) between April 2022 and March 2025. All patients underwent computed tomography-guided biopsy of radiologically identified infectious foci, with specimens processed concurrently for conventional culture and metagenomic next-generation sequencing. Diagnostic performance was benchmarked against the final comprehensive clinical diagnosis, and the influence of metagenomic next-generation sequencing findings on antimicrobial therapy modification was analyzed. Sample size calculation, based on a prior study estimating an metagenomic next-generation sequencing detection rate of 85% (α = 0.05, β = 0.2), indicated a minimum of 68 cases; accordingly, 78 patients were enrolled.ResultsComputed tomography-guided biopsy was technically successful in all 78 patients (100%). The pathogen detection rate of metagenomic next-generation sequencing (91.0%, 71/78) was significantly higher than that of conventional culture (55.1%, 43/78; p < 0.001). Using the final clinical diagnosis as the reference standard, metagenomic next-generation sequencing achieved a sensitivity of 94.7% (95% confidence interval: 86.9-98.5), specificity of 100.0% (95% confidence interval: 29.2-100.0), positive predictive value of 100.0% (95% confidence interval: 94.9-100.0), and negative predictive value of 42.9% (95% confidence interval: 9.9-81.6). Among the 35 culture-negative specimens, metagenomic next-generation sequencing established a definitive microbiological diagnosis in 28 cases (80.0%) and detected polymicrobial infections in 11 cases (14.1% of the cohort). Antimicrobial therapy was rationally adjusted based on metagenomic next-generation sequencing results in 69.2% (54/78) of the patients.ConclusionsThe integration of computed tomography-guided precision biopsy with metagenomic next-generation sequencing offers a highly effective diagnostic approach for blood culture-negative systemic infections. This synergistic strategy improves etiological diagnosis by providing high-yield target specimens that enable comprehensive, unbiased pathogen screening, facilitates differentiation between infectious and non-infectious etiologies, and supplies critical evidence for guiding precision antimicrobial therapy. These findings highlight the growing role of interventional radiology in the contemporary framework of precision infectious disease management.

Humans↗

PubMed1992

Image-guided stereotactic management of non-AIDS-related cerebral infection.

Every neurosurgeon can appreciate Dandy's recognition that the drainage of brain abscesses causes trauma to the delicate parenchyma. Over the years, brain surgery has evolved toward management of problems by using less and less invasive techniques and thus gaining ever lower morbidity. Clearly, the advent of better imaging techniques has improved the outcome in patients afflicted with intracerebral infections. The combination of stereotaxy with these imaging techniques is contributing a "zero mortality" in the treatment of these infections. In our series of 29 consecutive patients with non-AIDS-related infections, no patient died as a direct result of a stereotactic surgical procedure. Two patients (7%) had new neurologic deficits after surgery. The only patient left with a permanent disability had a kidney allograft and subacute bacterial endocarditis. His condition deteriorated 6 hours after aspiration of a sterile abscess, when an intra-abscess hematoma was diagnosed and evacuated. In retrospect, this complication may have been avoided by less vigorous aspiration. Three of the four patients with nonviral infections who died were iatrogenically immunosuppressed for their organ transplants. These patients are difficult to treat, and given the current popularity of transplantation procedures, neurosurgeons will face more and more opportunistic infections. In general, the patients with abscesses did well. On the other hand, nonoperative mortality was extremely high for patients with viral encephalitides. This high mortality may have resulted from a delay in diagnosis and treatment or from the unavailability of highly effective antiviral agents at the time the biopsies were performed. The importance of early diagnosis and treatment of infection cannot be overemphasized. T.H. Flewett's warning about the management of HSE applies to the management of all cerebral infections: "It seems clear from everybody's published results [in the papers already given] if we wait to do biopsy until the clinical indications are unmistakable, we have waited so long that the patient, if he survives, will be left a severe neurological cripple." Because it is relatively noninvasive, stereotactic neurosurgery has been used increasingly to diagnose brain masses in patients with AIDS. We recommend its use for establishing diagnoses in all suspected cases of cerebral infection. We agree with Rosenblum et al: Empiric treatment of brain infections should be regarded as "radical." Such treatment should be reserved for patients who have an identifiable source of infection and causative organism or for patients who are clinically too unstable to undergo surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Brain Abscess↗