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Image-guided percutaneous cutting needle biopsy in difficult locations
H Arioz Habibi1, M Cevener2, S Yilmaz3
1Department of Radiology, Private Varisson Radiology Center, Yeşilbahçe Mah. Metin Kasapoğlu Cad. Nuri Mancar Apt No: 42/A, 07160, Muratpaşa/Antalya, Turkey. arioz.hatice@gmail.com.
Japanese Journal of Radiology
|January 22, 2022
Summary
Image-guided percutaneous cutting needle biopsy (PCNB) enables tissue analysis in challenging locations like the larynx and pancreas. This technique expands diagnostic capabilities for oncologic treatments, despite traditional concerns about bleeding and trauma.
Area of Science:
- Radiology
- Oncology
- Interventional Radiology
Background:
- Percutaneous biopsy techniques have advanced significantly over 30 years, broadening their clinical applications.
- Modern oncology treatments necessitate larger cutting needles for accurate tissue analysis, posing new challenges for radiologists.
- Biopsies in unfamiliar or traditionally high-risk areas (e.g., larynx, deep pelvis) are often avoided due to bleeding and critical structure injury concerns.
Purpose of the Study:
- To demonstrate the feasibility and utility of image-guided percutaneous cutting needle biopsy (PCNB) in anatomically challenging and high-risk locations.
- To present a series of cases highlighting successful PCNB in diverse organs, including larynx, tongue, intestines, stomach, deep pelvis, uterus, pancreas, penis, and spleen.
- To discuss alternative biopsy methods, specific indications for PCNB, potential complications, and techniques to mitigate risks in these sensitive areas.
Main Methods:
- Retrospective review of nine cases where image-guided PCNB was performed for lesions in challenging anatomical sites.
- Detailed documentation of the biopsy procedures, including imaging guidance, needle type, and lesion location.
- Analysis of alternative biopsy approaches, indications, risks, and specific technical strategies employed to ensure safety and efficacy.
Main Results:
- Successful image-guided PCNB was performed in nine distinct, challenging locations: larynx, tongue, intestines, stomach, deep pelvis, uterus, pancreas, penis, and spleen.
- The study illustrates the practical application of PCNB in areas previously considered too risky for cutting needle biopsies.
- Specific techniques and considerations for each anatomical site were identified to manage potential complications like bleeding and trauma.
Conclusions:
- Image-guided PCNB is a safe and effective method for obtaining tissue diagnosis in a wide array of anatomically challenging locations.
- This technique expands the radiologist's ability to perform biopsies in organs and regions traditionally approached with reluctance, particularly for oncologic indications.
- Careful planning, understanding of local anatomy, and application of specific techniques are crucial for minimizing risks and achieving successful outcomes in PCNB.
