Skip to main content

Advertisement

SpringerLink
Log in

Percutaneous biopsy of focal lesions of the gastrointestinal tract

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the technical success and diagnostic accuracy of image-guided percutaneous biopsy of the gastrointestinal (GI) tract.

Materials and methods

An interventional radiology database was used to retrospectively identify patients who underwent image-guided percutaneous biopsy of the GI tract. The medical and imaging records were reviewed to assess biopsy results and complications.

Results

Twenty-nine patients (M:F = 19:10, mean age 65 years) were identified who underwent image-guided (CT/US) percutaneous biopsies of the GI tract. All biopsies were performed using coaxial technique with 18 g core and 22 g FNA needles. Twenty-two biopsies (76 %) were for circumferential or segmental wall thickening; the remaining were wall thickening with exophytic mass. Mean tumor diameter was 7.4 cm (SD = 3.4 cm), average wall thickening was 2.1 cm (SD 7.2), and exophytic mass was 10.0 cm (SD = 4.2). Tumor locations included stomach (n = 5), small bowel (n = 8), and colon (n = 16). Malignancy was confirmed in 22 patients, 12 of whom underwent excision, with 3 false positive samples. Benign disease was diagnosed in 7 patients, including 3 with pathology confirmation, with one false negative sample. The overall sensitivity was 83 % and accuracy was 84 %. There was one complication presenting as bleeding at the biopsy site, treated conservatively.

Conclusion

Percutaneous biopsy of the GI tract is an uncommon procedure. The results of this study suggest that it is a safe and sensitive procedure that may be considered for small bowel lesions in which endoscopy is not feasible, for submucosal lesions, or in the setting of patients with previously negative endoscopic biopsies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Rockey DC, Halvorsen RA, Higgins JL, Cello JP (1995) Prospective evaluation of patients with bowel wall thickening. Am J Gastroenterol 90:99–103

    PubMed  CAS  Google Scholar 

  2. Parker SH, Hopper KD, Yakes WF, et al. (1989) Image-directed percutaneous biopsies with a biopsy gun. Radiology 171:663–669

    PubMed  CAS  Google Scholar 

  3. Heriot AG, Kumar D, Thomas V, et al. (1998) Ultrasonographically guided fine-needle aspiration cytology in the diagnosis of colonic lesions. Br J Surg 85:1713–1715

    Article  PubMed  CAS  Google Scholar 

  4. Javid G, Gulzar GM, Khan B, et al. (1999) Percutaneous sonography-guided fine needle aspiration biopsy of colonoscopic biopsy: negative colonic lesions. Indian J Gastroenterol 18:146–148

    PubMed  CAS  Google Scholar 

  5. Abbitt PL (1991) Percutaneous fine needle aspiration of bowel wall abnormalities under ultrasound guidance. J Clin Ultrasound 19:310–314

    Article  PubMed  CAS  Google Scholar 

  6. Farmer KD, Harries SR, Fox BM, et al. (2000) Core biopsy of the bowel wall efficacy and safety in the clinical setting. AJR Am J Roentgenol 175:1627–1630

    Article  PubMed  CAS  Google Scholar 

  7. Tudor GR, Rodgers PM, West KP (1999) Bowel lesions: percutaneous US-guided 18 gauge needle biopsy. Preliminary experience. Radiology 212:594–597

    Article  PubMed  CAS  Google Scholar 

  8. Singh H, Wittich GR, Goodacre B, van Sonnenberg F (1999) CT or ultrasound guided biopsy of hollow visceral lesions. AJR Am J Roentgenol 172(Suppl):98

    Google Scholar 

  9. Bree RL, McGough MF, Schwab RE (1991) CT- or US-guided fine needle aspiration biopsy in gastric neoplasms. J Comput Assist Tomogr 15:565–569

    Article  PubMed  CAS  Google Scholar 

  10. Korman U, Ersavasti G, Kurugoglu S, et al. (1997) Radiologic evaluation of gastrointestinal leiomyosarcomatosis. Eur Radiol 7:1332–1334

    Article  PubMed  CAS  Google Scholar 

  11. Brocking A (1991) Cytological histologic evaluation of percutaneous biopsies. Cardiovasc Intervent Radiol 14:5–12

    Article  Google Scholar 

  12. Fields S, Libson E (2000) CT-Guided aspiration core needle biopsy of gastrointestinal wall lesions. J Comput Assist Tomogr 24:224–228

    Article  PubMed  CAS  Google Scholar 

  13. Marco-Domenech S, Gil-Sanchez S, Fernandez-Garcia P, et al. (2001) Sonographically guided percutaneous biopsy of gastrointestinal tract lesions. AJR Am J Roentgenol 176:147–151

