Researchers reported that the clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy may play a vital role in the early diagnosis of primary central nervous system lymphoma (PCNSL), according to a study published in Heliyon.

PCNSL, otherwise known as diffuse large B-cell lymphoma (DLBCL) confined to the central nervous system, tends to occur in older patients and carries a poor prognosis. Nevertheless, it is relatively sensitive to chemotherapy and treatment impact can be significant, meaning that an early diagnosis and the accurate characterization of pathology are important. 

Read more about DLBCL etiology 

“With the development of multimodal imaging technology and continuous update of stereotactic devices, combining the 2 effectively in clinical applications, under the premise of more accurate imaging diagnosis, needle biopsy of PCNSL patients using frameless stereotactic robot is performed to clarify the pathology, and provide treatment basis for subsequent chemoradiotherapy,” the authors of the study wrote. 

They hence sought to investigate the merits of such technology in achieving its stated aims. They analyzed the clinical data of 8 patients who were diagnosed with intracerebral PCNSL via multimodal imaging. Multimodal imaging included unenhanced and contrast-enhanced head magnetic resonance imaging (MRI) scans, a head computed tomography scan, MRI perfusion, and MR-spectroscopy. These imaging studies were performed to distinguish PCNSL from intracranial tumors such as gliomas and metastatic tumors. 

The research team reported that preoperative multimodal imaging yielded a suspected diagnosis of PCNSL in all 8 patients, which was confirmed later with results from pathological studies. This meant that the accuracy rate was 100%. This supports the potential potency of using multimodal imaging to diagnose PCNSL preoperatively—a minimally invasive, safe, and modern neurosurgical concept. 

A key limitation of this study is its small sample size (8 cases). Future studies that are larger in size and prospective in nature are needed to build upon this work.


Tang Y, Shi Y, Wang L, et al. Preliminary clinical application of multimodal imaging combined with frameless robotic stereotactic biopsy in the diagnosis of primary central nervous system lymphomaHeliyon. Published online December 8, 2022. doi:10.1016/j.heliyon.2022.e12162