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Large core biopsy of the pancreas under CT fluoroscopy control: results and complications
Christoph J Zech1, Thomas Helmberger, Matthias W Wichmann
1Institute of Clinical Radiology, Klinikum of the Ludwig-Maximilian-University-Grosshadern, Munich, Germany. czech@ikra.med.uni-muenchen.de
Purpose:
The objective of this study was to evaluate the accuracy and complication rate of CT fluoroscopy-guided percutaneous core biopsies of the pancreas in patients with a suspected pancreatic neoplasm.
Materials And Methods:
Sixty-three CT-guided biopsies were performed in 57 consecutive patients over a period of 20 months. Forty-nine of the 57 patients had a malignant lesion (85.9%). All procedures were done under CT fluoroscopic guidance. A high-speed biopsy gun with 14, 16, or 18 gauge cutting-type needles was used. Based on final pathologic diagnosis as the standard of reference, the diagnostic efficacy was determined. Complications during and afterward up to the patient's discharge from hospital (mean, 8.1 days; range, 1-48 days) were noted.
Results:
Core biopsy of the pancreas resulted in a correct diagnosis in 51 of 63 biopsies, yielding a sensitivity for malignancy of 78.1%, a specificity of 100%, a positive predictive value of 100%, and an overall accuracy of 81.0%. One patient of 57 developed an acute pancreatitis related to the biopsy (1.6%).
Conclusion:
CT fluoroscopic-guided core biopsy is a safe and reliable tool for the pretherapeutic evaluation of pancreatic lesions.