Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique?

Abstract

In patients with suspected advanced ovarian carcinoma, a precise histological diagnosis is required before commencing neo-adjuvant chemotherapy. This study aims to determine the diagnostic accuracy and complication rate of percutaneous biopsies performed under ultrasound or computed tomography guidance. Between 2002 to 2007, 60 consecutive image-guided percutaneous biopsies were performed in patients with suspected ovarian cancer. The following variables were recorded: tissue biopsied, imaging technique, experience of operator, biopsy needle gauge, number of passes, complications, and final histology. Forty-seven patients had omental biopsies, 12 pelvic mass biopsies, and 1 para-aortic lymph node biopsy. Thirty-five biopsies were performed under ultrasound, 25 under computed tomography guidance. Biopsy needle gauges ranged from 14-20 swg with two to five passes for each patient. There were no complications. Histology was obtained in 52 (87%) patients. Percutaneous image-guided biopsy of peritoneal disease or pelvic mass is safe with high diagnostic accuracy. The large-gauge biopsy needle is as safe as the small gauge needle, but has the added value of obtaining tissue samples for immunohistochemistry and genomic studies.

Ovarian cancer: current approaches to classification, diagnostics, staging and differential management of patients

“…Несмотря на это, чувствительность и специ-фичность результатов КТ в определении тех-нической возможности выполнения оптималь-ной циторедукции составляет лишь 69,2-79 и 71,4-75 % соответственно, в то время как для определения стадии заболевания чувствитель-ность составляет не более 50 % при специфич-ности 85-90 % [6,21]. Имеются публикации, в которых достоверность КТ в оценке резекта-бельности опухолевого процесса при заболе-вании на стадиях III-IV по FIGO оценивается в 63 %, в связи с чем авторы рекомендуют отка-заться от данной методики при решении вопро-са о возможности оперативного лечения таких пациенток [22].…”

“…Некоторые исследования показывают, что данная методика является безопасной и в боль-шинстве случаев обеспечивает получение доста-точного количества материала для проведения гистологического исследования, позволяющего подтвердить диагноз и подобрать оптимальный режим химиотерапии [21,27]. Таблица 2…”

Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma—experience of the BriTROC consortium

“…We and others have already demonstrated that image-guided biopsies can be obtained in patients with ovarian cancer (Spencer et al , 2006; Griffin et al , 2009; Swisher et al , 2017), whilst many early phase clinical trials now include translational research biopsies to investigate pharmacodynamic biomarkers. However, there is widespread variation in the reporting of outcomes of biopsy-driven studies (Freeman et al , 2013) and few data on the utility of these biopsies for complex genomic studies.…”

Is Tuberculosis Still a Threat in the Developed World? Two Cases of Tuberculosis Masquerading as Gynecologic Cancers

“…Image-guided biopsy is not traditionally employed in the diagnosis of abdominal TB or ovarian cancer. Ultrasound-guided biopsy yields a 25% accuracy in the diagnosis of abdominal tuberculosis10 and 87% accuracy for ovarian cancer [29]. While biopsy poses the theoretical risk of seeding ovarian tumor cells, it is rarely observed [29,30].…”