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Biopsy of the same organ within 30 days: a potential radiology performance measure

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Abstract

Purpose

To assess the potential value of repeat image-guided biopsy within 30 days as a radiology performance metric.

Methods

This was a HIPAA-compliant IRB-approved retrospective cohort study of all consecutive ultrasound- and CT-guided core biopsies of the chest, abdomen, and pelvis performed at one institution November 2016 to June 2020. The inclusion criterion was repeat biopsy of the same organ within 30 days of the initial biopsy. Details of both biopsies were recorded, including indication, organ, post-biopsy histology, performing service, performing provider. Histologic concordance between initial and repeat biopsies was calculated. Proportions and 95% confidence intervals were calculated.

Results

Repeat biopsy was performed after 1.9% (95% CI 1.5–2.4% [N = 89]) of 4637 initial biopsies. For structures with ≥ 100 biopsies performed, the repeat biopsy proportion ranged from 1.3% (5/378, US-guided renal biopsy) to 2.7% (11/413, CT-guided retroperitoneal biopsy). The most common indication for initial biopsy was possible malignancy (66% [59/89]). The most common indication for repeat biopsy was radiology–histology discrepancy (36% [32/89]). Repeat biopsies were more likely to show malignant cells and to have diagnostic tissue (Repeat: 48.3% malignant; 20.2% benign; 1.1% nondiagnostic; Initial: 25.8% malignant; 23.6% benign; 14.6% nondiagnostic). The most common histology difference after repeat biopsy was a change in malignant diagnosis (38.2% [34/89]).

Conclusion

Repeat percutaneous biopsy within 30 days of the same organ is uncommon (~ 2%), but when indicated, it commonly changes diagnosis and improves diagnostic yield. Repeat biopsy within 30 days is a potential performance measure for radiology procedure services.

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Funding

No financial or grant support was received for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Sonia Gaur, Prasad R. Shankar, Ellen Higgins, Elizabeth Lee & Matthew S. Davenport

  2. Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor, MI, USA

    Prasad R. Shankar, Elizabeth Lee & Matthew S. Davenport

  3. Michigan Medicine Department of Quality Analytics and Informatics, Ann Arbor, MI, USA

    Angy Perez Martinez

  4. Department of Urology, Michigan Medicine, Ann Arbor, MI, USA

    Matthew S. Davenport

Authors
  1. Sonia Gaur
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  2. Prasad R. Shankar
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  3. Ellen Higgins
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  4. Angy Perez Martinez
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  5. Elizabeth Lee
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  6. Matthew S. Davenport
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Contributions

All authors contributed to conception and/or design of the work, the writing and/or revision of the manuscript, approved the final version of the manuscript, and are accountable for the manuscript’s contents.

Corresponding author

Correspondence to Sonia Gaur.

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Conflict of interest

Sonia Gaur, Prasad R. Shankar, Ellen Higgins, Angy Perez Martinez, and Elizabeth Lee have no conflicts of interest or financial disclosures. Matthew S. Davenport reports unrelated royalties from Wolters Kluwer.

Ethical approval

This retrospective study was reviewed by the University of Michigan Institutional Review Board (HUM00183394) and approved with notice of exemption. This study was deemed secondary research for which consent is not required. The methods are in accordance with the ethical standards of our institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This project was deemed secondary research for which consent is not required.

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Gaur, S., Shankar, P.R., Higgins, E. et al. Biopsy of the same organ within 30 days: a potential radiology performance measure. Abdom Radiol 46, 4509–4515 (2021). https://doi.org/10.1007/s00261-021-03103-x

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