Ultrasound guided biopsy in hematology and oncology

Introduction Histology is the backbone to plan therapy in hematology and oncology. However, there are different ways to get a histology like endoscopy, CT guided biopsy or surgery

Ultrasound is an easy and broadly available procedure, with the potential to get a guided biopsy. Here we report target regions, efficacy and rate of complications of this method in our hands.

Methods This is a retrospective analysis of our ultrasound guided biopsies.

Ultrasound device: Thoshiba Aplio 400, later Canon Aplio 800i. According to localization we used a Convex array Transducer with Biopsy application or a Linear Transducer with “free hand” technique. We used True-cut needles: range from 14 G to 18 G, particularly 16G.

We done the biopsy with local anesthesia and under sterile condition. For each localization we done three biopsies average and a cytology specimen.

Complications we graded in three degree: 1 for little complications up to 3 for heavy complications.

Results Overall: 2214 biopsies. Subdivision: Lymph node: 750, Liver: 538, Lung: 209, Soft tissue: 153, Osteolytic bone: 131, Peritoneum: 78, Breast: 57, Abscess: 47, Pancreas: 46, “Pleurix” Catheter (Aszites/Pleura): 46, Pleuritic tumor: 35, Mediastinum: 30, Kidney: 30, Adrenal gland: 14, Retroperitoneum: 12, Thyreoid gl.: 10, Spleen: 6, Bowel:6 , Lymphocele: 6, Gallbladder: 4, Cyst: 3, Parotic gland: 2, Mouth base: 1

In 96,4% of the cases we get a reliable histology. 94,3% of biopsies were free of Complications. Complications occur in 5,7% overall. The most (4,4%) were little complications like short pain or little self-limiting bleeding. 0,8% moderate complications like Pneumothorax, and 0,4% heavy complications like bleeding with intervention. There were no cases of death.

Conclusions Our analysis shows that ultrasound guided biopsy can be safely performed in a broad spectrum of targets, with a low rate of complications (5,7% overall) and a high rate of reliable histologic findings (96,4%). We conclude that u.-guided biopsy is a minimal invasive, effective tool, which has the potential to shorten the diagnostic procedure.

Publikationsverlauf

Artikel online veröffentlicht:
29. August 2023