To evaluate the accuracy, efficiency, complication rate, technical features, and relations among followed parameters of CT-guided percutaneous biopsies of the pelvic lesions. 140 biopsies in 136 patients for tumors, sizes 17-160 mm in largest diameter, were carried out in patients with probable tumorous pelvic process within ten years period. The patients were women in 77 cases and men in 59 cases, aged 21 to 87 years. The lesions´ size varied from 17 mm to 160 mm in largest diameter. In 135 biopsies (96.4%) results were true positive or true negative; only 5 procedures (3.6%) were histologically false negative and had to be verified surgically. Metastatic affection was the most common diagnosis (26.4%). Lymphomas were diagnosed in 25%; serous adenocarcinoma of ovary or uterine tube was verified in 15.7% of cases. Totally 7 complications (5%) were confirmed, all were minor hemorrhages. A statistically significant relation between the complication rate and hypervascular character (p = 0.00004), and between needle gauge and histological accuracy (p = 0.00429) was revealed. Core needle biopsy using percutaneous approach and CT guidance had a high overall accuracy in determining the final histological diagnosis including subtyping. Concurrently, the complication incidence was low.

Department of Gynecology and Obstetrics Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Radiology 60564Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Urology 161959Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Faculty of Education 48282University of Hradec Kralove Hradec Kralove Czech Republic

Zobrazit více v PubMed

Dähnert W. Radiology review manual. 7th ed.Philadelphia: Lippincott Williams & Wilkins, 2011, p.1264.

Gangadhar K, Mahajan A, Sable N, et al.Magnetic resonance imaging of pelvic masses: a compartmental approach. Semin Ultrasound CT MR 2017; 38: 213–230. PubMed

McMahon CJ, Rofsky NM, Pedrosa I. Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology 2010; 254: 31–46. PubMed

Del Bravo V, Liuzza F, Perisano C, et al.Gluteal tumoral calcinosis. Hip Int 2012; 22: 585–591. PubMed

Marshall C, Rajdev MA, Somarouthu B, et al.Overview of systemic treatment in recurrent and advanced cervical cancer: a primer for radiologists. Abdom Radiol (NY) 2019; 44: 1506–1519. PubMed

Lin SY, Xiong YH, Yun M, et al.Transvaginal ultrasound-guided core needle biopsy of pelvic masses. J Ultrasound Med 2018; 37: 453–461. PubMed

Jenssen C, Dietrich CF. Endoscopic ultrasound-guided fine-needle aspiration biopsy and trucut biopsy in gastroenterology - An overview. Best Pract Res Clin Gastroenterol 2009; 23: 743–759. PubMed

Pinto PA, Chung PH, Rastinehad AR, et al.. Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. J Urol 2011; 186: 1281–1285. PubMed PMC

Triller J, Maddern G, Kraft P, et al.CT-guided biopsy of pelvic masses. Cardiovasc Intervent Radiol 1991; 14: 63–68. PubMed

Won SY, Kim HS, Park SY. Transrectal or transvaginal ultrasound-guided biopsy for pelvic masses: external validation and usefulness in oncologic patients. Ultrasonography 2019; 38: 149–155. PubMed PMC

Pawłowicz P, Ajdacka U. The role of laparoscopy in the surgical treatment of endometrial cancer. Videosurgery and Other Miniinvasive Techniques 2015; 10: 44–48. PubMed PMC

Ikoma N, You YN, Bednarski BK, et al.Impact of recurrence and salvage surgery on survival after multidisciplinary treatment of rectal cancer. J Clin Oncol 2017; 35: 2631–2638. PubMed PMC

Falzarano G, Rollo G, Bisaccia M, et al.Percutaneous screws CT guided to fix sacroiliac joint in tile C pelvic injury. Outcomes at 5 years of follow-up. SICOT J Actions 2018; 4: 52. PubMed PMC

Gupta S, Nguyen HL, Morello FA, Jr, et al.Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations. Radiographics 2004; 24: 175–189. PubMed

Ferrucci JT, Jr, Wittenberg J, Mueller PR, et al.Diagnosis of abdominal malignancy by radiologic fine-needle aspiration biopsy. AJR Am J Roentgenol 1980; 134: 323–330. PubMed

Biggs WS, Marks ST.Diagnosis and management of adnexal masses. Am Fam Physician 2016; 93: 676–681. PubMed

Rzouq F, Brown J, Fan F, et al.The utility of lower endoscopic ultrasound-guided fine needle aspiration for the diagnosis of benign and malignant pelvic diseases. J Clin Gastroenterol 2014; 48: 127–130. PubMed

Yarram SG, Nghiem HV, Higgins E, et al.Evaluation of imaging-guided core biopsy of pelvic masses. AJR Am J Roentgenol 2007; 188: 1208–1211. PubMed

Jung SE, Lee JM, Rha SE, et al.CT And MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics 2002; 22: 1305–1325. PubMed

Smith A, Crouch S, Lax S, et al.Lymphoma incidence, survival and prevalence 2004–2014: sub-type analyses from the UK’s haematological malignancy research network. Br J Cancer 2015; 112: 1575–1584. PubMed PMC

Alessandrino F, DiPiro PJ, Jagannathan JP, et al.Multimodality imaging of indolent B cell lymphoma from diagnosis to transformation: what every radiologist should know. Insights Imaging 2019; 10: 25. PubMed PMC

Johl A, Lengfelder E, Hiddemann W, et al.German low-grade lymphoma study group (GLSG). Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the lymph node registry Kiel. Ann Hematol 2016; 95: 1281–1286. PubMed

Shao H, McCarthy C, Wehrenberg-Klee E, et al.CT-guided percutaneous needle biopsy of retroperitoneal and pelvic lymphadenopathy: assessment of technique, diagnostic yield, and clinical value. J Vasc Interv Radiol 2018; 29: 1429–1436. PubMed

Berstock JR, Bunni J, Thorpe PL. Caution: laparoscopic biopsy of a large pelvic mass may result in disaster. J Minim Invasive Gynecol 2012; 19: 651–653. PubMed

Soh JS, Lee HS, Lee S, et al.The clinical usefulness of endoscopic ultrasound-guided fine needle aspiration and biopsy for rectal and perirectal lesions. Intest Res 2015; 13: 135–144. PubMed PMC

Rimondi E, Busacca M, Moio A, et al.Computerized tomography guided biopsy in the diagnosis of neoplastic and inflammatory lesions of the pelvis. Radiol Med 2001; 101: 60–65. PubMed

Carberry GA, Lubner MG, Wells SA, et al.Percutaneous biopsy in the abdomen and pelvis: a step-by-step approach. Abdom Radiol (NY) 2016; 41: 720–742. Falzarano G, Rollo G, Bisaccia M, Pace V, Lanzetti RM, Garcia-Prieto E, Pichierri P, Meccariello L. PubMed

ISUOG/ESGO Consensus Statement on ultrasound-guided biopsy in gynecological oncology