Table 3.
Panel A: Pre-biopsy clinical impression and biopsy result. Panel B: Accuracy of the pre-biopsy clinical impression and the impact on clinical management
| Pre-Biopsy Clinical Impression* | Biopsy Result | ||||
|---|---|---|---|---|---|
| Cancer Recurrence/ Progression | Necrosis | Total | |||
| Progression/probable progression | 7 (63.6%) | 17 (70.8%) | 24 | ||
| Probable necrosis | 3 (27.3%) | 3 (12.5%) | 6 | ||
| Unclear | 1 (9.1%) | 4 (16.7%) | 5 | ||
| Total | 11 | 24 | 35 | ||
| Accuracy of the Pre-Biopsy Clinical Impression** | Clinical Management*** | ||||
| Change In Management+ | Directed Management# | No Change in Management^ | No Follow-up | Total | |
| Consistent with biopsy result | 1 (5.6%) | 0 (0.0%) | 9 (81.8%) | 0 (0.0%) | 10 |
| Inconsistent with biopsy result | 17 (94.4%) | 0 (0.0%) | 2 (18.2%) | 1 (100.0%) | 20 |
| Unclear pre-biopsy impression | 0 (0.0%) | 5 (100.0%) | 0 (0.0%) | 0 (0.0%) | 5 |
| Total | 18 | 5 | 11 | 1 | 35 |
*The pre-biopsy clinical impression was obtained from the most recent MRI brain reading prior to biopsy and was based upon serial changes in lesion size, enhancement, and surrounding edema. Five categories were used: progression, probable progression, necrosis, probable necrosis, and unclear.
**Pre-biopsy clinical impressions were compared with biopsy results and determined to be consistent or inconsistent with the biopsy result.
***The clinical management decision post-biopsy was obtained from the first radiation oncology note documented after biopsy.
+Change in management indicates that the clinician documented a change in the treatment plan based upon the biopsy result.
#Directed management designates that biopsies were pursued for the sole purpose of guiding treatment and there was no documented evidence of a treatment plan pre-biopsy.
^No change in management indicates that the biopsy did not result in a change in treatment plan.