title: Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours.
abstract: OBJECTIVE
  This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics.
  
  
  METHODS
  41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed.
  
  
  RESULTS
  41 biopsies were performed in 38 patients. 68% schwannomas, 24% neurofibromas and 7% malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71% of lesions were surgically excised. 60% of patients reported pain related to their lesion. Following the biopsy, 12% reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain.
  
  
  CONCLUSIONS
  Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy.
authors.affiliation: St Vincent's Hospital, 41 Victoria Parade, Fitzroy, 3065, VIC, Australia, marcus.pianta@svha.org.au.
authors.forename: Marcus
authors.initials: M
authors.lastname: Pianta
authors.forename: Eric
authors.initials: E
authors.lastname: Chock
authors.forename: Stephen
authors.initials: S
authors.lastname: Schlicht
authors.forename: David
authors.initials: D
authors.lastname: McCombe
mesh_terms: D062005:Biopsy, Large-Core Needle / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D015641:Radiography, Interventional / Q000009:adverse effects* / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome