Results of Percutaneous Computed Tomography-Guided Biopsy of Adrenal Lesions and Spectrum of Computed Tomography Findings

Objective: Adrenal enlargement occurs in various conditions such as infections, benign, and malignant neoplasms. Percutaneous computed tomography (CT)-guided adrenal biopsy is a safe method for obtaining tissue specimen in cases where diagnosis cannot be established on imaging and biochemical grounds. The study aims to evaluate diagnostic yield, accuracy, and complications of percutaneous CT-guided adrenal biopsies. Furthermore, CT findings of various adrenal lesions have been described. Materials and Methods: Data of CT-guided adrenal biopsies performed from September 2009 to May 2019 were analyzed. Biopsies were performed on a 64-slice or a 128-slice multidetector CT scanner using a coaxial technique. Pathological and microbiological reports were retrieved from the hospital information system. Clinical details were obtained from clinical case records. Results: CT-guided adrenal biopsies were performed in 48 patients, 37 males and 11 females. Adrenal insufficiency was present in 31 (64%) cases and bilateral adrenal glands were affected in 35 (73%). Biopsy yielded a diagnosis in 35 cases (72.9%). The final diagnosis was achieved in 43 (90%) cases. Combined accuracy of CT-guided biopsy for identifying malignancy and infection was 88.3%. Adrenal histoplasmosis (AH) was the most common entity diagnosed (44%). After combining histopathology and microbiology results, the sensitivity for diagnosing AH was 100%. One (2%) patient had a major complication in the form of intra-abdominal hemorrhage requiring transfusion. Local hematoma and mild stable pneumothorax were noted in one patient each. Conclusion: Percutaneous CT-guided biopsy is a safe procedure for the diagnosis of adrenal lesions. It has good accuracy for diagnosing adrenal conditions such as infections and malignancies. However, the specific diagnosis of benign adrenal lesions was difficult to make. AH, tuberculosis, and metastasis have overlapping imaging findings.

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A retrospective analysis of computed tomography guided biopsy in the diagnosis of primary bone tumors

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171903 ◽

2017 ◽

Vol 3 (3) ◽

pp. 569

Author(s):

Kuriakku Puthur Dominic ◽

Davis Dijoe ◽

Jacob Toms

Keyword(s):

Computed Tomography ◽

Bone Tumors ◽

Diagnostic Efficiency ◽

Ct Guided ◽

Primary Bone Tumor ◽

Primary Bone Tumors ◽

Guided Biopsy ◽

Ct Guided Biopsy ◽

Significant Step ◽

Primary Bone

Background: Primary bone tumors account for a small yet significant number in the total incidence of tumors. Computed tomography (CT) guided percutaneous core biopsy is a novel yet significant step in the approach towards the diagnosis of bone tumors and is increasingly performed by orthopaedic oncologists around the world. This study is aimed to evaluate the diagnostic accuracy of CT guided biopsy in the diagnosis of primary bone tumors. Methods: Patients who underwent CT guided biopsy and subsequent excision for primary bone tumors from January 2008 to July 2015 were analysed. CT guided biopsy results were compared with post-operative histopathological reports to evaluate its sensitivity and specificity.Results: A total of 161 patients were included in the retrospective study. Among them, 147 were true positives, 7 were false negatives, 6 were true negatives and one was false positive. The sensitivity of CT guided biopsy in the diagnosis of primary bone tumor was 95.4 % with specificity of 85.7% with a diagnostic efficiency of 90.5%. The complication rate was 4.3%.Conclusions: CT guided biopsy is a safe, simple and effective procedure to rule out and rule in the diagnosis of primary bone tumors.

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Benign Notochordal Cell Tumor of the Sacrum with Atypical Imaging Features: The Value of CT Guided Biopsy for Diagnosis

The Open Neuroimaging Journal ◽

10.2174/1874440001307010036 ◽

2013 ◽

Vol 7 (1) ◽

pp. 36-40 ◽

Cited By ~ 8

Author(s):

Dario Pasalic ◽

Patrick H. Luetmer ◽

Christopher H. Hunt ◽

Peter S. Rose ◽

Felix E. Diehn ◽

...

Keyword(s):

Computed Tomography ◽

Definitive Diagnosis ◽

Cell Tumor ◽

Invasive Technique ◽

Imaging Features ◽

Ct Guided ◽

Notochordal Cell ◽

Orthopedic Surgeons ◽

Guided Biopsy ◽

Ct Guided Biopsy

We report a case of a benign notochordal cell tumor (BNCT) of the sacrum with atypical imaging features, which was incidentally discovered in a 74-year-old man undergoing evaluation for progressively worsening hip and back pain. It is important for radiologists, pathologists and orthopedic surgeons to be aware of the diagnosis of BNCT and be familiar with its radiographic features to avoid unnecessary treatment. This case illustrates the advantage of percutaneous computed tomography (CT)-guided biopsy as a minimally invasive technique for definitive diagnosis of a BNCT with atypical imaging features.

