Korean Journal of Radiology

  • 제18권2호
  • /
  • Pages.309-322
  • /
  • 2017
  • /
  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Ultrasound-Guided Percutaneous Core Needle Biopsy of Abdominal Viscera: Tips to Ensure Safe and Effective Biopsy

  • Kim, Jin Woong (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Shin, Sang Soo (Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School)
  • 투고 : 2016.05.24
  • 심사 : 2016.10.09
  • 발행 : 2017.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications.

키워드

과제정보

연구 과제 주관 기관 : Dongkook Pharmaceutical Co., Ltd.

참고문헌

  1. Reading CC. Percutaneous needle biopsy. Abdom Imaging 1997;22:311-312 https://doi.org/10.1007/s002619900196
  2. Atwell T, Charboneau JW, McGahan J, Reading CC. Ultrasoundguided biopsy of abdomen and pelvis. In: Rumack CM, Wilson SR, Charboneau JW, Levine D, eds. Diagnostic Ultrasound, 4th ed. Philadelphia, PA: Elsevier & Mosby, 2011:613-638
  3. Jennings PE, Donald JJ, Coral A, Rode J, Lees WR. Ultrasoundguided core biopsy. Lancet 1989;1:1369-1371
  4. Sheafor DH, Paulson EK, Simmons CM, DeLong DM, Nelson RC. Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 1998;207:705-710 https://doi.org/10.1148/radiology.207.3.9609893
  5. Charboneau JW, Reading CC, Welch TJ. CT and sonographically guided needle biopsy: current techniques and new innovations. AJR Am J Roentgenol 1990;154:1-10 https://doi.org/10.2214/ajr.154.1.2104689
  6. Lipnik AJ, Brown DB. Image-guided percutaneous abdominal mass biopsy: technical and clinical considerations. Radiol Clin North Am 2015;53:1049-1059 https://doi.org/10.1016/j.rcl.2015.05.007
  7. Uppot RN, Harisinghani MG, Gervais DA. Imaging-guided percutaneous renal biopsy: rationale and approach. AJR Am J Roentgenol 2010;194:1443-1449 https://doi.org/10.2214/AJR.10.4427
  8. Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS, et al. Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol 2010;194:784-789 https://doi.org/10.2214/AJR.08.2122
  9. O'Connor SD, Taylor AJ, Williams EC, Winter TC. Coagulation concepts update. AJR Am J Roentgenol 2009;193:1656-1664 https://doi.org/10.2214/AJR.08.2191
  10. Burger W, Chemnitius JM, Kneissl GD, Rucker G. Lowdose aspirin for secondary cardiovascular preventioncardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation-review and meta-analysis. J Intern Med 2005;257:399-414 https://doi.org/10.1111/j.1365-2796.2005.01477.x
  11. Akan H, Ozen N, Incesu L, Gumus˛ S, Gunes˛ M. Are percutaneous transgastric biopsies using 14-, 16- and 18-G Tru-Cut needles safe? An experimental study in the rabbit. Australas Radiol 1998;42:99-101 https://doi.org/10.1111/j.1440-1673.1998.tb00582.x
  12. Brandt KR, Charboneau JW, Stephens DH, Welch TJ, Goellner JR. CT- and US-guided biopsy of the pancreas. Radiology 1993;187:99-104 https://doi.org/10.1148/radiology.187.1.8451443
  13. Eckman MH, Erban JK, Singh SK, Kao GS. Screening for the risk for bleeding or thrombosis. Ann Intern Med 2003;138:W15-W24 https://doi.org/10.7326/0003-4819-138-10-200305200-00001
  14. Sammon J, Twomey M, Crush L, Maher MM, O'Connor OJ. Image-guided percutaneous splenic biopsy and drainage. Semin Intervent Radiol 2012;29:301-310 https://doi.org/10.1055/s-0032-1330064
  15. Stewart CJ, Coldewey J, Stewart IS. Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions. J Clin Pathol 2002;55:93-97 https://doi.org/10.1136/jcp.55.2.93
  16. Li L, Liu LZ, Wu QL, Mo YX, Liu XW, Cui CY, et al. CTguided core needle biopsy in the diagnosis of pancreatic diseases with an automated biopsy gun. J Vasc Interv Radiol 2008;19:89-94 https://doi.org/10.1016/j.jvir.2007.09.001
  17. Zamboni GA, D'Onofrio M, Idili A, Malago R, Iozzia R, Manfrin E, et al. Ultrasound-guided percutaneous fine-needle aspiration of 545 focal pancreatic lesions. AJR Am J Roentgenol 2009;193:1691-1695 https://doi.org/10.2214/AJR.09.2958
