Sonographically guided percutaneous needle biopsy of soft tissue masses with histopathologic correlation.
ABSTRACT The purpose of this study was to evaluate the accuracy of sonographically guided percutaneous core biopsy of soft tissue masses.
We retrospectively reviewed the medical records of patients who underwent sonographically guided biopsy of soft tissue masses at our institution during a 50-month period. Core biopsy histopathologic results were compared with surgical or clinical follow-up.
One hundred eighty-three patients, 76 male and 107 female, with a mean age of 48.5 years were included in the study. Thirteen patients had more than 1 biopsy, and the total number of biopsies performed was 196. Five patients were lost to follow-up. Biopsy results were diagnostically accurate in 174 (91%) cases. Thirteen biopsies were inconclusive. No complications occurred. The overall sensitivity, specificity, positive predictive value, and accuracy in separating malignant from benign lesions were 97%, 99%, 99%, and 98%, respectively.
Sonographically guided core needle biopsy is an accurate and safe means to obtain tissue samples for the histopathologic diagnosis of soft tissue masses. It obviates the need for open biopsy and should be performed routinely for treatment planning.
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ABSTRACT: Ultrasonography is the most appropriate tool for interventional procedures in the musculoskeletal system when the lesion is visible on ultrasonography. Procedures performed under ultrasonographic guidance include: taking biopsies; draining abscesses; bursitis; hematomas or muscle tears; treating cystic lesions; diagnostic or therapeutic arthrocentesis; injecting substances into joints or lesions; aspirating calcium deposits and extracting foreign bodies.Although some of these procedures are often carried out without imaging guidance, ultrasonographic guidance improves their efficacy. Drainage can be performed with catheters or needles and makes it possible to avoid more aggressive treatments in most cases.Urokinase is useful for draining hematomas or fibrinous collections. Injecting corticoids is useful in the treatment of synovial cysts, Baker's cyst, tendinitis, and non-infective arthritis. Calcifying tendinitis of the shoulder can be treated effectively with percutaneous calcium lavage.Radiología 11/2010; 52(6):525–533. DOI:10.1016/j.rx.2010.07.004
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ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy. A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23T open MRI scanner with an interventional stereotactic guidance system was used. The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82. MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.European journal of radiology 09/2013; 82(12). DOI:10.1016/j.ejrad.2013.09.005 · 2.16 Impact Factor
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ABSTRACT: OBJETIVO: Avaliar a eficácia da biópsia percutânea por agulha grossa (BPAG) de tumores de partes moles guiada por tomografia computadorizada (TC), em relação ao sucesso na obtenção de amostra para análise, e comparar o diagnóstico da BPAG com o resultado anatomopatológico da peça cirúrgica, quando disponível. MATERIAIS E MÉTODOS: Foram revisados os prontuários e laudos diagnósticos de 262 pacientes com tumores de partes moles submetidos a BPAG guiada por TC em um centro de referência oncológico entre 2003 e 2009. RESULTADOS: Das 262 biópsias realizadas, foi possível a obtenção de amostra adequada em 215 (82,1%). Os tumores mais prevalentes foram os sarcomas (38,6%), carcinomas metastáticos (28,8%), tumores mesenquimais benignos (20,5%) e linfomas (9,3%). Foi possível realizar graduação histológica em 92,8% dos pacientes com sarcoma, sendo a maioria (77,9%) classificada como alto grau. Do total de pacientes, 116 (44,3%) realizaram cirurgia para exérese e confirmação diagnóstica. A BPAG mostrou acurácia de 94,6% na identificação de sarcomas, com sensibilidade de 96,4% e especificidade de 89,5%. A graduação histológica teve concordância significativa entre a BPAG e a peça cirúrgica (p < 0,001; kappa = 0,75). CONCLUSÃO: A BPAG guiada por TC demonstrou elevada acurácia diagnóstica na avaliação de tumores de partes moles e na graduação histológica dos sarcomas, permitindo um adequado planejamento terapêutico.Radiologia Brasileira 10/2012; 45(5):259-262. DOI:10.1590/S0100-39842012000500005