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Biopsy Devices and Techniques

Chapter

Abstract

Image-guided biopsy is an integral part of the diagnostic workup for many medical conditions. Tissue sampling should be done carefully, with specific attention given to choosing the most effective biopsy technique and device such that adequate material is procured without complications. Various biopsy devices have been developed for specific indications. In planning and performing an image-guided biopsy, the interventional radiologist should consider the approach, select an appropriate device, and apply the appropriate technique. This chapter reviews the most commonly used biopsy devices and techniques.

Keywords

Biopsy Needle Hepatic Vein Guide Needle Biopsy Device Transjugular Liver Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK. CT and MR imaging of benign hepatic and biliary tumors. Radiographics. 1999;19:431–51.PubMedGoogle Scholar
  2. 2.
    Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology. 2005;66:484–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Bosniak MA, Megibow AJ, Hulnick DH, Horii S, Raghavendra BN. CT diagnosis of renal angiomyolipoma: the importance of detecting small amounts of fat. Am J Roentgenol. 1988;151:497–501.CrossRefGoogle Scholar
  4. 4.
    Bosniak MA. Angiomyolipoma (hamartoma) of the kidney: a preoperative diagnosis is possible in virtually every case. Urol Radiol. 1981;3:135–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Leslie DF, Johnson CD, Johnson CM, Ilstrup DM, Harmsen WS. Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns. Am J Roentgenol. 1995;164:625–9.CrossRefGoogle Scholar
  6. 6.
    Motosugi U, Ichikawa T, Onohara K, Sou H, Sano K, Muhi A, et al. Distinguishing hepatic metastasis from hemangioma using gadoxetic acid-enhanced magnetic resonance imaging. Invest Radiol. 2011;46:359–65.PubMedCrossRefGoogle Scholar
  7. 7.
    Czernin J, Benz MR, Allen-Auerbach MS. PET/CT imaging: the incremental value of assessing the glucose metabolic phenotype and the structure of cancers in a single examination. Eur J Radiol. 2010;73:470–80.PubMedCrossRefGoogle Scholar
  8. 8.
    Gemmel F, Rijk PC, Collins JM, Parlevliet T, Stumpe KD, Palestro CJ. Expanding role of 18F-fluoro-D-deoxyglucose PET and PET/CT in spinal infections. Eur Spine J. 2010;19:540–51.PubMedCrossRefGoogle Scholar
  9. 9.
    Poeppel TD, Krause BJ, Heusner TA, Boy C, Bockisch A, Antoch G. PET/CT for the staging and follow-up of patients with malignancies. Eur J Radiol. 2009;70:382–92.PubMedCrossRefGoogle Scholar
  10. 10.
    Gupta S. Role of image-guided percutaneous needle biopsy in cancer staging. Semin Roentgenol. 2006;41:78–90.PubMedCrossRefGoogle Scholar
  11. 11.
    Clark DP. Seize the opportunity: underutilization of fine-needle aspiration biopsy to inform targeted cancer therapy decisions. Cancer. 2009;117:289–97.PubMedGoogle Scholar
  12. 12.
    Mookerjee RP, Lackner C, Stauber R, Stadlbauer V, Deheragoda M, Aigelsreiter A, et al. The role of liver biopsy in the diagnosis and prognosis of patients with acute deterioration of alcoholic cirrhosis. J Hepatol. 2011;55(5):1103–11.PubMedCrossRefGoogle Scholar
  13. 13.
    Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann Intern Med. 1997;126:137–45.PubMedCrossRefGoogle Scholar
  14. 14.
    Mahgerefteh SY, Sosna J, Bogot N, Shapira MY, Pappo O, Bloom AI. Radiologic imaging and intervention for gastrointestinal and hepatic complications of hematopoietic stem cell transplantation. Radiology. 2011;258:660–71.PubMedCrossRefGoogle Scholar
  15. 15.
