title: Ultrasound-guided percutaneous biopsy for diagnosis of gastrointestinal lesions.
abstract: OBJECTIVE
  Endoscopical examination is not always sufficient for the diagnosis of gastrointestinal masses. This study assessed the diagnostic accuracy and safety of ultrasound-guided percutaneous biopsy of gastrointestinal lesions.
  
  
  METHODS
  This retrospective study evaluated 114 patients who underwent ultrasound-guided biopsy of gastrointestinal masses with a 18G needle. Thirty-two of these patients underwent a 22G fine-needle biopsy for cytology. Histology was compared with a composite standard of reference for diagnosis (i.e. post-surgery histological evaluation in 73 cases and computed tomography or magnetic resonance scan findings, together with a compatible clinical follow-up for at least 24 months, in the remaining 41 cases). Safety was assessed by recording side effects for up to 4h after the procedure.
  
  
  RESULTS
  Of the 114 lesions evaluated, 112 were malignant (98.2%) and 2 benign (1.8%). Specimens were adequate for histology in all but one case. Specimens were obtained from the stomach (n=38; 33.3%), small bowel (n=36; 31.6%) and colon (n=40; 35.1%). Diagnosis was correct in 113/114 cases (99.1%). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were 99.1%, 100%, 100%, 66%, and 99%, respectively. One of the 114 patients (0.9%) bled from a gastric GIST.
  
  
  CONCLUSIONS
  Ultrasound-guided percutaneous biopsy of gastrointestinal lesions is a valid alternative when diagnosis of a gastrointestinal mass cannot be obtained with an endoscopical procedure.
authors.affiliation: Department of Clinical and Experimental Medicine "Magrassi-Lanzara", Gastroenterology Unit, Second University of Naples, Naples, Italy. Electronic address: ilades@tiscali.it.
authors.forename: Ilario
authors.initials: I
authors.lastname: de Sio
authors.forename: Annalisa
authors.initials: A
authors.lastname: Funaro
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Vitale
authors.forename: Marco
authors.initials: M
authors.lastname: Niosi
authors.forename: Giampiero
authors.initials: G
authors.lastname: Francica
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.forename: Dolores
authors.initials: D
authors.lastname: Sgambato
authors.forename: Carmelina
authors.initials: C
authors.lastname: Loguercio
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D061705:Image-Guided Biopsy; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D013270:Stomach / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
keywords: Endoscopy; Gastrointestinal malignancy; Ultrasound-guided biopsy