Adequacy and Complications of CT-Guided Percutaneous Biopsy: A study of 334 Cases in Srinagarind Hospital

Objective: To evaluate the adequacy and complications of automated biopsy gun under CT-guided percutane-ous needle biopsy. Material and Method: The medical records, radiological records, and images of 334 patients who underwent CT-guided percutaneous needle biopsyin Srinagarind Hospital between January 2003 and June 2007 were retrospectively reviewed. The biopsies were performed by two groups, radiologists (44 procedures) and residents in training (290 procedures). The specimens were sent for histologic diagnosis. The immediate and late complications from the biopsies and diagnostic adequacy were analyzed. Results: Fifty, 215, and 69 patients underwent CT-guided percutaneous needle biopsies using 16, 18, and 20-gauge needles respectively. There was no statistically significant difference among the various needle sizes with complication rate (p = 0.291). Three pneumothorax and one abdominal infection occurred after procedures performed by residents. The overall diagnostic adequacy of the biopsy materials was low and varied by size of needle, 52%, 61.4%, and 52.1%, respectively. Conclusion: CT-guided needle biopsy using automated biopsy device is safe. The diagnostic adequacy in the present series is low, probably caused by single histologic analysis. Some complications occurred after the procedures are performed. Therefore, the authors recommend fellowship training in interventional radiology or periodic post-residency training in image-guided biopsy. To optimize the diagnostic adequacy, the authors suggest combined cytologic and histologic analysis from a single core biopsy sample