Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy

Abstract

Objective We propose the use of ultrasound-guided muscle biopsy as a viable method of obtaining muscle specimen to aid the diagnosis of myopathy. We retrospectively review the diagnostic accuracy and patient feedback of ultrasound-guided muscle biopsies in our neuromuscular service. Method Multidisciplinary team meeting reviewed select patients and agreed on those suitable for ultrasound-guided muscle biopsy. They then underwent biopsy using direct ultrasound guidance and a modified Bergström needle. The specimens were sent for histopathological analysis, and patients were given a feedback form. Results Ten patients underwent 11 ultrasound-guided muscle biopsies. Of these 11, one was processed incorrectly, but all others were good quality specimens suitable for analysis. All 10 of those processed correctly aided diagnosis. All patient feedback was rated good or excellent. In 4 patients with a previous unsuccessful surgical biopsy, ultrasound-guided biopsy was successful in obtaining suitable muscle. Of those 4 patients, 3 preferred ultrasound-guided biopsy, and 1 did not state a preference. Discussion Our ultrasound-guided muscle biopsy technique offers a viable alternative to surgical biopsy. It yields high-quality specimen that aids diagnosis and receives good feedback from patients. It can be performed quickly as a day case and does not require theatre space. Furthermore, direct visualization of structures minimizes the risk of complications and allows biopsy of otherwise difficult to access targets. Conclusion Utilization of ultrasound guided–modified Bergström needle technique for muscle biopsy provides comparable success rates to other techniques and has practical, clinical, operational, and patient-centred benefits compared with alternative techniques.

Muscle biopsy practices in the evaluation of neuromuscular disease: A systematic literature review

“…Inclusion of MRI as part of the diagnostic evaluation for idiopathic inflammatory myopathies showed that sampling a muscle of intense T2‐weighted signal reduced the false negative biopsy rate to 0.19 compared with the overall cohort false negative biopsy rate of 0.23 [ 23 ]. One small study suggested a 100% diagnostic yield of biopsies from sites selected by positive MRI and additional targeting of biopsy site using US at the time of the procedure [ 51 ].…”

Neurosurgical Intervention for Nerve and Muscle Biopsies

“…The tissue obtained through a needle biopsy is processed and examined histologically, and can also be used for biochemical and molecular studies [ 155 ]. For increased accuracy and safety, ultrasound guidance, as previously mentioned, can be employed during needle biopsies [ 156 ]. Ultrasound allows for real-time visualization of the muscle, helping to precisely target the area of interest, which minimizes the risk of complications and increases the diagnostic yield.…”