Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study

Abstract

Purpose The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the bioptic sampling of soft tissue tumors (STT) compared with unenhanced ultrasonography alone. Methods This is a prospective longitudinal study of 40 patients subjected to ultrasonography (US)-guided core needle biopsy (CNB) to characterize a suspected STT. Three series of bioptic samplings were carried out on each patient, respectively using unenhanced US alone and CEUS in both the areas of the tumor enhanced or not by the contrast medium. All bioptic samples underwent a histological evaluation and the results were analyzed by comparing the histology of the biopsy with the definitive diagnosis in 15 surgically excised samples. Results 27 (67.5 %) of the 40 patients completed the entire study procedure; in 19 cases (70.3 %) the three bioptic samplings gave unanimous results, also when compared to the surgical specimen; in seven cases (25.9 %) use of CEUS allowed to obtain additional or more accurate information about the mass in question, compared to simple US guidance without contrast; in one patient (3.7 %) sampling obtained using unenhanced ultrasonography guidance and in the areas enhanced by the contrast agent had precisely the same results of the surgical specimen. Conclusions CEUS, due to its ability to evaluate microvascular areas, has proven to be a promising method in guiding bioptic sampling of soft tissue tumor, directing the needle to the most significant areas of the tumor. Given the small number of patients evaluated in our study, to achieve statistically significant results, it would be appropriate to obtain a larger sample size, since the very first results seem to be encouraging and to justify the increase of the population.Keywords Contrast-enhanced ultrasonography Á Soft tissue tumors Á Core needle biopsy Riassunto Scopo Lo scopo di questo studio è stato quello di valutare l'utilità dell'ecografia conmdc (CEUS) rispetto alla ecografia tradizionale, nel prelievo bioptico dei tumori dei tessuti molli (STT). Metodi si tratta di uno studio longitudinale prospettico di 40 pazienti sottoposti ad ago-biopsia ecoguidata (US-CNB) per la caratterizzazione di un STT sospetto. Sono stati prelevati 3 campioni bioptici su ogni paziente, utilizzando ecografia b-mode e CEUS sia nelle aree del tumore non evidenziate dal mezzo di contrasto che in quelle dotate di contrast-enhancement. Tutti i campioni bioptici sono stati sottoposti a valutazione istologica e sono stati analizzati i risultati confrontando l'istologico della biopsia con i 15 campioni asportati chirurgicamente, con diagnosi definitiva. (2015( ) 18:335-342 DOI 10.1007 Risultati 27 (67,5%) dei 40 pazienti hanno completato l'intera procedura di studio; in 19 casi (70,3%) i tre campioni bioptici hanno dato risultati unanimi, anche rispetto al modello chirurgico; in 7 casi (25,9%) l'uso della CEUS ha permesso di ottenere informazioni supplementari, o più precise, circa la massa in questione, rispetto al semplice esame ecografico ...

Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

“…The main characteristics of the studies are summarized in Table . The publication year of the included studies ranged from 1998 to 2018.…”

“…The risk of bias assessment demonstrated a high risk of bias among the included studies (Fig. ) . All included trials were single‐center studies with a retrospective design, with the exception of 3 prospective studies .…”

“…Of these, 2 studies had cross‐sectional study designs with simultaneous CNB and IB or simultaneous CNB and FNA performed in the same individual . The clinical setting of the biopsy techniques was heterogeneous within and across studies (Table ) . Seven studies reported a single pathologist assessing the samples, whereas >1 pathologist was involved in 6 studies .…”

“…Risk of bias assessment. Quality assessment of the included studies according to Quality Assessment of Diagnostic Accuracy Studies Version 2 (QUADAS‐2) criteria …”

“…Of all reported biopsies, the rate of nondiagnostic samples after CNB and IB ranged from 0% to 10% and 0% to 4%, respectively (Table ) . The pooled rate of nondiagnostic samples among STS cases after CNB was 2% (7 of 433 cases), whereas all IBs yielded a diagnosis.…”