  18. Paulsen SD, Nghiem HV, Negussie E, Higgins EJ, Caoili EM, Francis IR. Evaluation of imaging-guided core biopsy of pancreatic masses. AJR Am J Roentgenol 2006;187:769-772 https://doi.org/10.2214/AJR.05.0366
  19. Olson MC, Atwell TD, Harmsen WS, Konrad A, King RL, Lin Y, et al. Safety and accuracy of percutaneous image-guided core biopsy of the spleen. AJR Am J Roentgenol 2016;206:655-659 https://doi.org/10.2214/AJR.15.15125
  20. Appelbaum L, Kane RA, Kruskal JB, Romero J, Sosna J. Focal hepatic lesions: US-guided biopsy--lessons from review of cytologic and pathologic examination results. Radiology 2009;250:453-458 https://doi.org/10.1148/radiol.2502080182
  21. Perez-Johnston R, Hahn PF, Shenoy-Bhangle AS, Shelly MJ, Gervais DA, Arellano RS. Percutaneous biopsy of focal lesions of the gastrointestinal tract. Abdom Imaging 2013;38:1197-1202 https://doi.org/10.1007/s00261-013-0023-7
  22. Hatfield MK, Beres RA, Sane SS, Zaleski GX. Percutaneous imaging-guided solid organ core needle biopsy: coaxial versus noncoaxial method. AJR Am J Roentgenol 2008;190:413-417 https://doi.org/10.2214/AJR.07.2676
  23. Yoshimatsu R, Yamagami T, Tanaka O, Miura H, Tanaka T, Suzuki T, et al. Comparison of fully automated and semi-automated biopsy needles for lung biopsy under CT fluoroscopic guidance. Br J Radiol 2012;85:208-213 https://doi.org/10.1259/bjr/15132704
  24. Sridharan R, Yunos SM, Aziz S, Hussain RI, Alhabshi SM, Suria Hayati MP, et al. Comparison on the use of semi-automated and automated core biopsy needle in ultrasound guided breast biopsy. Med J Malaysia 2015;70:326-333
  25. Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease. AJR Am J Roentgenol 1993;161:1293-1297 https://doi.org/10.2214/ajr.161.6.8249745
  26. Khati NJ, Gorodenker J, Hill MC. Ultrasound-guided biopsies of the abdomen. Ultrasound Q 2011;27:255-268 https://doi.org/10.1097/RUQ.0b013e3182394101
  27. Meier-Meitinger M, Anders K, Alibek S, Uder M, Baum U. CTguided biopsies of pancreatic lesions: impact of contrast application prior to versus following needle placement. Acad Radiol 2009;16:1386-1392 https://doi.org/10.1016/j.acra.2009.04.013
  28. Longo JM, Bilbao JI, Barettino MD, Larrea JA, Pueyo J, Idoate F, et al. Percutaneous vascular and nonvascular puncture under US guidance: role of color Doppler imaging. Radiographics 1994;14:959-972 https://doi.org/10.1148/radiographics.14.5.7991826
  29. Tang S, Li JH, Lui SL, Chan TM, Cheng IK, Lai KN. Free-hand, ultrasound-guided percutaneous renal biopsy: experience from a single operator. Eur J Radiol 2002;41:65-69 https://doi.org/10.1016/S0720-048X(01)00439-9
  30. Phal PM, Brooks DM, Wolfe R. Sonographically guided biopsy of focal lesions: a comparison of freehand and probeguided techniques using a phantom. AJR Am J Roentgenol 2005;184:1652-1656 https://doi.org/10.2214/ajr.184.5.01841652
  31. Yu SC, Lau WY, Leung WT, Liew CT, Leung NW, Metreweli C. Percutaneous biopsy of small hepatic lesions using an 18 gauge automated needle. Br J Radiol 1998;71:621-624 https://doi.org/10.1259/bjr.71.846.9849384
  32. Bisceglia M, Matalon TA, Silver B. The pump maneuver: an atraumatic adjunct to enhance US needle tip localization. Radiology 1990;176:867-868 https://doi.org/10.1148/radiology.176.3.2202015
  33. Feld R, Needleman L, Goldberg BB. Use of needle-vibrating device and color Doppler imaging for sonographically guided invasive procedures. AJR Am J Roentgenol 1997;168:255-256 https://doi.org/10.2214/ajr.168.1.8976955
  34. Tseng HS, Chen CY, Chan WP, Chiang JH. Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles. World J Gastroenterol 2009;15:5972-5975 https://doi.org/10.3748/wjg.15.5972
  35. Kim KW, Kim MJ, Kim HC, Park SH, Kim SY, Park MS, et al. Value of “patent track” sign on Doppler sonography after percutaneous liver biopsy in detection of postbiopsy bleeding: a prospective study in 352 patients. AJR Am J Roentgenol 2007;189:109-116 https://doi.org/10.2214/AJR.07.2071
