Accuracy of core-needle biopsy after contrast-enhanced ultrasound in soft-tissue tumours.
OBJECTIVE
Percutaneous biopsies are gaining acceptance in the diagnosis of soft-tissue tumours. Sampling in the most representative area is not easy in sarcomas of huge dimension. We hypothesised that ultrasound (US) contrast medium could identify the representative area for focus core-needle biopsy (CNB) METHODS: This is a retrospective cohort series of 115 soft-tissue masses treated from January 2007 to November 2008. Accuracy of US-guided CNB after contrast-enhanced US (CEUS) was determined by comparing the histology of the biopsy with the definitive diagnosis in 105 surgically excised samples (42 benign, 63 malignant) and with the expected outcome in the remaining ten malignant cases not surgically treated. A myxoid component was present in 21 sarcomas (34.4%).


RESULTS
Of samples, 94.8% were adequate for diagnosis with 97.1% sensitivity and 92.5% specificity. Sensitivity and specificity in specific histopathological subgroupings were 100%, and in grading definition they were 100% and 96.8%.


CONCLUSIONS
US-guided CNB is safe and effective. US contrast medium depicts tumour vascular supply and identifies the representative area(s) for sampling. Sensitivity and specificity are also high in subgrouping and grading, including myxoid types. Discussion about biopsy is part of the essential multidisciplinary strategy for these tumours.
De Marchi
Armanda
A
Department of Imaging, AO CTO/Maria Adelaide, Via Zuretti, 29, 10126, Turin, Italy. armanda.demarchi@tiscali.it
Brach del Prever
Elena Maria
EM
Linari
Alessandra
A
Pozza
Simona
S
Verga
Lucia
L
Albertini
Ugo
U
Forni
Marco
M
Gino
Gian Carlo
GC
Comandone
Alessandro
A
Brach del Prever
Adalberto Maria
AM
Piana
Raimondo
R
Faletti
Carlo
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011237:Predictive Value of Tests; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D013459:Sulfur Hexafluoride; D018084:Ultrasonography, Interventional; D055815:Young Adult
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride