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Abdelsalam ME, Lu T, Baiomy A, Awad A, Odisio BC, Habibollahi P, Irwin D, Karam JA, Matin SF, Stafford J, Ahrar K. Magnetic resonance imaging-guided renal biopsy shows high safety and diagnostic yield: a tertiary cancer center experience. Eur Radiol 2024; 34:5551-5560. [PMID: 38400904 DOI: 10.1007/s00330-024-10656-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/28/2023] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To evaluate the technical success and outcomes of renal biopsies performed under magnetic resonance imaging (MRI) using a closed-bore, 1.5-Tesla MRI unit. MATERIALS AND METHODS We retrospectively reviewed our institutional biopsy database and included 150 consecutive MRI-guided biopsies for renal masses between November 2007 and March 2020. We recorded age, sex, BMI, tumor characteristics, RENAL nephrometry score, MRI scan sequence, biopsy technique, complications, diagnostic yield, pathologic outcome, and follow-up imaging. Univariate logistic regression was used to assess the association between different parameters and the development of complications. McNemar's test was used to assess the association between paired diagnostic yield measurements for fine-needle aspiration and core samples. RESULTS A total of 150 biopsies for 150 lesions were performed in 150 patients. The median tumor size was 2.7 cm. The median BMI was 28.3. The lesions were solid, partially necrotic/cystic, and predominantly cystic in 137, eight, and five patients, respectively. Image guidance using fat saturation steady-state free precession sequence was recorded in 95% of the biopsy procedures. Samples were obtained using both fine-needle aspiration (FNA) and cores in 99 patients (66%), cores only in 40 (26%), and FNA only in three (2%). Tissue sampling was diagnostic in 144 (96%) lesions. No major complication developed following any of the biopsy procedures. The median follow-up imaging duration was 8 years and none of the patients developed biopsy-related long-term complication or tumor seeding. CONCLUSIONS MRI-guided renal biopsy is safe and effective, with high diagnostic yield and no major complications. CLINICAL RELEVANCE STATEMENT Image-guided renal biopsy is safe and effective, and should be included in the management algorithm of patients with renal masses. Core biopsy is recommended. KEY POINTS • MRI-guided biopsy is a safe and effective technique for sampling of renal lesions. • MRI-guided biopsy has high diagnostic yield with no major complications. • Percutaneous image-guided biopsy plays a key role in the management of patients with renal masses.
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Affiliation(s)
- Mohamed E Abdelsalam
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA.
| | - Thomas Lu
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
| | - Ali Baiomy
- Department of Radiology, The University of Texas Southwestern, Dallas, TX, 75390, USA
| | - Ahmed Awad
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
| | - Bruno C Odisio
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
| | - Peiman Habibollahi
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
| | - David Irwin
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
| | - Jose A Karam
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Surena F Matin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason Stafford
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kamran Ahrar
- Department of Interventional Radiology, Unit 1471, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA
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Corradini LG, Polidori T, Maresca L, Caruso D, Laghi A, Simonetti G, Stefanini M. MRI-guided thoraco-abdominal percutaneous needle biopsy: our initial experience. Eur Radiol 2023; 33:5719-5727. [PMID: 37256353 DOI: 10.1007/s00330-023-09763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/12/2023] [Accepted: 04/08/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aim of this study is to describe the technique and to report early results of thoraco-abdominal biopsies in the Interventional Magnetic Resonance Imaging Suite (IMRIS). MATERIALS AND METHODS We prospectively evaluated patients with indications for MRI-guided biopsy between January 2021 and May 2022. Exclusion criteria were indication for US-/CT-guided biopsy, contraindication to percutaneous biopsy, inability to lie flat for at least 30 min, claustrophobic, severe obesity, or non-MRI compatible devices. Biopsies were performed by 3 interventional radiologists, with at least 8 years of experience in oncological interventional radiology. Epidemiological, clinical, procedural, and histopathological data were retrospectively collected. RESULTS From an initial population of 117 patients, 57 patients (32 male, mean age 64 ± 8 y) were finally enrolled. All 57 patients suspected thoraco-abdominal malignant lesions finally underwent MRI-guided percutaneous biopsy. The mean duration of the entire procedure was 37 min (range 28-65 min); the mean duration of the total needle-in-patient time was 10 min (range 6-19 min). Technical and clinical success were obtained for all the biopsies performed. Malignancy was demonstrated in 47/57 (82%) cases and benignancy in the remaining 10/57 (18%) cases. No major complications were detected after the biopsies; two minor compliances (severe pain) occurred and were managed conservatively. CONCLUSION Our initial experience demonstrated the technical feasibility and the accuracy of MRI-guided biopsies of thoraco-abdominal masses. The reported data associated with the best comfort for the patient and for the operator make the use of MRI a valid alternative to other methods, especially in lesions that are difficult to approach via US or CT. CLINICAL RELEVANCE STATEMENT Interventional MRI is one of the most important innovations available for interventional radiologists. This method will broaden the diagnostic and therapeutic possibilities, allowing treatment of lesions up to now not approachable percutaneously. For this, it is necessary to start publishing the data of the few groups that are developing the method. KEY POINTS • To evaluate the use of MRI as a guide for percutaneous biopsies of various districts. • Our preliminary experience confirms experience demonstrated the technical feasibility and the accuracy of MRI-guided biopsies of thoraco-abdominal masses. • Interventional MRI can become the reference method for percutaneous biopsies in particular for lesions with difficult percutaneous approach.
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Affiliation(s)
- Luca Ginanni Corradini
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina, 1049, 00169, Rome, Italy
| | - Tiziano Polidori
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome -Sant'Andrea University Hospital, Via Di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Luciano Maresca
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina, 1049, 00169, Rome, Italy
| | - Damiano Caruso
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome -Sant'Andrea University Hospital, Via Di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome -Sant'Andrea University Hospital, Via Di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giovanni Simonetti
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina, 1049, 00169, Rome, Italy
| | - Matteo Stefanini
- Department of Diagnostic Imaging and Interventional Radiology, Casilino Hospital, Via Casilina, 1049, 00169, Rome, Italy.
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Del Cura JL. Presentation of the serie "Interventional ultrasound". RADIOLOGIA 2021; 63:534-535. [PMID: 34801187 DOI: 10.1016/j.rxeng.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J L Del Cura
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, Spain.
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Del Cura JL. Presentation of the serie "Interventional ultrasound". RADIOLOGIA 2021; 63:S0033-8338(21)00091-6. [PMID: 34148680 DOI: 10.1016/j.rx.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J L Del Cura
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, España.
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Daley NA, Reed WJ, Peterson JJ. Strategies for Biopsy of Musculoskeletal Tumors. Semin Roentgenol 2017; 52:282-290. [PMID: 28965547 DOI: 10.1053/j.ro.2017.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nathan A Daley
- Department of Radiology, Mayo Clinic Florida, Jacksonville, FL
| | - William J Reed
- Department of Radiology, Mayo Clinic Florida, Jacksonville, FL
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Odisio BC, Tam AL, Avritscher R, Gupta S, Wallace MJ. CT-guided adrenal biopsy: comparison of ipsilateral decubitus versus prone patient positioning for biopsy approach. Eur Radiol 2012; 22:1233-9. [PMID: 22227794 DOI: 10.1007/s00330-011-2363-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 10/29/2011] [Accepted: 11/19/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To compare ipsilateral decubitus and prone patient positioning for performing computed tomography guided adrenal biopsy using the requirements for out-of-plane approach (OOP) and the needle insertion time (NIT) as a surrogate for procedure complexity. METHODS The study included 106 adrenal biopsies performed in 104 patients with lesions measuring ≤ 4 cm that were divided into two groups: Ipsilateral decubitus (Group I) and prone (Group II) positions. The frequency of use of an OOP biopsy path and the NIT were recorded as well as diagnostic yield, adverse events and transgression of organs to approach the target lesion. RESULTS Groups I and II comprised 54 and 50 patients, respectively. The use of the OOP approach was significantly less frequent (P < 0.01) in Group I (n = 4) compared to Group II (n = 38). NIT was statistically shorter (P < 0.01) in Group I (9 min and 43 s) compared to Group II (19 min and 7 s). There were fewer organs traversed in Group I versus Group II. Diagnostic yield and post-biopsy complications were equal in both groups. CONCLUSION Ipsilateral adrenal biopsy approach is a less complex, equally reliable and safe compared to the prone approach based on the less frequent use of the OOP approach and the shorter NIT. KEY POINTS • Ipsilateral adrenal biopsy decubitus positioning provides a direct, non-transpulmonary path for sampling • Ipsilateral decubitus positioning reduces the need for potentially dangerous out-of-plane approaches (OOP) • Ipsilateral decubitus and prone positioning are equally reliable and safe techniques.
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Affiliation(s)
- Bruno C Odisio
- Department of Diagnostic Radiology, Section of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit Number: 1471, Room Number: FCT14.6000, Houston, TX 77230-1402, USA.
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Battistella M, Robert C, Gossot D, Dupuy A, Mateus C, Kérob D, Avril M, Basset-Seguin N, Lebbé C, de Kerviler E, Viguier M. Visceral lesions occurring during follow-up of melanoma patients: a true place for other diagnosis than melanoma metastasis. J Eur Acad Dermatol Venereol 2011; 26:602-10. [DOI: 10.1111/j.1468-3083.2011.04129.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Del Cura JL, Zabala R, Corta I. [US-guided interventional procedures: what a radiologist needs to know]. RADIOLOGIA 2010; 52:198-207. [PMID: 20347106 DOI: 10.1016/j.rx.2010.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 12/23/2009] [Accepted: 01/10/2010] [Indexed: 11/19/2022]
Abstract
US has important advantages in guiding interventional procedures: it is economical and widely available, it does not use ionizing radiation, and it requires less time than other techniques. US guidance can be provided using devices adapted to probes or using the freehand technique (holding the needle in one hand and the probe in the other). US-guided procedures require careful planning, adequate hemostasis or a directly compressible puncture site, the patient's informed consent, and appropriate measures to ensure asepsis and anesthesia. The technique involves introducing the needle or catheter through the plane of the US slice. The advance of the needle is controlled in real time. High resolution linear probes are ideal for interventional procedures in superficial tissues, but 3.5 MHz probes are required for procedures in deep tissues. The most common procedures include biopsies, drainages, and percutaneous injections. Biopsies can be carried out using fine needles to obtain material for cytological study (fine-needle aspiration cytology) or using large needles to obtain specimens for histologic study (core biopsy). Core biopsy is more sensitive and more specific, and it has a low rate of complications. Drainage almost always involves placing a catheter in a fluid collection; it can be done using the Seldinger techniques, trocars, or pleural catheters. US-guided percutaneous injections can be used to inject substances into infectious lesions, tumors, or nerve plexuses, and they are especially useful in musculoskeletal disease.
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Affiliation(s)
- J L Del Cura
- Departamento de Radiología, Cirugía y Medicina Física, Universidad del País Vasco - Euskalherriko Unibertsitatea, Donostia-San Sebastián, España.
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Del Cura J, Zabala R, Corta I. US-guided interventional procedures: what a radiologist needs to know. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70012-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ortega MR, de Adana JCR, Millán MAD, Matías AH, Herrero JL, García AB, Marirrodriga IG, Esteban ML. [Laparoscopic biopsy of non-digestive intra-abdominal masses]. Cir Esp 2007; 81:276-8. [PMID: 17498457 DOI: 10.1016/s0009-739x(07)71318-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Laparoscopic surgery offers an alternative diagnostic technique in multiple diseases requiring biopsy of non-digestive intra-abdominal masses in which image-guided biopsy cannot be performed. Laparoscopic biopsy aims to reduce the surgical aggression and complications associated with laparotomy and favors the early treatment of malignancies. PATIENTS AND METHOD We performed a retrospective descriptive study of our results in a series of patients in our hospital with intra-abdominal masses of unknown etiology who underwent laparoscopic surgery between January 2001 and April 2006. None of the patients were candidates for image-guided percutaneous biopsy. RESULTS We carried out 23 biopsies: 8 retroperitoneal (34.7%), 5 mesenteric (21.7%), 5 hepatic, 4 pelvic, and 1 in the iliac chain, as well as 5 complementary biopsies. In all patients, sufficient material for histologic diagnosis was obtained. The mean operating time was 71 minutes. Length of hospital stay was less than 24 hours in 61% of the patients. The median length of hospital stay was 1.5 days. CONCLUSIONS The laparoscopic approach allows complete visualization and examination of the entire peritoneal cavity. Laparoscopic biopsy is a safe and effective procedure with excellent patient recovery and allows early definitive treatment.
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Affiliation(s)
- María Rodríguez Ortega
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Getafe, Madrid, España
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