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Biopsy of Pelvic Lesions

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Percutaneous Image-Guided Biopsy

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Abstract

Access route planning for image-guided biopsy of deep pelvic masses is challenging because vital structures such as the bowel, bladder, uterus, adnexa, iliac vessels, and osseous structures can intervene in the projected needle path. Thus, a thorough understanding of the cross-sectional anatomy of the pelvis is needed, and the best approach and techniques to use for each patient will depend on the characteristics and exact location of the patient’s lesion. In this article we provide an overview of the relevant anatomy of the pelvic region and discuss the various types of imaging (computed tomography [CT], ultrasound, CT fluoroscopy, magnetic resonance imaging, and magnetic field-based electronic guidance system), needles (aspiration and small- and large-caliber cutting needles; single or coaxial), and approaches (anterior or anterolateral transabdominal, transgluteal, anterolateral extraperitoneal, transosseous, transvaginal, and transrectal) that can be used in image-guided pelvic biopsy, along with the advantages and limitations of each technique.

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References

  1. Gupta S, Nguyen HL, Morello Jr FA, et al. Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations. Radiographics. 2004;24(1):175–89.

    Article  PubMed  Google Scholar 

  2. Bodne DJ, Carrasco CH, Richli WR. Transosseous air contrast CT-guided needle biopsy of a cystic neoplasm. Cardiovasc Intervent Radiol. 1993;16(2):122–3.

    Article  PubMed  CAS  Google Scholar 

  3. Butch RJ, Mueller PR, Ferrucci Jr JT, et al. Drainage of pelvic abscesses through the greater sciatic foramen. Radiology. 1986;158(2):487–91.

    PubMed  CAS  Google Scholar 

  4. Carlson P, Crummy AB, Wojtowycz M, McDermott JC. A safe route for deep pelvic biopsy with distention of the iliacus muscle. J Vasc Interv Radiol. 1991;2(2):277–8.

    Article  PubMed  CAS  Google Scholar 

  5. Guo Z, Kurtycz DF, De Las Casas LE, Hoerl HD. Radiologically guided percutaneous fine-needle aspiration biopsy of pelvic and retroperitoneal masses: a retrospective study of 68 cases. Diagn Cytopathol. 2001;25(1):43–9.

    Article  PubMed  CAS  Google Scholar 

  6. Harisinghani MG, Gervais DA, Hahn PF, et al. CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome. Radiographics. 2002;22(6):1353–67.

    Article  PubMed  Google Scholar 

  7. Pardes JG, Schneider M, Koizumi J, Engel IA, Auh YH, Rubenstein W. Percutaneous needle biopsy of deep pelvic masses: a posterior approach. Cardiovasc Intervent Radiol. 1986;9(2):65–8.

    Article  PubMed  CAS  Google Scholar 

  8. Phillips VM, Bernardino M. The parallel iliac approach: a safe and accurate technique for deep pelvic node biopsy. J Comput Tomogr. 1984;8(3):237–8.

    Article  PubMed  CAS  Google Scholar 

  9. Rapport 2nd RL, Ferguson GS. Dorsal approach to presacral biopsy: technical case report. Neurosurgery. 1997;40(5):1087–8.

    Article  PubMed  Google Scholar 

  10. Triller J, Maddern G, Kraft P, Heidar A, Vock P. CT-guided biopsy of pelvic masses. Cardiovasc Intervent Radiol. 1991;14(1):63–8.

    Article  PubMed  CAS  Google Scholar 

  11. Gupta S, Ahrar K, Morello Jr FA, Wallace MJ, Madoff DC, Hicks ME. Using a coaxial technique with a curved inner needle for CT-guided fine-needle aspiration biopsy. Am J Roentgenol. 2002;179(1):109–12.

    Article  Google Scholar 

  12. Schweiger GD, Yip VY, Brown BP. CT fluoroscopic guidance for percutaneous needle placement into abdominopelvic lesions with difficult access routes. Abdom Imaging. 2000;25(6):633–7.

    Article  PubMed  CAS  Google Scholar 

  13. Yueh N, Halvorsen Jr RA, Letourneau JG, Crass JR. Gantry tilt technique for CT-guided biopsy and drainage. J Comput Assist Tomogr. 1989;13(1):182–4.