  36. Weigand K, Weigand K. Percutaneous liver biopsy: retrospective study over 15 years comparing 287 inpatients with 428 outpatients. J Gastroenterol Hepatol 2009;24:792-799 https://doi.org/10.1111/j.1440-1746.2008.05718.x
  37. Micames C, Jowell PS, White R, Paulson E, Nelson R, Morse M, et al. Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointest Endosc 2003;58:690-695 https://doi.org/10.1016/S0016-5107(03)02009-1
  38. Horwhat JD, Paulson EK, McGrath K, Branch MS, Baillie J, Tyler D, et al. A randomized comparison of EUS-guided FNA versus CT or US-guided FNA for the evaluation of pancreatic mass lesions. Gastrointest Endosc 2006;63:966-975 https://doi.org/10.1016/j.gie.2005.09.028
  39. Erturk SM, Mortele KJ, Tuncali K, Saltzman JR, Lao R, Silverman SG. Fine-needle aspiration biopsy of solid pancreatic masses: comparison of CT and endoscopic sonography guidance. AJR Am J Roentgenol 2006;187:1531-1535 https://doi.org/10.2214/AJR.05.1657
  40. Zech CJ, Helmberger T, Wichmann MW, Holzknecht N, Diebold J, Reiser MF. Large core biopsy of the pancreas under CT fluoroscopy control: results and complications. J Comput Assist Tomogr 2002;26:743-749 https://doi.org/10.1097/00004728-200209000-00014
  41. Gupta S, Ahrar K, Morello FA Jr, Wallace MJ, Hicks ME. Masses in or around the pancreatic head: CT-guided coaxial fineneedle aspiration biopsy with a posterior transcaval approach. Radiology 2002;222:63-69 https://doi.org/10.1148/radiol.2221010437
  42. Sofocleous CT, Schubert J, Brown KT, Brody LA, Covey AM, Getrajdman GI. CT-guided transvenous or transcaval needle biopsy of pancreatic and peripancreatic lesions. J Vasc Interv Radiol 2004;15:1099-1104 https://doi.org/10.1097/01.RVI.0000130815.79121.EC
  43. McInnes MD, Kielar AZ, Macdonald DB. Percutaneous imageguided biopsy of the spleen: systematic review and metaanalysis of the complication rate and diagnostic accuracy. Radiology 2011;260:699-708 https://doi.org/10.1148/radiol.11110333
  44. Keogan MT, Freed KS, Paulson EK, Nelson RC, Dodd LG. Imaging-guided percutaneous biopsy of focal splenic lesions: update on safety and effectiveness. AJR Am J Roentgenol 1999;172:933-937 https://doi.org/10.2214/ajr.172.4.10587123
  45. Venkataramu NK, Sood BP, Gupta S, Gulati M, Khandelwal N, Suri S. Ultrasound-guided fine needle aspiration biopsy of gall bladder malignancies. Acta Radiol 1999;40:436-439 https://doi.org/10.3109/02841859909177760
  46. Pandey M, Sood BP, Shukla RC, Aryya NC, Singh S, Shukla VK. Carcinoma of the gallbladder: role of sonography in diagnosis and staging. J Clin Ultrasound 2000;28:227-232 https://doi.org/10.1002/(SICI)1097-0096(200006)28:5<227::AID-JCU4>3.0.CO;2-4
  47. Whittier WL, Korbet SM. Renal biopsy: update. Curr Opin Nephrol Hypertens 2004;13:661-665 https://doi.org/10.1097/00041552-200411000-00013
  48. Lebret T, Poulain JE, Molinie V, Herve JM, Denoux Y, Guth A, et al. Percutaneous core biopsy for renal masses: indications, accuracy and results. J Urol 2007;178(4 Pt 1):1184-1188;discussion 1188 https://doi.org/10.1016/j.juro.2007.05.155
  49. Vanderveen KA, Thompson SM, Callstrom MR, Young WF Jr, Grant CS, Farley DR, et al. Biopsy of pheochromocytomas and paragangliomas: potential for disaster. Surgery 2009;146:1158-1166 https://doi.org/10.1016/j.surg.2009.09.013
  50. Casola G, Nicolet V, vanSonnenberg E, Withers C, Bretagnolle M, Saba RM, et al. Unsuspected pheochromocytoma: risk of blood-pressure alterations during percutaneous adrenal biopsy. Radiology 1986;159:733-735 https://doi.org/10.1148/radiology.159.3.3517958
  51. Carson BW, Brown JA, Cooperberg PL. Ultrasonographically guided percutaneous biopsy of gastric, small bowel, and colonic abnormalities: efficacy and safety. J Ultrasound Med 1998;17:739-742 https://doi.org/10.7863/jum.1998.17.12.739
  52. Farmer KD, Harries SR, Fox BM, Maskell GF, Farrow R. Core biopsy of the bowel wall: efficacy and safety in the clinical setting. AJR Am J Roentgenol 2000;175:1627-1630 https://doi.org/10.2214/ajr.175.6.1751627
