title: Accuracy of core-needle biopsy after contrast-enhanced ultrasound in soft-tissue tumours.
abstract: 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.
authors.affiliation: Department of Imaging, AO CTO/Maria Adelaide, Via Zuretti, 29, 10126, Turin, Italy. armanda.demarchi@tiscali.it
authors.forename: Armanda
authors.initials: A
authors.lastname: De Marchi
authors.forename: Elena Maria
authors.initials: EM
authors.lastname: Brach del Prever
authors.forename: Alessandra
authors.initials: A
authors.lastname: Linari
authors.forename: Simona
authors.initials: S
authors.lastname: Pozza
authors.forename: Lucia
authors.initials: L
authors.lastname: Verga
authors.forename: Ugo
authors.initials: U
authors.lastname: Albertini
authors.forename: Marco
authors.initials: M
authors.lastname: Forni
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Gino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Comandone
authors.forename: Adalberto Maria
authors.initials: AM
authors.lastname: Brach del Prever
authors.forename: Raimondo
authors.initials: R
authors.lastname: Piana
authors.forename: Carlo
authors.initials: C
authors.lastname: Faletti
mesh_terms: 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
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride