title: Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique?
abstract: In patients with suspected advanced ovarian carcinoma, a precise histological diagnosis is required before commencing neo-adjuvant chemotherapy. This study aims to determine the diagnostic accuracy and complication rate of percutaneous biopsies performed under ultrasound or computed tomography guidance. Between 2002 to 2007, 60 consecutive image-guided percutaneous biopsies were performed in patients with suspected ovarian cancer. The following variables were recorded: tissue biopsied, imaging technique, experience of operator, biopsy needle gauge, number of passes, complications, and final histology. Forty-seven patients had omental biopsies, 12 pelvic mass biopsies, and 1 para-aortic lymph node biopsy. Thirty-five biopsies were performed under ultrasound, 25 under computed tomography guidance. Biopsy needle gauges ranged from 14-20 swg with two to five passes for each patient. There were no complications. Histology was obtained in 52 (87%) patients. Percutaneous image-guided biopsy of peritoneal disease or pelvic mass is safe with high diagnostic accuracy. The large-gauge biopsy needle is as safe as the small gauge needle, but has the added value of obtaining tissue samples for immunohistochemistry and genomic studies.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital, Cambridge, UK. nyreegriffin@hotmail.com
authors.forename: Nyree
authors.initials: N
authors.lastname: Griffin
authors.forename: Lee A
authors.initials: LA
authors.lastname: Grant
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Freeman
authors.forename: Mercedes
authors.initials: M
authors.lastname: Jimenez-Linan
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Berman
authors.forename: Helena
authors.initials: H
authors.lastname: Earl
authors.forename: Ahmed Ashour
authors.initials: AA
authors.lastname: Ahmed
authors.forename: Robin
authors.initials: R
authors.lastname: Crawford
authors.forename: James
authors.initials: J
authors.lastname: Brenton
authors.forename: Evis
authors.initials: E
authors.lastname: Sala
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*