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Related Experiment Videos

Is it necessary to biopsy the obvious?

M Y Chen1, D W Gelfand, R E Bechtold

  • 1Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1088, USA.

AJR. American Journal of Roentgenology
|January 11, 2000
PubMed
Summary

Radiologists and oncologists can often rely on imaging to diagnose recurrent cancer, as new primary tumors are rarely missed when biopsy is avoided. Further prospective studies are needed to confirm if imaging alone is sufficient for treatment decisions.

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Area of Science:

  • Oncology
  • Radiology
  • Diagnostic Imaging

Background:

  • Histologic confirmation via biopsy is standard before altering cancer therapy.
  • Radiologists and oncologists frequently suspect recurrent disease based on imaging.

Purpose of the Study:

  • To evaluate the accuracy of imaging in distinguishing recurrent cancer from new primary tumors or benign conditions.
  • To determine if biopsy is always necessary when imaging suggests recurrence.

Main Methods:

  • Retrospective review of medical and imaging records for 253 patients undergoing CT-guided biopsy.
  • Analysis of imaging patterns in 69 patients with a history of primary tumors to assess for recurrence or metastasis.

Main Results:

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  • In 55 of 69 patients, imaging suggested recurrence, which was confirmed by biopsy.
  • In 14 patients, imaging was atypical for recurrence; biopsy revealed new primary tumors (n=4), benign processes (n=2), or recurrence (n=8).
  • No new primary tumors were missed in patients whose imaging suggested recurrence.

    • Conclusions:

    • Imaging findings suggestive of recurrence did not lead to missed diagnoses of new primary tumors in this cohort.
    • Prospective data are needed to assess the feasibility of treatment decisions based solely on imaging findings without biopsy.