History of Image-Guided Biopsy

AbstractThe peritoneum, omenta, and mesenteries can be affected by a myriad of disease processes, but many common pathologies cannot be definitively distinguished based on clinical history and imaging characteristics alone. Percutaneous image-guided biopsy is a safe, well-tolerated procedure with high diagnostic accuracy, which has supplanted more invasive means of obtaining tissue and is increasingly essential in directing patient care. An understanding of the indications, pre-procedural evaluation, technical considerations, and potential complications is essential for the radiologist who performs these procedures, and more broadly for any clinician who may request them.

Download Full-text

The air bubble technique for confirming the location of an image-guided biopsy – a technical note

British Journal of Neurosurgery ◽

10.1080/02688690802710676 ◽

2009 ◽

Vol 23 (3) ◽

pp. 329-331

Author(s):

R. A. Weerakkody ◽

M. R. Guilfoyle ◽

M. R. Garnett ◽

S. Thomson

Keyword(s):

Technical Note ◽

Air Bubble ◽

Image Guided ◽

Guided Biopsy

Download Full-text

Percutaneous Image-Guided Biopsy of the Pancreas

Digestive Disease Interventions ◽

10.1055/s-0038-1660431 ◽

2018 ◽

Vol 02 (02) ◽

pp. 095-100

Author(s):

Stephen McRae

Keyword(s):

Needle Aspiration ◽

Target Lesion ◽

Pathological Diagnosis ◽

Surgical Biopsy ◽

Cross Sectional ◽

Image Guided ◽

Guided Biopsy ◽

Lower Complication ◽

Lower Complication Rate ◽

Mass Lesions

AbstractPercutaneous image-guided biopsy of the pancreas is a safe, effective, efficient, and minimally invasive way to obtain samples for pathological diagnosis of pancreatic mass lesions. The myriad of diseases that can involve the pancreas require different therapies. Therefore, pathological diagnosis is key. With proper imaging resources and techniques, most mass lesions of the pancreas that are visible on cross-sectional imaging can be approached safely and accurately percutaneously under either computed tomography (CT) or ultrasound guidance. These lesions may be accessed through anterior, posterior, and/or lateral approaches depending upon their proximity to the anticipated skin puncture site, and the presence or absence of intervening structures. While the ideal percutaneous route to any pancreatic target lesion is the one that has no vital structures in its path, methods and tools exist to make even the most seemingly obstructed paths to pancreatic targets navigable. Once accessed, the targets may be sampled by either fine-needle aspiration or core needle biopsy. The alternatives to percutaneous image-guided biopsy of the pancreas include open (surgical) biopsy and endoscopic ultrasound-guided (EUS) biopsy. Percutaneous image-guided biopsy poses less risk to the patient than open biopsy and has been shown to be as accurate as EUS biopsy with an even lower complication rate.

Download Full-text

Image-Guided Biopsy for Relapsed Neuroblastoma: Focus on Safety, Adequacy for Genetic Sequencing, and Correlation of Tumor Cell Percent With Quantitative Lesion MIBG Uptake

JCO Precision Oncology ◽

10.1200/po.20.00171 ◽

2021 ◽

pp. 275-285

Author(s):

Andrew Samoyedny ◽

Abhay Srinivasan ◽

Lisa States ◽

Yael P. Mosse ◽

Emma Alai ◽

...

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Tumor Cell ◽

Single Photon ◽

Photon Emission ◽

Emission Computed Tomography ◽

Mibg Uptake ◽

Genetic Sequencing ◽

Image Guided ◽

Guided Biopsy

PURPOSE Many novel therapies for relapsed and refractory neuroblastoma require tumor tissue for genomic sequencing. We analyze our experience with image-guided biopsy in these patients, focusing on safety, yield, adequacy for next-generation sequencing (NGS), and correlation of tumor cell percent (TC%) with quantitative uptake on 123I-meta-iodobenzylguanidine (MIBG) single-photon emission computed tomography with computed tomography (SPECT/CT). MATERIALS AND METHODS An 11-year retrospective review of image-guided biopsy on 66 patients (30 female), with a median age of 8.7 years (range, 0.9-49 years), who underwent 95 biopsies (55 bone and 40 soft tissue) of relapsed or refractory neuroblastoma lesions was performed. RESULTS There were seven minor complications (7%) and one major complication (1%). Neuroblastoma was detected in 88% of MIBG- or fluorodeoxyglucose-avid foci. The overall NGS adequacy was 69% (64% in bone and 74% in soft tissue, P = .37). NGS adequacy within neuroblastoma-positive biopsies was 88% (82% bone and 96% soft tissue, P = .11). NGS-adequate biopsies had a greater mean TC% than inadequates (51% v 18%, P = .03). NGS-adequate biopsies had a higher mean number of needle passes (7.5 v 3.4, P = .0002). The mean tissue volume from NGS-adequate soft-tissue lesions was 0.16 cm3 ± 0.12. Lesion:liver and lesion:psoas MIBG uptake ratios correlated with TC% (r = 0.74, r = 0.72, and n = 14). Mean TC% in NGS-adequate samples was 51%, corresponding to a lesion:liver ratio of 2.9 and a lesion:psoas ratio of 9.0. Thirty percent of biopsies showed an actionable ALK mutation or other therapeutically relevant variant. CONCLUSION Image-guided biopsy for relapsed or refractory neuroblastoma was safe and likely to provide NGS data to guide therapy decisions. A lesion:liver MIBG uptake ratio of ≥ 3 or a lesion:psoas ratio of > 9 was associated with a TC% sufficient to deliver NGS results.

Download Full-text