Korean J Radiol.  2011 Jun;12(3):351-357. 10.3348/kjr.2011.12.3.351.

Clinical Value of CT-Guided Needle Biopsy for Retroperitoneal Lesions

• Tomozawa Y
• Inaba Y
• Yamaura H
• Sato Y
• Kato M
• Kanamoto T
• Sakane M

• KMID: 1122332
• DOI: http://doi.org/10.3348/kjr.2011.12.3.351

Abstract

OBJECTIVE
The purpose of this study was to investigate retrospectively the clinical procedural performance of CT-guided needle biopsy for retroperitoneal lesions.
MATERIALS AND METHODS
CT-guided needle biopsy was performed in 74 consecutive patients (M:F = 44:30; mean age, 59.7 years) with retroperitoneal lesions between April 1998 and June 2009. The target lesion ranged from 1.5 to 12.5 cm in size. The biopsy access path ranged from 3.5 to 11.5 cm in depth. A biopsy specimen was obtained using an 18-gauge core needle under a CT or CT-fluoroscopy guidance and with the patient under local anesthesia. The histopathological diagnoses from the biopsies were obtained. The diagnostic confirmation of the subtype of lymphoma was evaluated.
RESULTS
Satisfactory biopsy samples were obtained in 73 (99%) of 74 patients and a pathological diagnosis was made in 70 (95%) of 74 patients. Sixty three lesions were malignant (45 lymphomas, nine primary tumors, nine lymph node metastases) and seven were benign. The subtype of lymphoma was specified in 43 (96%) of 45 patients who were diagnosed with lymphoma. Analysis of the value of CT-guided biopsy in this series indicated 63 true positives, zero false positive, six true negatives and five false negatives. This test had a sensitivity of 93%, a specificity of 100% and an accuracy of 93%. No major complications were seen and minor complications were noted in seven patients (five with local hematomas, two with transient pain at the puncture site).
CONCLUSION
CT-guided needle biopsy for retroperitoneal lesions is highly practical and useful, and particularly for determining the subtypes in patients with lymphoma.

Keyword

CT-guided needle biopsy; Retroperitoneal lesion; Lymphoma

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
*Biopsy, Needle
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Radiography, Interventional/*methods
Retroperitoneal Space/*pathology/radiography
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed/*methods

Figure

• 

  Fig. 1 53-year-old man with paraaortic lesion. A. Diagnostic axial contrast enhanced CT scan that was obtained prior to biopsy procedure with patient in supine position shows 2-cm paraaortic mass lesion (arrow). B. Initial axial CT scan obtained with patient in prone position shows tracking scale crossing retrocaval mass lesion. Distance from skin to leading edge of lesion was 10 cm. C. CT fluoroscopic image obtained during biopsy procedure shows safe insertion of biopsy needle (arrow) into lesion. Pathologic diagnosis was nodular sclerosis of Hodgkin's disease. D. CT scan immediately after two punctures reveals no complications.

• 

  Fig. 2 56-year-old man with paraaortic lesion. A. Diagnostic axial contrast enhanced CT scan obtained prior to biopsy procedure with patient in supine position shows 3-cm paraaortic mass lesion (arrow). B. CT scan immediately after two punctures by posterior approach for biopsy reveals retroperitoneal hematoma (arrow).

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