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Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study

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Abstract

Purpose

The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the bioptic sampling of soft tissue tumors (STT) compared with unenhanced ultrasonography alone.

Methods

This is a prospective longitudinal study of 40 patients subjected to ultrasonography (US)-guided core needle biopsy (CNB) to characterize a suspected STT. Three series of bioptic samplings were carried out on each patient, respectively using unenhanced US alone and CEUS in both the areas of the tumor enhanced or not by the contrast medium. All bioptic samples underwent a histological evaluation and the results were analyzed by comparing the histology of the biopsy with the definitive diagnosis in 15 surgically excised samples.

Results

27 (67.5 %) of the 40 patients completed the entire study procedure; in 19 cases (70.3 %) the three bioptic samplings gave unanimous results, also when compared to the surgical specimen; in seven cases (25.9 %) use of CEUS allowed to obtain additional or more accurate information about the mass in question, compared to simple US guidance without contrast; in one patient (3.7 %) sampling obtained using unenhanced ultrasonography guidance and in the areas enhanced by the contrast agent had precisely the same results of the surgical specimen.

Conclusions

CEUS, due to its ability to evaluate microvascular areas, has proven to be a promising method in guiding bioptic sampling of soft tissue tumor, directing the needle to the most significant areas of the tumor. Given the small number of patients evaluated in our study, to achieve statistically significant results, it would be appropriate to obtain a larger sample size, since the very first results seem to be encouraging and to justify the increase of the population.

Riassunto

Scopo

Lo scopo di questo studio è stato quello di valutare l’utilità dell’ecografia conmdc (CEUS) rispetto alla ecografia tradizionale, nel prelievo bioptico dei tumori dei tessuti molli (STT).

Metodi

si tratta di uno studio longitudinale prospettico di 40 pazienti sottoposti ad ago-biopsia ecoguidata (US-CNB) per la caratterizzazione di un STT sospetto. Sono stati prelevati 3 campioni bioptici su ogni paziente, utilizzando ecografia b-mode e CEUS sia nelle aree del tumore non evidenziate dal mezzo di contrasto che in quelle dotate di contrast-enhancement. Tutti i campioni bioptici sono stati sottoposti a valutazione istologica e sono stati analizzati i risultati confrontando l’istologico della biopsia con i 15 campioni asportati chirurgicamente, con diagnosi definitiva.

Risultati

27 (67,5%) dei 40 pazienti hanno completato l’intera procedura di studio; in 19 casi (70,3%) i tre campioni bioptici hanno dato risultati unanimi, anche rispetto al modello chirurgico; in 7 casi (25,9%) l’uso della CEUS ha permesso di ottenere informazioni supplementari, o più precise, circa la massa in questione, rispetto al semplice esame ecografico senza mezzo di contrasto; in 1 paziente (3,7%) i campioniottenuti usando sia l’ecografia tradizionale che quella con contrasto sono risultati esattamente corrispondenti ai campioni chirurgici.

Conclusioni

la CEUS, grazie alla sua capacità di valutare la microvascolarizzazione, ha dimostrato di essere un metodo promettente nel guidare il prelievo bioptico negli STT, dirigendo l’ago nelle zone più caratteristiche del tumore. Secondo i risultati di questo studio pilota, sarebbe pertanto opportuno esaminare un maggior numero di pazienti per confermare le potenzialità della metodica.

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Abbreviations

CEUS:

Contrast-enhanced ultrasonography

STT:

Soft tissue tumors

CNB:

Core-needle biopsy

References

  1. Doyle LA, Nascimento AF (2011) Soft tissue tumors. Essentials of anatomic pathology, 3rd edn, pp 995–1045

  2. Fletcher CD, Krishnan K, Mertens F (2002) Pathology and Genetics of tumours of soft tissue and bone

  3. De Vita VT Jr, Hellman S, Rosenberg SA (2001) Cancer: Principles and practice of oncology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1841–1891

    Google Scholar 

  4. Grimer RJ (2006) Size matters for sarcomas. Ann R Coll Surg Engl 88:519–524

    Article  PubMed Central  PubMed  Google Scholar 

  5. Iyer VK (2008) Cytology of soft tissue tumors: benign soft tissue tumors including reactive, non-neoplastic lesions. J Cytol 25:81–86