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Diagnostic yield, accuracy, and complication rate of CT-guided biopsy for spinal lesions: a systematic review and meta-analysis

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017419 ◽

2021 ◽

pp. neurintsurg-2021-017419

Author(s):

Giorgos D Michalopoulos ◽

Yagiz Ugur Yolcu ◽

Abdul Karim Ghaith ◽

Mohammed Ali Alvi ◽

Carrie M Carr ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Complication Rate ◽

Diagnostic Performance ◽

Diagnostic Yield ◽

Meta Analysis ◽

Ct Guided ◽

Spinal Lesions ◽

Guided Biopsy ◽

Ct Guided Biopsy

BackgroundCT-guided biopsy is a commonly used diagnostic procedure for spinal lesions. This meta-analysis aims to investigate its diagnostic performance and complications, as well as factors influencing outcomes.MethodsA systematic review of the literature was performed to identify studies reporting outcomes of CT-guided biopsies for spinal lesions. Diagnostic yield (ie, the rate of procedures resulting in a specific pathological diagnosis) and diagnostic accuracy (ie, the rate of procedures resulting in the correct diagnosis) were the primary outcomes of interest. Complications following biopsy procedures were also included.ResultsThirty-nine studies with 3917 patients undergoing 4181 procedures were included. Diagnostic yield per procedure was 91% (95% CI 88% to 94%) among 3598 procedures. The most common reason for non-diagnostic biopsies was inadequacy of sample. No difference in diagnostic yield between different locations and between lytic, sclerotic, and mixed lesions was found. Diagnostic yield did not differ between procedures using ≤13G and ≥14G needles. Diagnostic accuracy per procedure was 86% (95% CI 82% to 89%) among 3054 procedures. Diagnostic accuracy among 2426 procedures that yielded a diagnosis was 94% (95% CI 92% to 96%). Complication rate was 1% (95% CI 0.4% to 1.9%) among 3357 procedures. Transient pain and minor hematoma were the most common complications encountered.ConclusionIn our meta-analysis of 39 studies reporting diagnostic performance and complications of CT-guided biopsy, we found a diagnostic yield of 91% and diagnostic accuracy of 86% with a complication rate of 1%. Diagnostic yield did not differ between different locations, between lytic, sclerotic and mixed lesions, and between wide- and thin-bore needles.

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Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features

Acta Radiologica ◽

10.1177/0284185121990286 ◽

2021 ◽

pp. 028418512199028

Author(s):

Anil Kumar Singh ◽

Zafar Neyaz ◽

Ritu Verma ◽

Anshul Gupta ◽

Richa Mishra ◽

...

Keyword(s):

Diagnostic Yield ◽

Final Diagnosis ◽

Microbiological Analysis ◽

Imaging Features ◽

Imaging Findings ◽

Chi Square ◽

Tissue Samples ◽

Ct Guided ◽

Guided Biopsy ◽

Ct Guided Biopsy

Background Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels. Purpose To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories. Material and Methods This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests. Results CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma. Conclusion Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.

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The impact of antibiotic pre‐treatment on diagnostic yield of CT‐guided biopsy for spondylodiscitis: A multi‐centre retrospective study and meta‐analysis

Journal of Medical Imaging and Radiation Oncology ◽

10.1111/1754-9485.13118 ◽

2020 ◽

Author(s):

Hayley Wong ◽

Gregory P Tarr ◽

Kunaal Rajpal ◽

Lara Sweetman ◽

Anthony Doyle

Keyword(s):

Retrospective Study ◽

Diagnostic Yield ◽

Meta Analysis ◽

Ct Guided ◽

Guided Biopsy ◽

Ct Guided Biopsy ◽

Pre Treatment ◽

The Impact

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Usefulness of Computed Tomography (CT)-Guided Biopsy for Etiological Diagnosis of Vertebral Destruction Syndrome

Journal of Spine ◽

10.4172/2165-7939.1000295 ◽

2016 ◽

Vol 05 (02) ◽

Author(s):

Alejandro Antonio Reyes-Sánchez ◽

Claudia Obil-Chavarría

Keyword(s):

Computed Tomography ◽

Ct Guided ◽

Etiological Diagnosis ◽

Guided Biopsy ◽

Ct Guided Biopsy

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Role of Computed Tomography-guided Biopsies in the Era of Electromagnetic Navigational Bronchoscopy: A Retrospective Study of Factors Predicting Diagnostic Yield in Electromagnetic Navigational Bronchoscopy and Computed Tomography Biopsies

Journal of Clinical Imaging Science ◽

10.25259/jcis_53_2020 ◽

2020 ◽

Vol 10 ◽

pp. 33

Author(s):

