Computer Tomography (CT)-guided Percutaneous Core-needle Biopsy for the Diagnosis of Pancreatic Tumors Using a...

To investigate the performance of CT-guided percutaneous CNB for the diagnosis of pancreatic tumors using a blunt-tip needle technique.

This is a retrospective cohort study included 103 consecutive patients (64 males and 39 females; mean age 61±12.3 years；range 21-86) who underwent CT-guided percutaneous CNB of pancreatic lesions using a blunt-tip needle technique between October 2021 and October 2023. The procedures were divided into two subgroups: hard-to-reach group and conventional group based on intraprocedural images. Patient demographics and clinical characteristics including age, sex, lesion location and size were recorded, as well as the histopathologic report, the clinical and radiological follow-ups were reviewed. The technical success rate, diagnostic performance, and procedural data were calculated and compared between the two groups.

Within the 103 procedures, the overall technique success rate was 100% (103/103). There were 94 (91.3%, 95%CI 84.1%-95.9%) conclusive and 9 (8.7%, 95%CI 4.1%-15.9%) inconclusive results; the accuracy, sensitivity, specificity, positive and negative predictive values were 91.8% (95%CI 84.5%-96.4%), 100% (95%CI 47.8%-100%), 100% (95%CI 96.0%-100%), and 38.5% (95%CI 13.9%-68.4%), respectively. Complication rate was 7.77% (95%CI 3.4%-14.7%). The mean procedure duration was 22.5±7.4(interquartile range (IQR) 16-22, range:8-47) min and the median number of needle adjustments was 5 (IQR: 3.0, 7.0，range:1-11). There were no significant differences in diagnostic yield (90.0% versus 93.9%, p=0.774), accuracy (90.0% versus 93.9%, p=0.774), and complication rate (7.1% versus 9.1%, p=0.730) between the hard-to-reach group and conventional group.

CT-guided percutaneous CNB using a blunt-tip needle technique appears to be a safe and effective method for the diagnosis of pancreatic tumors, even for those that are difficult to reach.