CT-assisted pelvic and abdominal aspiration biopsies in gynecological malignancy

Twenty-four CT-directed biopsies were performed in 17 women with proved gynecological malignancy which had been treated previously by surgery, radiotherapy, chemotherapy or a combination of modalities. CT proved superior to ultrasound biopsy in that the presence of gas in the bowel does not hinder imaging and the use of contrast agents to outline bladder and ureters enables identification of pathological masses even in the presence of massive adhesions and anatomical distortion. Even in small lesions, CT can locate the tip of the needle. The technique, difficulties, specimen handling and clinical relevance are discussed.