Contrast enhanced ultrasound guidance: a new tool to improve accuracy in percutaneous biopsies

The performance of percutaneous echoguided biopsy in the tumoral diagnosis is limited by several factors, among which tumor characteristics such as tumor type, size and location play an important role. With all the advantages offered by the ultrasound guidance, the overall sensitivity of this method in the tumoral diagnosis of tumor has remained around 90%. Contrast enhanced ultrasound guided percutaneous biopsy is a new developed technique aimed to increase the acurracy of percutaneous biopsies. With new ultrasound devices with split-screen mode, which displays both the CEUS and background B-mode US image simultaneously, on a single monitor, the procedure is technically feasible. CEUS guided percutaneous biopsy should be applied in large tumors with consistent necrosis, in hypovascular tumors or in those invisible or poorly visible to conventional ultrasound. The increased accuracy was demonstrated in liver tumors and in prostate adenocarcinoma.