    Article  PubMed  CAS  Google Scholar 

  14. Gupta S, Madoff DC, Ahrar K, et al. CT-guided needle biopsy of deep pelvic lesions by extraperitoneal approach through iliopsoas muscle. Cardiovasc Intervent Radiol. 2003;26(6):534–8.

    Article  PubMed  Google Scholar 

  15. Fischerova D, Cibula D, Dundr P, et al. Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors. Int J Gynecol Cancer. 2008;18(4):833–7.

    Article  PubMed  CAS  Google Scholar 

  16. Scanlan KA, Propeck PA, Lee Jr FT. Invasive procedures in the female pelvis: value of transabdominal, endovaginal, and endorectal US guidance. Radiographics. 2001;21(2):491–506.

    PubMed  CAS  Google Scholar 

  17. O'Neill MJ, Rafferty EA, Lee SI, et al. Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 2001;21(3):657–72.

    PubMed  Google Scholar 

  18. Rinnab L, Kufer R, Hautmann RE, Gottfried HW. Use of transrectal ultrasound-guided biopsy in the diagnosis of pelvic malignancies. J Clin Ultrasound. 2006;34(9):440–5.

    Article  PubMed  Google Scholar 

  19. Roy D, Kulkarni A, Kulkarni S, Thakur MH, Maheshwari A, Tongaonkar HB. Transrectal ultrasound-guided biopsy of recurrent cervical carcinoma. Br J Radiol. 2008;81(971):902–6.

    Article  PubMed  CAS  Google Scholar 

  20. Oyen RH, Van Poppel HP, Ameye FE, Van de Voorde WA, Baert AL, Baert LV. Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: prospective study of 285 patients. Radiology. 1994;190(2):315–22.

    PubMed  CAS  Google Scholar 

  21. Welch TJ, Sheedy 2nd PF, Johnson CD, Johnson CM, Stephens DH. CT-guided biopsy: prospective analysis of 1,000 procedures. Radiology. 1989;171(2):493–6.

    PubMed  CAS  Google Scholar 

  22. Yarram SG, Nghiem HV, Higgins E, Fox G, Nan B, Francis IR. Evaluation of imaging-guided core biopsy of pelvic masses. Am J Roentgenol. 2007;188(5):1208–11.

    Article  Google Scholar 

  23. Griffin N, Grant LA, Freeman SJ, et al. Image-guided biopsy in patients with suspected ovarian carcinoma: a safe and effective technique? Eur Radiol. 2009;19(1):230–5.

    Article  PubMed  Google Scholar 

  24. Zanetta G, Brenna A, Pittelli M, Lissoni A, Trio D, Riotta S. Transvaginal ultrasound-guided fine needle sampling of deep cancer recurrences in the pelvis: usefulness and limitations. Gynecol Oncol. 1994;54(1):59–63.

    Article  PubMed  CAS  Google Scholar 

  25. Zanetta G, Lissoni A, Franchi D, Pittelli MR, Cormio G, Trio D. Safety of transvaginal fine needle puncture of gynecologic masses: a report after 500 consecutive procedures. J Ultrasound Med. 1996;15(5):401–4.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, The Ohio State University, 395 West 12th Avenue, Columbus, OH, 43210, USA

    Efe Ozkan MD

  2. Department of Interventional Radiology, Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1471, Houston, TX, 77030, USA

    Sanjay Gupta MD, DNB

Authors
  1. Efe Ozkan MD
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  2. Sanjay Gupta MD, DNB
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Corresponding author

Correspondence to Sanjay Gupta MD, DNB .

Editor information

Editors and Affiliations

  1. Dept. Vascular & Interventional Radiol., University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Kamran Ahrar

  2. Department of Diagnostic Radiology Section of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Sanjay Gupta

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Ozkan, E., Gupta, S. (2014). Biopsy of Pelvic Lesions. In: Ahrar, K., Gupta, S. (eds) Percutaneous Image-Guided Biopsy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8217-8_20

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  • DOI: https://doi.org/10.1007/978-1-4614-8217-8_20

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8216-1

  • Online ISBN: 978-1-4614-8217-8

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