CardioVascular and Interventional Radiology

, Volume 40, Issue 10, pp 1501–1513 | Cite as

CIRSE Guidelines on Percutaneous Needle Biopsy (PNB)

  • Andrea VeltriEmail author
  • Irene Bargellini
  • Luigi Giorgi
  • Paulo Alexandre Matos Silva Almeida
  • Okan Akhan
CIRSE Standards of Practice Guidelines


Image-guided percutaneous needle biopsy (PNB) has proven to be a safe and effective procedure, and it became a common procedure representing an essential step for diagnosis and treatment planning in many situations.

Compared to open or excisional biopsy, image-guided percutaneous biopsy is less invasive and can be proposed as an outpatient service in the majority of cases.

However, success of PNB is strictly related to proper patient selection, preparation and post-procedural management as well as adequate procedural planning and monitoring.

Moreover, in the era of personalized cancer therapy, role of PNB is evolving since biomarker status today is guiding therapeutic decisions in many solid tumours, not only at initial diagnosis but also at the time of progression. Biological specimens are also becoming mandatory in many clinical trials. This new role of PNB implies a more intense involvement of interventional radiologists (IRs) in multidisciplinary discussions and...


Percutaneous biopsy Fine-needle biopsy Large-core needle biopsy Image-guided biopsy Diagnostic techniques and procedures CIRSE guidelines 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Supplementary material

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  1. 1.
    Tam AL, Lim HJ, Wistuba II, Tamrazi A, Kuo MD, Ziv E, et al. Image-guided biopsy in the era of personalized cancer care: proceedings from the society of interventional radiology research consensus panel. J Vasc Interv Radiol. 2016;27(1):8–19. doi: 10.1016/j.jvir.2015.10.019.CrossRefPubMedGoogle Scholar
  2. 2.
    Solomon SB, Zakowski MF, Pao W, Thornton RH, Ladanyi M, Kris MG, et al. Core needle lung biopsy specimens: adequacy for EGFR and KRAS mutational analysis. Am J Roentgenol. 2010;194(1):266–9. doi: 10.2214/AJR.09.2858.CrossRefGoogle Scholar
  3. 3.
    Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:S199–202.CrossRefPubMedGoogle Scholar
  4. 4.
    Taslakian B, Georges Sebaaly M, Al-Kutoubi A. Patient evaluation and preparation in vascular and interventional radiology: what every interventional radiologist should know (part 1: patient assessment and laboratory tests). Cardiovasc Intervent Radiol. 2016;39(3):325–33.CrossRefPubMedGoogle Scholar
  5. 5.
    Lee MJ, Fanelli F, Haage P, Hausegger K, Van Lienden KP. Patient safety in interventional radiology: a CIRSE IR checklist. Cardiovasc Intervent Radiol. 2012;35(2):244–6. doi: 10.1007/s00270-011-0289-5.CrossRefPubMedGoogle Scholar
  6. 6.
    Douketis JD, Spyropoulos AC, Spencer FA, Mayr M, Jaffer AK, Eckman MH, et al. American College of Chest Physicians. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e326S–50S. doi: 10.1378/chest.11-2298.
  7. 7.
    Patel IJ, Davidson JC, Nikolic B, Salazar GM, Schwartzberg MS, Walker TG, et al. Standards of practice committee, with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 2012;23(6):727–36. doi: 10.1016/j.jvir.2012.02.012.CrossRefPubMedGoogle Scholar
  8. 8.
    Hinojar R, Jiménez-Natcher JJ, Fernández-Golfín C, Zamorano JL. New oral anticoagulants: a practical guide for physicians. Eur Heart J Cardiovasc Pharmacother. 2015;1(2):134–45. doi: 10.1093/ehjcvp/pvv002.CrossRefPubMedGoogle Scholar
  9. 9.