    Fuiano G, Mazza G, Comi N, Caglioti A, De Nicola L, Iodice C, et al. Current indications for renal biopsy: a questionnaire-based survey. Am J Kidney Dis. 2000;35:448–57.PubMedCrossRefGoogle Scholar
  16. 16.
    Furness PN, Philpott CM, Chorbadjian MT, Nicholson ML, Bosmans JL, Corthouts BL, et al. Protocol biopsy of the stable renal transplant: a multicenter study of methods and complication rates. Transplantation. 2003;76:969–73.PubMedCrossRefGoogle Scholar
  17. 17.
    Gazelle GS, Haaga JR. Biopsy needle characteristics. Cardiovasc Intervent Radiol. 1991;14:13–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Gazelle GS, Haaga JR, Rowland DY. Effect of needle gauge, level of anticoagulation, and target organ on bleeding associated with aspiration biopsy. Work in progress. Radiology. 1992;183:509–13.PubMedGoogle Scholar
  19. 19.
    Okuda K, Tanikawa K, Emura T, Kuratomi S, Jinnouchi S. Nonsurgical, percutaneous transhepatic cholangiography – diagnostic significance in medical problems of the liver. Am J Dig Dis. 1974;19:21–36.PubMedCrossRefGoogle Scholar
  20. 20.
    Isler RJ, Ferrucci Jr JT, Wittenberg J, Mueller PR, Simeone JF, vanSonnenberg E, et al. Tissue core biopsy of abdominal tumors with a 22 gauge cutting needle. Am J Roentgenol. 1981;136:725–8.CrossRefGoogle Scholar
  21. 21.
    Wittenberg J, Mueller PR, Ferrucci Jr JT, Simeone JF, vanSonnenberg E, Neff CC, et al. Percutaneous core biopsy of abdominal tumors using 22 gauge needles: further observations. Am J Roentgenol. 1982;139:75–80.CrossRefGoogle Scholar
  22. 22.
    Ferrucci Jr JT, Wittenberg J. CT biopsy of abdominal tumors: aids for lesion localization. Radiology. 1978;129:739–44.PubMedGoogle Scholar
  23. 23.
    Ferrucci Jr JT, Wittenberg J, Mueller PR, Simeone JF, Harbin WP, Kirkpatrick RH, et al. Diagnosis of abdominal malignancy by radiologic fine-needle aspiration biopsy. Am J Roentgenol. 1980;134:323–30.CrossRefGoogle Scholar
  24. 24.
    Sundaram M, Wolverson MK, Heiberg E, Pilla T, Vas WG, Shields JB. Utility of CT-guided abdominal aspiration procedures. Am J Roentgenol. 1982;139:1111–15.CrossRefGoogle Scholar
  25. 25.
    Yamamoto R, Tatsuta M, Noguchi S, Kasugai H, Okano Y, Okuda S, et al. Histocytologic diagnosis of pancreatic cancer by percutaneous aspiration biopsy under ultrasonic guidance. Am J Clin Pathol. 1985;83:409–14.PubMedGoogle Scholar
  26. 26.
    Hall-Craggs MA, Lees WR. Fine-needle aspiration biopsy: pancreatic and biliary tumors. Am J Roentgenol. 1986;147:399–403.CrossRefGoogle Scholar
  27. 27.
    Dickey JE, Haaga JR, Stellato TA, Schultz CL, Hau T. Evaluation of computed tomography guided percutaneous biopsy of the pancreas. Surg Gynecol Obstet. 1986;163:497–503.PubMedGoogle Scholar
  28. 28.
    Andriole JG, Haaga JR, Adams RB, Nunez C. Biopsy needle characteristics assessed in the laboratory. Radiology. 1983;148:659–62.PubMedGoogle Scholar
  29. 29.
    Akins EW, Hawkins Jr IF, Mladinich C, Tupler R, Siragusa RJ, Pry R. The blunt needle: a new percutaneous access device. Am J Roentgenol. 1989;152:181–2.CrossRefGoogle Scholar
  30. 30.
    de Bazelaire C, Farges C, Mathieu O, Zagdanski AM, Bourrier P, Frija J, et al. Blunt-tip coaxial introducer: a revisited tool for difficult CT-guided biopsy in the chest and abdomen. Am J Roentgenol. 2009;193:W144–8.CrossRefGoogle Scholar
  31. 31.
