Preferential Use of Sonographically Guided Biopsy to Minimize Patient Discomfort and Procedure Time in a Percutaneous Image-Guided Breast Biopsy Program

2002 ◽  
Vol 21 (11) ◽  
pp. 1221-1226 ◽  
Author(s):  
Martha B. Mainiero ◽  
Ilana F. Gareen ◽  
Chloe E. Bird ◽  
Wendy Smith ◽  
Cynthia Cobb ◽  
...  
Keyword(s):  
Breast Biopsy ◽  
Procedure Time ◽  
Patient Discomfort ◽  
Image Guided ◽  
Guided Biopsy

Ultrasound-Guided Core Biopsy

2018 ◽  
Author(s):  
Philip A. Di Carlo
Keyword(s):  
Core Biopsy ◽  
Breast Biopsy ◽  
Excisional Biopsy ◽  
Ultrasound Guided ◽  
Needle Localization ◽  
Image Guided ◽  
Guided Biopsy ◽  
Multiple Imaging ◽  
Key Points

Prior to 1993, when ultrasound-guided core breast biopsy was first described by Parker and colleagues, surgery following image-guided needle localization was necessary to obtain a histological diagnosis of breast lesions. But there are many financial, practical, and clinical advantages of image-guided core biopsy over surgical excisional biopsy. There are also many advantages to ultrasound-guided biopsy over stereotactic- or MRI-guided biopsy, detailed in this chapter. Ultrasound is now usually the modality of choice by which to perform core biopsies if the lesion is visualized by multiple imaging modalities. This chapter, appearing in the section on interventions and surgical changes, reviews the key points of performing ultrasound-guided core biopsy. Topics discussed include protocols for both spring-loaded and vacuum-assisted devices; pre-procedure and post-procedure management, and imaging follow-up.

scholarly journals Prospective Randomized Trial for Image-Guided Biopsy Using Cone-Beam CT Navigation Compared with Conventional CT

2016 ◽  
Vol 27 (9) ◽  
pp. 1342-1349 ◽  
Author(s):  
Nadine Abi-Jaoudeh ◽  
Teresa Fisher ◽  
John Jacobus ◽  
Marlene Skopec ◽  
Alessandro Radaelli ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cone Beam Ct ◽  
Prospective Randomized Trial ◽  
Cone Beam ◽  
Image Guided ◽  
Guided Biopsy ◽  
Conventional Ct

Understanding Patient Anxiety and Pain During Initial Image-guided Breast Biopsy

2020 ◽  
Vol 2 (6) ◽  
pp. 583-589
Author(s):  
Santo Maimone ◽  
Andrey P Morozov ◽  
Annamaria Wilhelm ◽  
Inna Robrahn ◽  
Tedra D Whitcomb ◽  
...  
Keyword(s):  
Breast Biopsy ◽  
Procedural Pain ◽  
Patient Anxiety ◽  
Initial Image ◽  
Image Guided ◽  
Pain Scores ◽  
Multiple Biopsies ◽  
Lower Pain ◽  
Malignant Lesions ◽  
Positive Correlations

Abstract Objective Image-guided breast biopsies are safe, efficient, and reliable. However, patients are often anxious about these procedures, particularly those who have never undergone a prior biopsy. Methods This prospective IRB-approved study surveyed 163 patients undergoing their first breast biopsy. Participants provided informed consent and completed a short written survey prior to and immediately after their procedure. Level of anxiety as well as anticipated and actual levels of pain prior to and following the procedure were assessed using a 0–10-point Likert scale. Correlation, bivariate, and regression analyses were performed. Results Regarding the biopsy experience, 133/163 (81.6%) of patients reported it as better than expected. Anxiety decreased significantly from a prebiopsy mean score of 5.52 to a postbiopsy mean score of 2.25 (P < 0.001). Average and greatest pain experienced during the procedure had mean scores of 2.03 and 2.77, respectively, both significantly lower compared to preprocedural expectation (mean 4.53) (P < 0.001). Lower pain scores were reported in US-guided procedures compared to stereotactic- and MRI-guided biopsies (P < 0.001). No significant differences in pain scores were seen in those undergoing single versus multiple biopsies, or when benign, elevated-risk, or malignant lesions were sampled. Positive correlations were seen with prebiopsy anxiety levels and procedural pain as well as with anticipated pain and actual procedural pain. Conclusion Image-guided biopsies are often better tolerated by patients than anticipated. We stress the benefit of conveying this information to patients prior to biopsy, as decreased anxiety correlates with lower levels of pain experienced during the procedure.

scholarly journals Image-guided Biopsy of Mesenteric, Omental, and Peritoneal Disease

2018 ◽  
Vol 02 (02) ◽  
pp. 106-115
Author(s):  
Joshua Cornman-Homonoff ◽  
David Madoff
Keyword(s):  
Diagnostic Accuracy ◽  
Patient Care ◽  
Clinical History ◽  
Peritoneal Disease ◽  
Image Guided ◽  
High Diagnostic Accuracy ◽  
Guided Biopsy ◽  
Imaging Characteristics ◽  
Procedural Evaluation ◽  
Technical Considerations

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.

scholarly journals Intraductal Papilloma Without Atypia on Image- Guided Breast Biopsy: Upgrade Rates to Carcinoma at Surgical Excision

Breast Care ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. 364-368 ◽  
Author(s):  
Doris Leithner ◽  
Benjamin Kaltenbach ◽  
Petra Hödl ◽  
Volker Möbus ◽  
Volker Brandenbusch ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Statistical Tests ◽  
Menopausal Status ◽  
Surgical Excision ◽  
Lesion Size ◽  
Intraductal Papilloma ◽  
Image Guided ◽  
Institutional Review

Background: The management of intraductal papilloma without atypia (IDP) in breast needle biopsy remains controversial. This study investigates the upgrade rate of IDP to carcinoma and clinical and radiologic features predictive of an upgrade. Methods: Patients with a diagnosis of IDP on image-guided (mammography, ultrasound, magnetic resonance imaging) core needle or vacuum-assisted biopsy and surgical excision of this lesion at a certified breast center between 2007 and 2017 were included in this institutional review board-approved retrospective study. Appropriate statistical tests were performed to assess clinical and radiologic characteristics associated with an upgrade to malignancy at excision. Results: For 60 women with 62 surgically removed IDPs, the upgrade rate to malignancy was 16.1% (10 upgrades, 4 invasive ductal carcinoma, 6 ductal carcinoma in situ). IDPs with upgrade to carcinoma showed a significantly greater distance to the nipple (63.5 vs. 36.8 mm; p = 0.012). No significant associations were found between upgrade to carcinoma and age, menopausal status, lesion size, microcalcifications, BI-RADS descriptors, initial BI-RADS category, and biopsy modality. Conclusion: The upgrade rate at excision for IDPs diagnosed with needle biopsy was higher than expected according to some guideline recommendations. Observation only might not be appropriate for all patients with IDP, particularly for those with peripheral IDP.

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

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

Percutaneous Image-Guided Biopsy of the Pancreas

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.

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

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.

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