    Lorentzen T, Nolsøe CP, Ewertsen C, Nielsen MB, Leen E, Havre RF, et al. EFSUMB. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General aspects (long version). Ultraschall Med. 2015;36(5):E1–14. doi: 10.1055/s-0035-1553593.PubMedGoogle Scholar
  10. 10.
    Zani EL, Clark OA, Rodrigues Netto N Jr. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane Database Syst Rev. 2011 May 11;(5):CD006576. doi: 10.1002/14651858.CD006576.pub2.
  11. 11.
    Cussans A, Somani BK, Basarab A, Dudderidge TJ. The role of targeted prophylactic antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in reducing infection rates: a systematic review. BJU Int. 2016;117(5):725–31. doi: 10.1111/bju.13402.CrossRefPubMedGoogle Scholar
  12. 12.
    McGrath A, Sabharwal T. General principles of biopsy and drainage. In: Gervais DA, Sabharwal T, editors. Interventional radiology procedures in biopsy and drainage. London: Springer-Verlag; 2011. p. 1–10.Google Scholar
  13. 13.
    Gupta S, Krishnamurthy S, Broemeling LD, Morello FA Jr, Wallace MJ, Ahrar K, et al. Small (≤ 2-cm) subpleural pulmonary lesions: short- versus long-needle-path CT-guided biopsy—comparison of diagnostic yields and complications. Radiology. 2005;234:631–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Sainani NI, Arellano RS, Shyn PB, Gervais DA, Mueller PR, Silverman SG. The challenging image-guided abdominal mass biopsy: established and emerging techniques ‘if you can see it, you can biopsy it’. Abdom Imaging. 2013;38(4):672–96. doi: 10.1007/s00261-013-9980-0.CrossRefPubMedGoogle Scholar
  15. 15.
    Tsetis D, Uberoi R, Fanelli F, Roberston I, Krokidis M, van Delden O, et al. The provision of interventional radiology services in Europe: CIRSE recommendations. Cardiovasc Intervent Radiol. 2016;39(4):500–6. doi: 10.1007/s00270-016-1299-0.CrossRefPubMedGoogle Scholar
  16. 16.
    ACR–SIR–SPR Practice parameter for the performance of image-guided percutaneous needle biopsy (PNB) Res. 35 – 2013, Amended 2014 (Res. 39). Available from
  17. 17.
    Tam AL, Kim ES, Lee JJ, Ensor JE, Hicks ME, Tang X, et al. Feasibility of image-guided transthoracic core-needle biopsy in the BATTLE lung trial. J Thorac Oncol. 2013;8(4):436–42. doi: 10.1097/JTO.0b013e318287c91e.CrossRefPubMedGoogle Scholar
  18. 18.
    Gupta S. New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol. 2004;27(2):91–104.CrossRefPubMedGoogle Scholar
  19. 19.
    Abi-Jaoudeh N, Kruecker J, Kadoury S, Kobeiter H, Venkatesan AM, Levy E, et al. Multimodality image fusion-guided procedures: technique, accuracy, and applications. Cardiovasc Intervent Radiol. 2012;35(5):986–98.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Chehab MA, Brinjikji W, Copelan A, Venkatesan AM. navigational tools for interventional radiology and interventional oncology applications. Semin Intervent Radiol. 2015;32(4):416–27. doi: 10.1055/s-0035-1564705.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Aviram G, Greif J, Man A, Schwarz Y, Marmor S, Graif M, Blachar A. Diagnosis of intrathoracic lesions: are sequential fine-needle aspiration (FNA) and core needle biopsy (CNB) combined better than either investigation alone? Clin Radiol. 2007;62(3):221–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Shabana W, Kielar A, Vermani V, Fernandes DD, Antoniscu R, Schweitzer M. Accuracy of sonographically guided biopsy using a freehand versus needle-guided technique: computed tomographic correlation study. J Ultrasound Med. 2013;32(3):535–40.CrossRefPubMedGoogle Scholar
  23. 23.