    Article  Google Scholar 

  6. Shidham VB, Acker SM, Hackbarth DA, et al. (2012) Benign and malignant soft tissue tumors. Emedicine

  7. Cai W, Chen X (2008) Multimodality molecular imaging of tumor angiogenesis. J Nucl Med 49:113S–128S

    Article  CAS  PubMed  Google Scholar 

  8. Lassau N, Lamuraglia M, Leclere J et al (2004) Functional and early evaluation of treatment in oncology: interest of ultrasonographic contrast agents. J Radiol 85:704–712

    Article  CAS  PubMed  Google Scholar 

  9. Lassau N, Koscielny S, Opolon P et al (2001) Evaluation of contrast enhanced color Doppler ultrasound for the quantification of angiogenesis in vivo. Invest Radiol 36:50–55

    Article  CAS  PubMed  Google Scholar 

  10. Kissin MW, Fisher C, Carter RL et al (1986) Value of Tru-cut biopsy in the diagnosis of soft tissue tumours. Br J Surg 73:742–744

    Article  CAS  PubMed  Google Scholar 

  11. Torriani M, Etchebehere M, Amstalden E (2002) Sonographically guided core needle biopsy of bone and soft tissue tumors. J Ultrasound Med 21(3):275–281

    PubMed  Google Scholar 

  12. Simon MA (1982) Biopsy of musculoskeletal tumors. J Bone Jt Surg Am 64:1253–1257

    CAS  Google Scholar 

  13. Soudack M, Nachtigal A, Vladovski E et al (2006) Sonographically guided percutaneous needle biopsy of soft tissue masses with histopathologic correlation. J Ultrasound Med 25(10):1271–1277 (quiz 1278-9)

    PubMed  Google Scholar 

  14. De Marchi A, Branch del Prever EM et al (2010) Accuracy of core needle biopsy after contrast-enhanced ultrasound in soft-tissue tumours. Eur Radiol 20(11):2740–2748

    Article  PubMed  Google Scholar 

  15. Stramare R, Gazzola M, Coran A et al (2013) Contrast-enhanced ultrasound findings in soft-tissue lesions: preliminary results. J Ultrasound 16(1):21–27

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Mocellin S, Rossi CR, Brandes A et al (2006) Adult soft tissue sarcomas: conventional therapies and molecularly targeted approaches. Cancer Treat Rev 32(1):9–27

    Article  CAS  PubMed  Google Scholar 

  17. Clark MA, Fisher C, Judson I et al (2005) Soft-tissue sarcomas in adults. N Engl J Med 353(7):701–711

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Radiology Section, Department of Medicine, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Alessandro Coran, Enrico Alberioli, Shady Attar, Paolo Ortolan, Carlo Bortolanza & Roberto Stramare

  2. Oncological Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy

    Antonio Di Maggio & Elisabetta Bezzon

  3. Melanoma and Soft tissue Sarcoma Group, Veneto Oncological Institute IOV-IRCCS, Padua, Italy

    Marco Rastrelli & Carlo Riccardo Rossi

  4. Pathology Unit, Veneto Oncological Institute IOV-IRCSS, Padua, Italy

    Annalisa Tosi & Maria Cristina Montesco

Authors
  1. Alessandro Coran
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  2. Antonio Di Maggio
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  3. Marco Rastrelli
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  4. Enrico Alberioli
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  5. Shady Attar
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  6. Paolo Ortolan
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  7. Carlo Bortolanza
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  8. Annalisa Tosi
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  9. Maria Cristina Montesco
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  10. Elisabetta Bezzon
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  11. Carlo Riccardo Rossi
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  12. Roberto Stramare
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Corresponding author

Correspondence to Roberto Stramare.

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Coran, A., Di Maggio, A., Rastrelli, M. et al. Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study. J Ultrasound 18, 335–342 (2015). https://doi.org/10.1007/s40477-015-0161-6

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  • DOI: https://doi.org/10.1007/s40477-015-0161-6

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