    Menghini G. One-second needle biopsy of the liver. N Engl J Med. 1970;282:582–5.CrossRefGoogle Scholar
  32. 32.
    Franseen CC. Aspiration biopsy, with a description of a new type of needle. N Engl J Med. 1941;224:1054–8.CrossRefGoogle Scholar
  33. 33.
    Westcott JL. Direct percutaneous needle aspiration of localized pulmonary lesions: result in 422 patients. Radiology. 1980;137:31–5.PubMedGoogle Scholar
  34. 34.
    Cope C. New pleural biopsy needle; preliminary study. J Am Med Assoc. 1958;167:1107–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Abrams LD. A pleural-biopsy punch. Lancet. 1958;1:30–1.PubMedCrossRefGoogle Scholar
  36. 36.
    Littlewood ER, Gilmore IT, Murray-Lyon IM, Stephens KR, Paradinas FJ. Comparison of the Trucut and Surecut liver biopsy needles. J Clin Pathol. 1982;35:761–3.PubMedCrossRefGoogle Scholar
  37. 37.
    Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 1. Biopsy of diffuse hepatic disease. Am J Roentgenol. 1993;161:1293–7.CrossRefGoogle Scholar
  38. 38.
    Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 2. Biopsy of medical renal disease. Am J Roentgenol. 1993;161:1299–301.CrossRefGoogle Scholar
  39. 39.
    Haggarth L, Ekman P, Egevad L. A new core-biopsy instrument with an end-cut technique provides prostate biopsies with increased tissue yield. BJU Int. 2002;90:51–5.PubMedCrossRefGoogle Scholar
  40. 40.
    Ozden E, Gogus C, Tulunay O, Baltaci S. The long core needle with an end-cut technique for prostate biopsy: does it really have advantages when compared with standard needles? Eur Urol. 2004;45:287–91.PubMedCrossRefGoogle Scholar
  41. 41.
    Klein JS, Zarka MA. Transthoracic needle biopsy: an overview. J Thorac Imaging. 1997;12:232–49.PubMedCrossRefGoogle Scholar
  42. 42.
    Moulton JS, Moore PT. Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive value. Radiology. 1993;186:515–22.PubMedGoogle Scholar
  43. 43.
    Lucidarme O, Howarth N, Finet JF, Grenier PA. Intrapulmonary lesions: percutaneous automated biopsy with a detachable, 18-gauge, coaxial cutting needle. Radiology. 1998;207:759–65.PubMedGoogle Scholar
  44. 44.
    Colapinto RF, Blendis LM. Liver biopsy through the transjugular approach. Modification of instruments. Radiology. 1983;148:306.PubMedGoogle Scholar
  45. 45.
    Smith TP, Presson TL, Heneghan MA, Ryan JM. Transjugular biopsy of the liver in pediatric and adult patients using an 18-gauge automated core biopsy needle: a retrospective review of 410 consecutive procedures. Am J Roentgenol. 2003;180:167–72.CrossRefGoogle Scholar
  46. 46.
    Misra S, Gyamlani G, Swaminathan S, Buehrig CK, Bjarnason H, McKusick MA, et al. Safety and diagnostic yield of transjugular renal biopsy. J Vasc Interv Radiol. 2008;19:546–51.PubMedCrossRefGoogle Scholar
  47. 47.
    Sofocleous CT, Bahramipour P, Mele C, Hinrichs CR, Barone A, Abujudeh H. Transvenous transjugular renal core biopsy with a redesigned biopsy set including a blunt-tipped needle. Cardiovasc Intervent Radiol. 2002;25:155–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Bilbao JI, Idoate F, Joly MA, Vazquez C, Sangro B, Larrea JA, et al. Renal biopsy with forceps through the femoral vein. J Vasc Interv Radiol. 1995;6:641–5.PubMedCrossRefGoogle Scholar
  49. 49.