    Kim GR, Hur J, Lee SM, Lee HJ, Hong YJ, Nam JE, et al. CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol. 2011;21(2):232–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Heck SL, Blom P, Berstad A. Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses. Eur Radiol. 2006;16(6):1387–92.CrossRefPubMedGoogle Scholar
  25. 25.
    Prosch H, Stadler A, Schilling M, Bürklin S, Eisenhuber E, Schober E, et al. CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose. Eur J Radiol. 2012;81(5):1029–33.CrossRefPubMedGoogle Scholar
  26. 26.
    Mammarappallil JG, Hiatt KD, Ge Q, Clark HP. Computed tomography fluoroscopy versus conventional computed tomography guidance for biopsy of intrathoracic lesions: a retrospective review of 1143 consecutive procedures. J Thorac Imaging. 2014;29(6):340–3. doi: 10.1097/RTI.0000000000000109.CrossRefPubMedGoogle Scholar
  27. 27.
    Lü Y, Fritz J, Li C, Liu M, Lee P, Wu L, et al. Magnetic resonance imaging-guided percutaneous biopsy of mediastinal masses: diagnostic performance and safety. Invest Radiol. 2013;48(6):452–7. doi: 10.1097/RLI.0b013e31827a4a17.CrossRefPubMedGoogle Scholar
  28. 28.
    Verheyden C, Pages-Bouic E, Balleyguier C, Cherel P, Lepori D, Laffargue G, et al. Underestimation rate at MR imaging-guided vacuum-assisted breast biopsy: a multi-institutional retrospective study of 1509 breast biopsies. Radiology. 2016;29:151947.Google Scholar
  29. 29.
    Woodrum DA, Gorny KR, Greenwood B, Mynderse LA. MRI-guided prostate biopsy of native and recurrent prostate cancer. Semin Intervent Radiol. 2016;33(3):196–205. doi: 10.1055/s-0036-1586151.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Weiss CR, Nour SG, Lewin JS. MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging. 2008;27(2):311–25.CrossRefPubMedGoogle Scholar
  31. 31.
    Muthigi A, George AK, Sidana A, Kongnyuy M, Simon R, Moreno V, et al. Missing the mark: prostate cancer upgrading by systematic biopsy over MRI/TRUS fusion biopsy. J Urol. 2016;. doi: 10.1016/j.juro.2016.08.097.Google Scholar
  32. 32.
    El-Haddad G. PET-based percutaneous needle biopsy. PET Clin. 2016;11(3):333–49. doi: 10.1016/j.cpet.2016.02.009.CrossRefPubMedGoogle Scholar
  33. 33.
    Stewart CJ, Coldewey J, Stewart IS. Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions. J Clin Pathol. 2002;55(2):93–7.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Maturen KE, Nghiem HV, Marrero JA, Hussain HK, Higgins EG, Fox GA, et al. Lack of tumor seeding of hepatocellular carcinoma after percutaneous needle biopsy using coaxial cutting needle technique. Am J Roentgenol. 2006;187(5):1184–7.CrossRefGoogle Scholar
  35. 35.
    Robertson EG, Baxter G. Tumour seeding following percutaneous needle biopsy: the real story! Clin Radiol. 2011;66(11):1007–14. doi: 10.1016/j.crad.2011.05.012.CrossRefPubMedGoogle Scholar
  36. 36.
    Hatfield MK, Beres RA, Sane SS, Zaleski GX. Percutaneous imaging-guided solid organ core needle biopsy: coaxial versus noncoaxial method. Am J Roentgenol. 2008;190(2):413–7. doi: 10.2214/AJR.07.2676.CrossRefGoogle Scholar
  37. 37.
