IMAGING GUIDED PERCUTANEAL CORE BIOPSY OF THORACIC BONE AND SOFT TISSUE LESIONS - TECHNIQUE AND COMPLICATIONS

The purpose of the paper is to present our experience of Imaging Guided Percutaneal Core Biopsy (IGPCB) of thoracic bone and soft tissue lesions in terms of procedure planning, biopsy technique, procedure complications and their management. The results of investigation of 81 patients are presented. According to imaging guidance type the patients were subdivided in two main groups - US guided biopsy (26 patients, 26 procedures) and CT guided biopsy (55 patients, 59 procedures). 85 procedures were performed. In 4 cases the repeated biopsy procedure has been performed as the obtained specimen appeared to be non-informative. Adequate tissue material was obtained at the first attempt in 77 (95.1 %) cases; in 4 (4.9%) cases the repeated procedure was needed (when the target size was above 2-5 or >5 cm using CT guided biopsy and it was due to tumor necrosis. Procedure related complications were detected in 1 (%) case (CT guided biopsy). In 1 case the significant pain, requiring administration of additional analgetics in postprocedure period was mentioned. Percutaneous US and CT guided bone and soft tissue lesions biopsy is an effective, highly accurate, and safe method of tissue obtaining for the diagnosis of indeterminate lesions. US is fast, cheap, avoids ionizing radiation, and allows the needle tip to be monitored throughout the procedure. CT has the ability to visualize both bone and soft tissue with the advantage of making easier needle localization into lesions too deep to see on US. CT also allows for better visualization lesions with a large amount of overlying cortex, and deep-seated lesions with extensive overlying soft tissue. CT-guided percutaneous biopsy is a safe and accurate method. US is the preferable tool for biopsy procedure guidance if the target is adequately imaged by US. CT should be used in cases when US imaging is not possible due to visualization problem.