title: Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach.
abstract: Aim.To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach.Methods.Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group (n= 75). All CEUS findings and clinical data were evaluated in MDT.Results.CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%).Conclusion.The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Mao
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
authors.forename: Zhengbiao
authors.initials: Z
authors.lastname: Ji
authors.affiliation: Shanghai Institute of Medical Imaging, 200032 Shanghai, China.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
authors.forename: Wen-Ping
authors.identifier: 0000-0002-6797-1835
authors.initials: WP
authors.lastname: Wang
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D000066491:Clinical Decision-Making; D003287:Contrast Media / Q000737:chemistry*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media