    Nour-Eldin NE, Alsubhi M, Emam A, Lehnert T, Beeres M, Jacobi V, et al. Pneumothorax complicating coaxial and non-coaxial CT-guided lung biopsy: comparative analysis of determining risk factors and management of pneumothorax in a retrospective review of 650 patients. Cardiovasc Intervent Radiol. 2016;39(2):261–70. doi: 10.1007/s00270-015-1167-3.CrossRefPubMedGoogle Scholar
  38. 38.
    Jandaghi AB, Habibzadeh H, Falahatkar S, Heidarzadeh A, Pourghorban R. Transperineal prostate core needle biopsy: a comparison of coaxial versus noncoaxial method in a randomised trial. Cardiovasc Intervent Radiol. 2016 Aug 2. [Epub ahead of print].Google Scholar
  39. 39.
    Zins M, Vilgrain V, Gayno S, Rolland Y, Arrivé L, Denninger MH, et al. US-guided percutaneous liver biopsy with plugging of the needle track: a prospective study in 72 high-risk patients. Radiology. 1992;184(3):841–3.CrossRefPubMedGoogle Scholar
  40. 40.
    Tran AA, Brown SB, Rosenberg J, Hovsepian DM. Tract embolization with gelatin sponge slurry for prevention of pneumothorax after percutaneous computed tomography-guided lung biopsy. Cardiovasc Intervent Radiol. 2014;37(6):1546–53. doi: 10.1007/s00270-013-0823-8.CrossRefPubMedGoogle Scholar
  41. 41.
    Baadh AS, Hoffmann JC, Fadl A, Danda D, Bhat VR, Georgiou N, et al. Utilization of the track embolization technique to improve the safety of percutaneous lung biopsy and/or fiducial marker placement. Clin Imaging. 2016;40(5):1023–8. doi: 10.1016/j.clinimag.2016.06.007.CrossRefPubMedGoogle Scholar
  42. 42.
    Li Y, Du Y, Luo TY, Yang HF, Yu JH, Xu XX, et al. Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy. Clin Radiol. 2015;70(11):1192–7. doi: 10.1016/j.crad.2015.06.081.CrossRefPubMedGoogle Scholar
  43. 43.
    Lang EK, Ghavami R, Schreiner VC, Archibald S, Ramirez J. Autologous blood clot seal to prevent pneumothorax at CT-guided lung biopsy. Radiology. 2000;216(1):93–6.CrossRefPubMedGoogle Scholar
  44. 44.
    Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC. Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol. 2010;21(7):969–75. doi: 10.1016/j.jvir.2010.01.011.CrossRefPubMedGoogle Scholar
  45. 45.
    Gupta S, Henningsen JA, Wallace MJ, Madoff DC, Morello FA Jr, Ahrar K, et al. Percutaneous biopsy of head and neck lesions with CT guidance: various approaches and relevant anatomic and technical considerations. Radiographics. 2007;27(2):371–90.CrossRefPubMedGoogle Scholar
  46. 46.
    Learned KO, Lev-Toaff AS, Brake BJ, Wu RI, Langer JE, Loevner LA. US-guided biopsy of neck lesions: the head and neck neuroradiologist’s perspective. Radiographics. 2016;36(1):226–43. doi: 10.1148/rg.2016150087.CrossRefPubMedGoogle Scholar
  47. 47.
    Zhang HF, Zeng XT, Xing F, Fan N, Liao MY. The diagnostic accuracy of CT-guided percutaneous core needle biopsy and fine needle aspiration in pulmonary lesions: a meta-analysis. Clin Radiol. 2016;71(1):e1–10. doi: 10.1016/j.crad.2015.09.009.CrossRefPubMedGoogle Scholar
  48. 48.
    Gupta S, Seaberg K, Wallace MJ, Madoff DC, Morello FA Jr, Ahrar K, et al. Imaging-guided percutaneous biopsy of mediastinal lesions: different approaches and anatomic considerations. Radiographics. 2005;25(3):763–88.CrossRefPubMedGoogle Scholar
  49. 49.
    Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American association for the study of liver diseases. Liver Biopsy Hepatol. 2009;49(3):1017–44. doi: 10.1002/hep.22742.CrossRefGoogle Scholar
  50. 50.
    Kalambokis G, Manousou P, Vibhakorn S, Marelli L, Cholongitas E, Senzolo M, et al. Transjugular liver biopsy–indications, adequacy, quality of specimens, and complications–a systematic review. J Hepatol. 2007;47(2):284–94.CrossRefPubMedGoogle Scholar
  51. 51.
    Howlett DC, Drinkwater KJ, Lawrence D, Barter S, Nicholson T. Findings of the UK national audit evaluating image-guided or image-assisted liver biopsy. Part I. Procedural aspects, diagnostic adequacy, and accuracy. Radiology. 2012;265(3):819–31. doi: 10.1148/radiol.12111562.CrossRefPubMedGoogle Scholar
  52. 52.
    Howlett DC, Drinkwater KJ, Lawrence D, Barter S, Nicholson T. Findings of the UK national audit evaluating image-guided or image-assisted liver biopsy. Part II. Minor and major complications and procedure-related mortality. Radiology. 2013;266(1):226–35. doi: 10.1148/radiol.12120224.CrossRefPubMedGoogle Scholar
  53. 53.
    Lipnik AJ, Brown DB. Image-guided percutaneous abdominal mass biopsy: technical and clinical considerations. Radiol Clin North Am. 2015;53(5):1049–59. doi: 10.1016/j.rcl.2015.05.007.CrossRefPubMedGoogle Scholar
  54. 54.
    McInnes MD, Kielar AZ, Macdonald DB. Percutaneous image-guided biopsy of the spleen: systematic review and meta-analysis of the complication rate and diagnostic accuracy. Radiology. 2011;260(3):699–708. doi: 10.1148/radiol.11110333.CrossRefPubMedGoogle Scholar
  55. 55.
    Rajiah P, Sinha R, Cuevas C, Dubinsky TJ, Bush WH Jr, Kolokythas O. Imaging of uncommon retroperitoneal masses. Radiographics. 2011;31(4):949–76. doi: 10.1148/rg.314095132.CrossRefPubMedGoogle Scholar
  56. 56.
    Marconi L, Dabestani S, Lam TB, Hofmann F, Stewart F, Norrie J, et al. Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol. 2016;69(4):660–73. doi: 10.1016/j.eururo.2015.07.072.CrossRefPubMedGoogle Scholar
  57. 57.
    Bancos I, Tamhane S, Shah M, Delivanis DA, Alahdab F, Arlt W, et al. DIAGNOSIS OF ENDOCRINE DISEASE: the diagnostic performance of adrenal biopsy: a systematic review and meta-analysis. Eur J Endocrinol. 2016;175(2):R65–80. doi: 10.1530/EJE-16-0297.CrossRefPubMedGoogle Scholar
  58. 58.
    Vanderveen KA, Thompson SM, Callstrom MR, Young WF Jr, Grant CS, Farley DR, et al. Biopsy of pheochromocytomas and paragangliomas: potential for disaster. Surgery. 2009;146(6):1158–66. doi: 10.1016/j.surg.2009.09.013.CrossRefPubMedGoogle Scholar
  59. 59.
    Ukimura O, Coleman JA, de la Taille A, Emberton M, Epstein JI, Freedland SJ, et al. Contemporary role of systematic prostate biopsies: indications, techniques, and implications for patient care. Eur Urol. 2013;63(2):214–30. doi: 10.1016/j.eururo.2012.09.033.CrossRefPubMedGoogle Scholar
  60. 60.
    Jiang X, Zhu S, Feng G, Zhang Z, Li C, Li H, et al. Is an initial saturation prostate biopsy scheme better than an extended scheme for detection of prostate cancer? A systematic review and meta-analysis. Eur Urol. 2013;63(6):1031–9. doi: 10.1016/j.eururo.2013.01.035.CrossRefPubMedGoogle Scholar
  61. 61.