Naomi K. Atkins ◽

Jasraj Marjara ◽

Jussuf T. Kaifi ◽

Jeffrey R. Kunin ◽

Sachin S. Saboo ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Yield ◽

New Technology ◽

High Risk Population ◽

Ct Guided ◽

Lung Lesions ◽

High Diagnostic Yield ◽

Bronchoscopic Biopsy ◽

Ct Guided Biopsy ◽

Electromagnetic Navigational Bronchoscopy

Objectives: Over 25% of the high-risk population screened for lung cancer have an abnormal computed tomography (CT) scan. Conventionally, these lesions have been biopsied with CT guidance with a high diagnostic yield. Electromagnetic navigational bronchoscopy (ENB) with transbronchial biopsy has emerged as a technology that improves the diagnostic sensitivity of conventional bronchoscopic biopsy. It has been used to biopsy lung lesions, due to the low risk of pneumothorax. It is, however, a new technology that is expensive and its role in the diagnosis of the solitary pulmonary nodule (SPN) is yet to be determined. The purpose of this study was to evaluate the diagnostic yield of CT-guided biopsy (CTB) following non-diagnostic ENB biopsy and identify characteristics of the lesion that predicts a low diagnostic yield with ENB, to ensure appropriate use of ENB in the evaluation of SPN. Materials and Methods: One hundred and thirty-five lung lesions were biopsied with ENB from January 2017 to August 2019. Biopsies were considered diagnostic if pathology confirmed malignancy or inflammation in the appropriate clinical and imaging setting. We evaluated lesions for several characteristics including size, lobe, and central/peripheral distribution. The diagnostic yield of CTB in patients who failed ENB biopsies was also evaluated. Logistic regression was used to identify factors likely to predict a non-diagnostic ENB biopsy. Result: Overall, ENB biopsies were performed in 135 patients with solitary lung lesions. ENB biopsies were diagnostic in 52% (70/135) of the patients. In 23 patients with solitary lung lesions, CTBs were performed following a non-diagnostic ENB biopsy. The CTBs were diagnostic in 87% of the patients (20/23). ENB biopsies of lesions <21.5 mm were non-diagnostic in 71% of cases (42/59); 14 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% of them were diagnostic (12/14). ENB biopsies of lesions in the lower lobes were non- diagnostic in 59% of cases (35/59); 12 of these patients with non-diagnostic ENB biopsies had CTBs, and 83% were diagnostic (10/12). ENB biopsies of lesions in the outer 2/3 were non-diagnostic in 57% of cases (50/87); 21 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% were diagnostic (18/21). Conclusion: CTBs have a high diagnostic yield even following non-diagnostic ENB biopsies. Lesions <21.5 mm, in the outer 2/3 of the lung, and in the lower lung have the lowest likelihood of a diagnostic yield with ENB biopsies. Although CTBs have a slightly higher pneumothorax rate, these lesions would be more successfully diagnosed with CTB as opposed to ENB biopsy, in the process expediting the diagnosis and saving valuable medical resources.

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Diagnostic Yield and Safety of Image-Guided Pleural Biopsy: A Systematic Review and Meta-Analysis

Respiration ◽

10.1159/000511626 ◽

2020 ◽

pp. 1-11

Author(s):

Federico Mei ◽

Martina Bonifazi ◽

Matteo Rota ◽

Laura Cirilli ◽

Martina Grilli ◽

...

Keyword(s):

Systematic Review ◽

Selection Criteria ◽

Diagnostic Yield ◽

Meta Analysis ◽

Pleural Biopsy ◽

Ultrasound Technique ◽

Ct Guided ◽

Guided Biopsy ◽

Ct Guided Biopsy ◽

Over Time

Background: Diagnostic yield (DY) and safety of computed tomography (CT)- and thoracic ultrasound (TUS)-guided biopsies in the diagnosis of pleural lesions have been investigated in a number of studies, but no synthesis of data from the literature has ever been performed. Objectives: We aimed to provide the first systematic review and meta-analysis on the DY and safety of CT- versus TUS-guided biopsy in the diagnosis of pleural lesions. Method: We searched MEDLINE and EMBASE for all studies reporting outcomes of interest published up to April 2018. Two authors reviewed all titles/abstracts and retrieved selected full text to identify studies according to predefined selection criteria. Summary estimates were derived using the random-effects model. Cumulative meta-analysis assessed the influence of increasing adoption of the procedures over time. Results: Thirty original studies were included in the present review; the number of studies on TUS-guided biopsy was almost three-fold higher than those on CT-guided biopsy. The pooled DYs of the 2 procedures were overall excellent and differed <10%, being 84% for TUS-guided biopsy and 93% for CT-guided biopsy. Safety profiles were reassuring for both the techniques, being 7 and 3% for CT- and TUS-guided biopsy, respectively. DY of ultrasound technique significantly improved over time, while no time effect was observed for CT-guided biopsy. Conclusions: Data show that CT- and TUS-guided biopsies in the diagnosis of pleural lesions are both excellent procedures, without meaningful differences in DYs and safety. Considering that TUS is non-ionizing and easily performed at the bedside, it should be the preferred approach in presence of adequate skills.

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