    Khosa F, McNulty JG, Hickey N, O’Brien P, Tobin A, Noonan N, et al. Transvenous liver biopsy via the femoral vein. Clin Radiol. 2003;58:487–91.PubMedCrossRefGoogle Scholar
  50. 50.
    Jung GS, Huh JD, Lee SU, Han BH, Chang HK, Cho YD. Bile duct: analysis of percutaneous transluminal forceps biopsy in 130 patients suspected of having malignant biliary obstruction. Radiology. 2002;224:725–30.PubMedCrossRefGoogle Scholar
  51. 51.
    Xing GS, Geng JC, Han XW, Dai JH, Wu CY. Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients with obstructive jaundice. Hepatobiliary Pancreat Dis Int. 2005;4:98–103.PubMedGoogle Scholar
  52. 52.
    Selvaggi SM. Biliary brushing cytology. Cytopathology. 2004;15:74–9.PubMedCrossRefGoogle Scholar
  53. 53.
    Kattapuram SV, Rosenthal DI. Percutaneous biopsy of skeletal lesions. Am J Roentgenol. 1991;157:935–42.CrossRefGoogle Scholar
  54. 54.
    Roberts CC, Morrison WB, Leslie KO, Carrino JA, Lozevski JL, Liu PT. Assessment of bone biopsy needles for sample size, specimen quality and ease of use. Skeletal Radiol. 2005;34:329–35.PubMedCrossRefGoogle Scholar
  55. 55.
    Buckley O, Benfayed W, Geoghegan T, Al-Ismail K, Munk PL, Torreggiani WC. CT-guided bone biopsy: initial experience with a commercially available hand held Black and Decker drill. Eur J Radiol. 2007;61:176–80.PubMedCrossRefGoogle Scholar
  56. 56.
    Cohen SC, Gore JM. Evaluation of a powered intraosseous device for bone marrow sampling. Anticancer Res. 2008;28:3843–6.PubMedGoogle Scholar
  57. 57.
    Culp WC, McCowan TC, Goertzen TC, Habbe TG, Hummel MM, LeVeen RF, et al. Relative ultrasonographic echogenicity of standard, dimpled, and polymeric-coated needles. J Vasc Interv Radiol. 2000;11:351–8.PubMedCrossRefGoogle Scholar
  58. 58.
    Jandzinski DI, Carson N, Davis D, Rubens DJ, Voci SL, Gottlieb RH. Treated needles: do they facilitate sonographically guided biopsies? J Ultrasound Med. 2003;22:1233–7.PubMedGoogle Scholar
  59. 59.
    Schulz T, Puccini S, Schneider JP, Kahn T. Interventional and intraoperative MR: review and update of techniques and clinical experience. Eur Radiol. 2004;14:2212–27.PubMedCrossRefGoogle Scholar
  60. 60.
    Weiss CR, Nour SG, Lewin JS. MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging. 2008;27:311–25.PubMedCrossRefGoogle Scholar
  61. 61.
    Adam G, Bucker A, Nolte-Ernsting C, Tacke J, Gunther RW. Interventional MR imaging: percutaneous abdominal and skeletal biopsies and drainages of the abdomen. Eur Radiol. 1999;9:1471–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Hueftle MG, Haaga JR. Effect of suction on biopsy sample size. Am J Roentgenol. 1986;147:1014–16.CrossRefGoogle Scholar
  63. 63.
    Zajdela A, Zillhardt P, Voillemot N. Cytological diagnosis by fine needle sampling without aspiration. Cancer. 1987;59:1201–5.PubMedCrossRefGoogle Scholar
  64. 64.
    Santos JE, Leiman G. Nonaspiration fine needle cytology. Application of a new technique to nodular thyroid disease. Acta Cytol. 1988;32:353–6.PubMedGoogle Scholar
  65. 65.