    Pua BB, Solomon SB. Lymph Node Biopsy. In: Gervais DA, Sabharwal T, editors. Interventional radiology procedures in biopsy and drainage. London: Springer; 2011. p. 73–9.Google Scholar
  62. 62.
    Traina F, Errani C, Toscano A, Pungetti C, Fabbri D, Mazzotti A, Donati D, Faldini C. Current concepts in the biopsy of musculoskeletal tumors. J Bone Joint Surg Am. 2015;97(1):e7.CrossRefGoogle Scholar
  63. 63.
    Huang AJ, Kattapuram SV. Musculoskeletal neoplasms: biopsy and intervention. Radiol Clin North Am. 2011;49(6):1287–305. doi: 10.1016/j.rcl.2011.07.010.CrossRefPubMedGoogle Scholar
  64. 64.
    Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS, et al. Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. Am J Roentgenol. 2010;194(3):784–9. doi: 10.2214/AJR.08.2122.CrossRefGoogle Scholar
  65. 65.
    Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27(1):138–48.CrossRefPubMedGoogle Scholar
  66. 66.
    Moreland A, Novogrodsky E, Brody L, Durack J, Erinjeri J, Getrajdman G, et al. Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors. Eur Radiol. 2016;26(10):3483–91. doi: 10.1007/s00330-015-4200-7.CrossRefPubMedGoogle Scholar
  67. 67.
    Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. Am J Roentgenol. 2011;196(6):W678–82. doi: 10.2214/AJR.10.4659.CrossRefGoogle Scholar
  68. 68.
    Tomiyama N, Yoshifumi Y, Yasuo N, et al. CT-guided needle biopsy of lung lesions: a survey of severe complications based on 9783 biopsies in Japan. Eur J Radiol. 2006;59:60–4.CrossRefPubMedGoogle Scholar
  69. 69.
    Herts B, Baker M. The current role of percutaneous biopsy in the evaluation of renal masses. Curr Opin Urol. 2000;10:105–9.CrossRefPubMedGoogle Scholar
  70. 70.
    Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57:1592–6.CrossRefPubMedGoogle Scholar
  71. 71.
    Stigliano R, Marelli L, Yu D, Davies N, Patch D, Burroughs AK. Seeding following percutaneous diagnostic and therapeutic approaches for hepatocellular carcinoma: what is the risk and the outcome? Seeding risk for percutaneous approach of HCC. Cancer Treat Rev. 2007;33:437–47.CrossRefPubMedGoogle Scholar
  72. 72.
    Rodgers M, Collinson R, Desai S, et al. Risk of dissemination with biopsy of colorectal liver metastases. Dis Colon Rectum. 2003;46:454–9.CrossRefPubMedGoogle Scholar
  73. 73.
    Jones O, Rees M, John T, et al. Biopsy of resectable colorectal liver metastases causes tumour dissemination and adversely affects survival after liver resection. Br J Surg. 2005;92:1165–8.CrossRefPubMedGoogle Scholar
  74. 74.
    Agarwal P, Seely J, Matzinger F, et al. Pleural mesothelioma: sensitivity and incidence of needle tract seeding after image-guided biopsy versus surgical biopsy. Radiology. 2006;241:589–94.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Andrea Veltri
    • 1
    Email author
  • Irene Bargellini
    • 2
  • Luigi Giorgi
    • 2
  • Paulo Alexandre Matos Silva Almeida
    • 3
  • Okan Akhan
    • 4
  1. 1.Radiology Unit, Oncology Department, San Luigi Gonzaga HospitalUniversity of TorinoOrbassanoItaly
  2. 2.Department of Interventional RadiologyPisa University HospitalPisaItaly
  3. 3.Angiography Section, Radiology DepartmentHospital S. TeotónioViseuPortugal
  4. 4.Department of Radiology, Faculty of MedicineHacettepe UniversityAnkaraTurkey

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