Biopsy has high diagnostic yield, a low risk of complications, and can unlock crucial insights1-3
Improvements in surgical techniques and technology have shifted the paradigm toward biopsy in patients with imaging suggestive of diffuse midline glioma (DMG)1
Stereotactic biopsy is a reliable, image-guided, minimally invasive procedure known for its diagnostic accuracy in hard-to-reach areas of the brain4,5
Meta-analyses evaluated diagnostic yield and risk of complications of biopsy, including stereotactic (including frame-based, frameless, and mixed), microsurgical (open), robotic-assisted, and endoscopic.1-3
High diagnostic
yield1-3
~94% to 99%
pooled diagnostic yield estimates reported across published meta-analyses*
*Yield estimates were derived from separate meta-analyses and should not be interpreted as a single pooled estimate.
Low risk of
complications1-3
<1%
risk of permanent disability
(95% CI: 0.0%-3.03%)
6% to 11%
pooled estimates of transient neurological damage reported across published meta-analyses†
†Estimates were derived from separate meta-analyses and should not be interpreted as a single pooled estimate.
A guiding principle of biopsy is to obtain sufficient tissue to enable accurate neuropathologic and molecular evaluation. An adequate tissue sample can provide insights into the molecular features of patients’ DMG.5-7
When it comes to biopsy, decisions should be a collaboration between patients, their loved ones, and their care team. Find answers to questions that may be asked during the shared decision-making process.8
References: 1. Fu AY, Kavia J, Yadava Y, et al. Biopsy of diffuse midline glioma is safe and impacts targeted therapy: a systematic review and meta-analysis. Childs Nerv Sys. 2024;40(3):625-634. 2. Du H, Wang J, Liu Q, Luo G. Diagnostic yield, safety, and molecular-era clinical utility of stereotactic biopsy for brainstem lesions: a contemporary systematic review and meta-analysis. Front Surg. 2026;13:1-14. 3. He L, He D, Qi Y, et al. Stereotactic biopsy for brainstem lesions: a meta-analysis with noncomparative binary data. Cancer Control. 2021;28:10732748211059858. 4. Sharie SA, Laban DA, Al-Hussaini M. Decoding diffuse midline gliomas: a comprehensive review of pathogenesis, diagnosis and treatment. Cancers (Basel). 2023;15(19):4869. 5. Llorens GM, Pérez VM, Simón BC, Castells-Yus I, Vázquez Sufuentes S, Schuhmacher AJ. Epidemiology, diagnostic strategies, and therapeutic advances in diffuse midline glioma. J Clin Med. 2023;12(16):5261. 6. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers V.3.2026. © National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed August 28, 2026. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 7. Sheikh SR, Recinos VM, Thompson EM, et al. The role of brainstem biopsy and targeted therapies in pediatric diffuse midline glioma/diffuse intrinsic pontine glioma. Front Oncol. 2024;14:1504440. 8. Bras IJ, Joosen MC, Rutten GJ, et al. A thematic analysis of shared decision-making in consultations with patients with a presumed brain tumor and neurosurgeons. Neurooncol Pract. 2024;12(2):219-230.