    Article  PubMed  CAS  Google Scholar 

  14. Rybicki F, Shu K, Cibas E, et al. (2003) Percutaneous biopsy of renal masses: sensitivity and negative predictive value stratified by clinical setting and size of masses. AJR Am J Roentgenol 180:1281–1287

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  16. Souza F, Mortele KJ, Cibas E, et al. (2009) Predictive value of percutaneous imaging-guided biopsy of peritoneal and omental masses: results in 111 patients. AJR Am J Roentgenol 192:131–136

    Article  PubMed  Google Scholar 

  17. Paulsen SD, Nghiem HV, Negussie E, et al. (2006) Evaluation of imaging-guided core biopsy of pancreatic masses. AJR Am J Roentgenol 187:769–772

    Article  PubMed  Google Scholar 

  18. Dhawan S, Jain D, Kalhan SK (2011) Xanthogranulomatous inflammation of the ascending colon with mucosal involvement: report of a first case. J Crohns Colitis 5:245–248

    Article  PubMed  Google Scholar 

  19. Anadol AZ, Gonu II, Tezel E (2009) Xanthogranulomatous inflammation of the colon: a rare cause of cecal mass with bleeding. South Med J 102:196–199

    PubMed  Google Scholar 

  20. Li L, Parwani AV (2011) Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med 135:671–674

    PubMed  Google Scholar 

  21. Lewis JS (2008) Spindle cell lesions—neoplastic or non-neoplastic? Head Neck Pathol 2:103–110

    Article  PubMed  Google Scholar 

  22. Vlachou P, Khalili K, Jang HJ, et al. (2011) IgG4-related sclerosing disease: autoimmune pancreatitis and extra pancreatic manifestations. Radiographics 31:1379–1402

    Article  PubMed  Google Scholar 

  23. Moulton JS, Moore PT (1993) Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive values. Radiology 186:515–522

    PubMed  CAS  Google Scholar 

  24. Gupta S, Wallace M, Cardella J, et al. (2010) Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 21:969–975

    Article  PubMed  Google Scholar 

  25. Yeh CH, Pan KT, Chu SY, et al. (2012) Safety and efficacy of image-guided percutaneous biopsies in the diagnosis if gastrointestinal stromal tumors. Clin Imaging 36:19–23

    Article  PubMed  Google Scholar 

  26. Petit P, Bret PM, Tough JO, Reinhold C (1992) Risks associated with intestinal perforation during experimental percutaneous drainage. Invest Radiol 27:1012–1019

    Article  PubMed  CAS  Google Scholar 

  27. Brandt KR, Charboneau JW, Stephens DH, et al. (1993) CT- and US-guided biopsy of the pancreas. Radiology 187:99–104

    PubMed  CAS  Google Scholar 

  28. Berger H, Permanetter W, Steiner W, Markl A (1988) Fine-needle and incisional biopsy techniques in the percutaneous puncture of abdominal space occupying lesions. Radiologe 28:265–268

    PubMed  CAS  Google Scholar 

  29. Avritscher R, Gupta S (2009) Gastrointestinal stromal tumor: role of interventional radiology in diagnosis and treatment. Hematol Oncol Clin North Am 23:129–137

    Article  PubMed  Google Scholar 

  30. Nguyen NQ (2012) Endoscopic ultrasound-guided fine needle core biopsy versus aspiration for gastrointestinal mass lesions: a randomized trial. J Clin Oncol 30(suppl 4):abstr 161.

  31. Pasha SF, Leighton JA (2013) Endoscopic techniques for small bowel imaging. Radiol Clin North Am 51:177–187

    Article  PubMed  Google Scholar 

  32. Cangemi DJ, Patel MK, Gomez V, et al. (2013) Small bowel tumors discovered during double-balloon enteroscopy: Analysis of a large prospectively collected single-center database. J Clin Gastroenterol. doi:10.1097/MCG.0b013e318281a44e

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Rocio Perez-Johnston, Peter F. Hahn, Anuradha S. Shenoy-Bhangle, Martin J. Shelly, Debra A. Gervais & Ronald S. Arellano

Authors
  1. Rocio Perez-Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter F. Hahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anuradha S. Shenoy-Bhangle
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin J. Shelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Debra A. Gervais
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ronald S. Arellano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rocio Perez-Johnston.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Perez-Johnston, R., Hahn, P.F., Shenoy-Bhangle, A.S. et al. Percutaneous biopsy of focal lesions of the gastrointestinal tract. Abdom Imaging 38, 1197–1202 (2013). https://doi.org/10.1007/s00261-013-0023-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-013-0023-7

Keywords

Search

Navigation