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Adequacy of image guided biopsies in view of new standards of practice issued by CIRSE
Poster Title: Adequacy of image guided biopsies in view of new standards of practice issued by CIRSE
Submitted on 30 Sep 2019
Author(s): J Deakin, Z Habib, V Rachapalli
Affiliations: Aintree University Hospital Foundation NHS Trust
This poster was presented at BIR Annual Congress 2019
Poster Views: 635
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Poster Information
Abstract: Purpose: Image guided biopsy plays a pivotal role in diagnosis and eventual patient management. CIRSE recently issued standards of practice in relation to percutaneous needle biopsy (PNB). The aim was to assess if our institute met the current recommended standards.

Materials and methods: Biopsies undertaken over a one year period were identified from the hospital Radiology Information System. Bone, breast and breast related axillary lymph node biopsies were excluded. Data relating to adequacy of samples, complications and the type of biopsy needle used were captured and analysed.

Results: 355 biopsies were undertaken in 323 patients. Technical success rate, positive histological diagnosis rate plus minor and major complication rates for non-thoracic 99%, 75%, 1.6%, 0.4% and thoracic PNB were 99%, 66%, 51%, 3.8% respectively. 20G (90%) and 18G (6.6%) biopsy needles (BN) were used in thoracic cases, 16G (28%) and 18G (68%) BN in non-targeted and targeted liver biopsy; and 16G (24%) and 18G (57%) BN for lymph node biopsies. In those with failed histology, 33% had repeat PNB and 18% underwent subsequent surgical biopsies. The clinical impact of all cases was evaluated at MDTs.

Conclusion: Technical success for both thoracic and non-thoracic PNB and complication rates for non-thoracic PNB were acceptable. However, the complication rates and histological outcomes for thoracic PNB were below recommended thresholds. The reasons for this were evaluated and steps to reduce pneumothoraces will be presented. We will also present steps to be taken to ensure adequate samples are obtained to allow for a satisfactory histological diagnosis.
Summary: Appropriate patient selection and using the right biopsy needle can help prevent delay in patient care. We found there was increased rate of pneumothorax in patients undergoing lung biopsies. Various embolisation techniques can be used to try and limit the size of pneumothorax. References: Veltri A, Bargellini I, Giorgi L, Almeida PAMS, Akhan O. CIRSE Guidelines on Percutaneous Needle Biopsy (PNB). Cardiovasc Intervent Radiol. 2017, 40(10): 1501-1513Report abuse »
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