Abstract
Introduction
Open surgical muscle biopsy has traditionally been required for the histological diagnosis of myopathy but requires neurosurgical expertise with a variable diagnostic yield. Ultrasound guided percutaneous approaches are less resource intensive and invasive. This follow-up study aims to assess the diagnostic yield and tolerability of this approach to assess its utility as an adjunct to the traditional open surgical technique.
Methodology
Between March of 2020 and June of 2021, 24 patients underwent a muscle biopsy following discussion at our regional neuromuscular multi-disciplinary team meeting. A consultant musculoskeletal radiologist used a modified Bergstrom needle to obtain a minimum of 2 samples under 500 mmHg of suction and ultrasound guidance. These were followed up to assess the diagnostic yield. A survey was also sent to the patients to assess the tolerability of the procedure.
Results
21 out of the 24 biopsies performed provided diagnostic information. Of these 3 non diagnostic samples were obtained, two were insufficient in size and one consisted of fatty tissue. Of the 21 patients who responded to the survey, 18 rated the procedure as good or excellent with 3 patients rated it as average or poor citing administrative or communication issues rather than procedural. All 5 patients who had previously undergone surgical biopsy expressed a preference for the ultrasound guided percutaneous approach. No patients experienced any complications.
Conclusion
This follow-up study reinforces the conclusion of its predecessor by highlighting that ultrasound guided percutaneous muscle biopsy is a useful and tolerable adjunct to the traditional surgical technique in investigating muscle disorders.
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Data availability
The anonymised research data is based upon confidential medical information of patients under the care of Imperial College Healthcare NHS trust.
References
Walters J, Baborie A (2020) Muscle biopsy: what and why and when? Pract Neurol 20:385–395
Lai C, Melli G, Chang J, Skolasky R, Corse A, Wagner K, Cornblath D (2010) Open muscle biopsy in suspected myopathy: diagnostic yield and clinical utility. Eur J Neurol 17:136–142
Prayson R (2006) Diagnostic yield associated with multiple simultaneous skeletal muscle biopsies. Am J Clin Pathol 126:843–848
Raithatha A, Reza Ashraghi M, Lord C, Limback-Stanic C, Viegas S, Amiras D (2020) Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy. Skeletal Radiol 49:1855–1859
Barthelemy F, Woods J, Nieves-Rodriguez S, Douine R, Wanagat J, Micelli C, Nelson S (2020) A well-tolerated core needle muscle biopsy process suitable for children and adults. Muscle Nerve 62:688–698
Billakota S, Dejesus-Acosta C, Gable K, Massey E, Hobson-Webb L (2016) Ultrasound in EMG-guided biopsies: a prospective, randomized pilot trial. Muscle Nerve 54:786–788
Merit Medical (2022) Muscle biopsy needle. https://www.merit.com/merit-spine/biopsy/bone-biopsy/muscle-biopsy-needle/. Accessed 7 Dec 21
Lassche S, Janssen B, Ijzermans T, Futterer J, Voermans N, Heerschap A, Kusters B, Mann R, Van Engelen B (2018) MRI-guided biopsy as a tool for diagnosis and research of muscle disorders. J Neuromuscul Dis 5:315–319
Tarnopolsky M, Pearce E, Smith K, Lach B (2011) Suction-modified Bergström muscle biopsy technique: experience with 13,500 procedures. Muscle Nerve 43:716–725
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Connell, P., Koh, W.S., Vonberg, F. et al. The utility and tolerability of ultrasound guided muscle biopsy in the investigation of myopathy: a follow-up study. J Ultrasound 26, 793–797 (2023). https://doi.org/10.1007/s40477-023-00790-8
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DOI: https://doi.org/10.1007/s40477-023-00790-8