    Zajdela A, de Maublanc MA, Schlienger P, Haye C. Cytologic diagnosis of orbital and periorbital palpable tumors using fine-needle sampling without aspiration. Diagn Cytopathol. 1986;2:17–20.PubMedCrossRefGoogle Scholar
  66. 66.
    Fagelman D, Chess Q. Nonaspiration fine-needle cytology of the liver: a new technique for obtaining diagnostic samples. Am J Roentgenol. 1990;155:1217–19.CrossRefGoogle Scholar
  67. 67.
    Mair S, Dunbar F, Becker PJ, Du Plessis W. Fine needle cytology–is aspiration suction necessary? A study of 100 masses in various sites. Acta Cytol. 1989;33:809–13.PubMedGoogle Scholar
  68. 68.
    Hopper KD, Grenko RT, Fisher AI, TenHave TR. Capillary versus aspiration biopsy: effect of needle size and length on the cytopathological specimen quality. Cardiovasc Intervent Radiol. 1996;19:341–4.PubMedCrossRefGoogle Scholar
  69. 69.
    Monsein LH, Kelsey CA, Williams WL, Olson NJ. Fine needle biopsy without syringe aspiration. Cardiovasc Intervent Radiol. 1993;16:11–3.PubMedCrossRefGoogle Scholar
  70. 70.
    Hopper KD, Abendroth CS, TenHave TR, Hartzel J, Savage CA. Multiple fine-needle biopsies using a coaxial technique: efficacy and a comparison of three methods. Cardiovasc Intervent Radiol. 1995;18:307–11.PubMedCrossRefGoogle Scholar
  71. 71.
    Kopecky KK, Broderick LS, Davidson DD, Burney BT. Side-exiting coaxial needle for aspiration biopsy. Am J Roentgenol. 1996;167:661–2.CrossRefGoogle Scholar
  72. 72.
    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;179:109–12.CrossRefGoogle Scholar
  73. 73.
    Singh AK, Leeman J, Shankar S, Ferrucci JT. Core biopsy with curved needle technique. Am J Roentgenol. 2008;191:1745–50.CrossRefGoogle Scholar
  74. 74.
    vanSonnenberg E, Lin AS, Casola G, Nakamoto SK, Wing VW, Cubberly DA. Removable hub needle system for coaxial biopsy of small and difficult lesions. Radiology. 1984;152:226.PubMedGoogle Scholar
  75. 75.
    Bull HJ, Gilmore IT, Bradley RD, Marigold JH, Thompson RP. Experience with transjugular liver biopsy. Gut. 1983;24:1057–60.PubMedCrossRefGoogle Scholar
  76. 76.
    Gamble P, Colapinto RF, Stronell RD, Colman JC, Blendis L. Transjugular liver biopsy: a review of 461 biopsies. Radiology. 1985;157:589–93.PubMedGoogle Scholar
  77. 77.
    Lebrec D, Goldfarb G, Degott C, Rueff B, Benhamou JP. Transvenous liver biopsy: an experience based on 1000 hepatic tissue samplings with this procedure. Gastroenterology. 1982;83:338–40.PubMedGoogle Scholar
  78. 78.
    McAfee JH, Keeffe EB, Lee RG, Rosch J. Transjugular liver biopsy. Hepatology. 1992;15:726–32.PubMedCrossRefGoogle Scholar
  79. 79.
    Teare JP, Watkinson AF, Erb SR, Mayo JR, Connell DG, Weir IH, et al. Transfemoral liver biopsy by forceps: a review of 104 consecutive procedures. Cardiovasc Intervent Radiol. 1994;17:252–7.PubMedCrossRefGoogle Scholar
  80. 80.
    Savader SJ, Prescott CA, Lund GB, Osterman FA. Intraductal biliary biopsy: comparison of three techniques. J Vasc Interv Radiol. 1996;7:743–50.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Interventional Radiology, Department of Thoracic and Cardiovascular SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of RadiologyBaylor College of MedicineHoustonUSA

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