US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions.
OBJECTIVE
To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses.


METHODS
Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy.


RESULTS
USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications.


CONCLUSIONS
Although biopsy under microlaryngoscopy remains the "gold-standard" technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses.
Preda
Lorenzo
L
Department of Radiology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. lorenzo.preda@ieo.it
De Fiori
Elvio
E
Rampinelli
Cristiano
C
Ansarin
Mohssen
M
Petralia
Giuseppe
G
Maffini
Fausto
F
Alterio
Daniela
D
Bonello
Luke
L
Chiesa
Fausto
F
Bellomi
Massimo
M
D000368:Aged; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*