  53. Marco-Domenech SF, Gil-Sanchez S, Fernandez-Garcia P, De La Iglesia-Carrena P, Gonzalez-Anon M, Arenas-Jimenez JJ, et al. Sonographically guided percutaneous biopsy of gastrointestinal tract lesions. AJR Am J Roentgenol 2001;176:147-151 https://doi.org/10.2214/ajr.176.1.1760147
  54. Puylaert JB. Acute appendicitis: US evaluation using graded compression. Radiology 1986;158:355-360 https://doi.org/10.1148/radiology.158.2.2934762
  55. Memel DS, Dodd GD 3rd, Esola CC. Efficacy of sonography as a guidance technique for biopsy of abdominal, pelvic, and retroperitoneal lymph nodes. AJR Am J Roentgenol 1996;167:957-962 https://doi.org/10.2214/ajr.167.4.8819394
  56. Fisher AJ, Paulson EK, Sheafor DH, Simmons CM, Nelson RC. Small lymph nodes of the abdomen, pelvis, and retroperitoneum: usefulness of sonographically guided biopsy. Radiology 1997;205:185-190 https://doi.org/10.1148/radiology.205.1.9314983
  57. Spencer JA, Weston MJ, Saidi SA, Wilkinson N, Hall GD. Clinical utility of image-guided peritoneal and omental biopsy. Nat Rev Clin Oncol 2010;7:623-631 https://doi.org/10.1038/nrclinonc.2010.155
  58. Que Y, Wang X, Liu Y, Li P, Ou G, Zhao W. Ultrasound-guided biopsy of greater omentum: an effective method to trace the origin of unclear ascites. Eur J Radiol 2009;70:331-335 https://doi.org/10.1016/j.ejrad.2008.01.036
  59. Lee JK, Baek SY, Lim SM, Lee KH. Reticular infiltrations alone without mass in the mesentery and omentum identified at contrast-enhanced CT: efficacy of US-guided percutaneous core biopsy. Radiology 2011;261:311-317 https://doi.org/10.1148/radiol.11103523
  60. Smith EH. Complications of percutaneous abdominal fineneedle biopsy. Review. Radiology 1991;178:253-258 https://doi.org/10.1148/radiology.178.1.1984314
  61. Tan KT, Rajan DK, Kachura JR, Hayeems E, Simons ME, Ho CS. Pain after percutaneous liver biopsy for diffuse hepatic disease: a randomized trial comparing subcostal and intercostal approaches. J Vasc Interv Radiol 2005;16:1215-1219 https://doi.org/10.1097/01.RVI.0000173282.14018.79
  62. Mueller PR, Biswal S, Halpern EF, Kaufman JA, Lee MJ. Interventional radiologic procedures: patient anxiety, perception of pain, understanding of procedure, and satisfaction with medication--a prospective study. Radiology 2000;215:684-688 https://doi.org/10.1148/radiology.215.3.r00jn33684
  63. Ralls PW, Barakos JA, Kaptein EM, Friedman PE, Fouladian G, Boswell WD, et al. Renal biopsy-related hemorrhage: frequency and comparison of CT and sonography. J Comput Assist Tomogr 1987;11:1031-1034 https://doi.org/10.1097/00004728-198711000-00021
  64. Haaga JR, LiPuma JP, Bryan PJ, Balsara VJ, Cohen AM. Clinical comparison of small-and large-caliber cutting needles for biopsy. Radiology 1983;146:665-667 https://doi.org/10.1148/radiology.146.3.6828680
  65. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD; American Association for the Study of Liver Diseases. Liver biopsy. Hepatology 2009;49:1017-1044 https://doi.org/10.1002/hep.22742
  66. Martino CR, Haaga JR, Bryan PJ, LiPuma JP, El Yousef SJ, Alfidi RJ. CT-guided liver biopsies: eight years' experience. Work in progress. Radiology 1984;152:755-757 https://doi.org/10.1148/radiology.152.3.6463257
  67. Elvin A, Andersson T, Scheibenpflug L, Lindgren PG. Biopsy of the pancreas with a biopsy gun. Radiology 1990;176:677-679 https://doi.org/10.1148/radiology.176.3.2167498
  68. Chang S, Kim SH, Lim HK, Lee WJ, Choi D, Lim JH. Needle tract implantation after sonographically guided percutaneous biopsy of hepatocellular carcinoma: evaluation of doubling time, frequency, and features on CT. AJR Am J Roentgenol 2005;185:400-405 https://doi.org/10.2214/ajr.185.2.01850400
  69. Ferrucci JT, Wittenberg J, Margolies MN, Carey RW. Malignant seeding of the tract after thin-needle aspiration biopsy. Radiology 1979;130:345-346 https://doi.org/10.1148/130.2.345

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