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Analysis of factors affecting the diagnostic yield of image-guided percutaneous core needle biopsy for peritoneal/omental lesions

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic yield, safety, and factors associated with the diagnostic yield of percutaneous core needle biopsy (PNB) for peritoneal/omental lesions.

Methods

Consecutive 297 patients (67 men, 230 women; median age, 64 years [range 15–87]) who underwent a PNB for 311 peritoneal/omental lesions at a single center from April 2010 to March 2020 were evaluated retrospectively. The preprocedural CT findings, diagnostic yield, sensitivity, specificity, PPV, NPV, technical success rate, and adverse events were analyzed. Surgical or clinical diagnosis with follow-up was the diagnostic reference standard. Adverse events were evaluated using the Society of Interventional Radiology guidelines.

Results

The median anteroposterior (AP) diameter and CT value of the target lesion were 24 mm (range 5–78) and 46 HU (range − 75 to 140), respectively. Ascites was interposed on the puncture route in 106 patients (34.1%). The technical success rate was 100%. The diagnostic yield, sensitivity, specificity, PPV, and NPV were 93.9%, 93.8%, 100%, 100%, and 20.8%, respectively. Minor complications were observed following five procedures (1.6%). The diagnostic yield was lower for fat-dominant lesions than for other lesions (82.6% vs. 95.8%, p = 0.002). The diagnostic PNB group had a greater AP diameter than did the non-diagnostic PNB group (27.3 ± 13.0 vs. 20.7 ± 8.4 mm, p = 0.037).

Conclusion

PNB for peritoneal/omental lesions provided a sufficiently high diagnostic yield and minimal adverse events. Lesions with a greater AP diameter and a higher density on CT would provide more diagnostic specimens from this technique.

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Abbreviations

AP:

Anteroposterior

PNB:

Percutaneous core needle biopsy

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Acknowledgments

The guarantor of this research is Miyuki Sone. This study was approved by the relevant institutional review board of a National Cancer Center Hospital (2020-074). This work was supported by the National Cancer Center Research and Development Fund (31-A-13); National Cancer Center under the National Cancer Center Research and Development Fund (29-A-11); research grant from Canon Medical Systems; and the Japan Agency for Medical Research and Development (AMED) under the Practical Research for Innovative Cancer Control Grant (16ck0106058h0003). The results of the PNB for 81 patients have been reported in a previous study [31]. The earlier study evaluated the diagnostic yield of the ascitic fluid cell block in patients with gynecological malignancies and compared it with that of PNB and the CA125/CEA ratio in ascites. The current study focused on the diagnostic yield of PNB for peritoneal/omental lesions caused by various diseases and evaluated the factors associated with the diagnostic yield in a larger study population.

Funding

Funding was provided by National Cancer Center Research and Development Fund (29-A-11), National Cancer Center Research and Development Fund (31-A-13), Canon Medical Systems and Japan Agency for Medical Research and Development (16ck0106058h0003).

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Authors and Affiliations

  1. Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Shunsuke Sugawara, Miyuki Sone, Chihiro Itou, Shintaro Kimura, Masahiko Kusumoto & Yasuaki Arai

  2. Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Tomoyasu Kato

  3. Department of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Kan Yonemori

  4. Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yasushi Yatabe

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  1. Shunsuke Sugawara
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Correspondence to Shunsuke Sugawara.

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Sugawara, S., Sone, M., Itou, C. et al. Analysis of factors affecting the diagnostic yield of image-guided percutaneous core needle biopsy for peritoneal/omental lesions. Abdom Radiol 46, 4499–4508 (2021). https://doi.org/10.1007/s00261-021-03088-7

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  • DOI: https://doi.org/10.1007/s00261-021-03088-7

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