title: Clinical utility of image-guided peritoneal and omental biopsy.
abstract: Image-guided core biopsy of the omentum and peritoneum was described a decade ago and has since been validated in a number of large studies as a safe and effective means of providing a tissue diagnosis in patients with undiagnosed peritoneal disease. Some studies have addressed its ability for determining whether peritoneal infiltration and/or omental masses in patients with prior malignancy represent recurrent disease or a new disease process. Others have focused on the specific issue of women suspected to have advanced peritoneal carcinomatosis from ovarian or primary peritoneal cancer where the primary management of the patient is directed by the tissue diagnosis. The initial management of many of these women, especially those with advanced disease or substantial comorbidity, is with primary chemotherapy. With current clinical trials for ovarian cancer directed to specific morphological subtypes of the disease, image-guided core biopsy offers a rapid and well tolerated nonsurgical means of providing this information. In this Review, we discuss the technique and its clinical applications, and critically examine the currently available alternative options.
authors.affiliation: Department of Clinical Radiology, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. johnaspencer50@hotmail.com
authors.forename: John A
authors.initials: JA
authors.lastname: Spencer
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Weston
authors.forename: Samir A
authors.initials: SA
authors.lastname: Saidi
authors.forename: Nafisa
authors.initials: N
authors.lastname: Wilkinson
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Hall
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D014408:Biomarkers, Tumor; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D009852:Omentum / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media