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Stuart G. Silverman - One of the best experts on this subject based on the ideXlab platform.
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anastomosing hemangiomas locations of occurrence imaging features and diagnosis with Percutaneous Biopsy
Abdominal Radiology, 2016Co-Authors: Ailbhe C Oneill, Stuart G. Silverman, Jeffrey W Craig, Raquel Oliva AlencarAbstract:Purpose To describe a series of anastomosing hemangiomas and report its locations, imaging features, and the use of image-guided Percutaneous Biopsy to establish the diagnosis.
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pet ct guided Percutaneous Biopsy of abdominal masses initial experience
Journal of Vascular and Interventional Radiology, 2011Co-Authors: Servet Tatli, Kemal Tuncali, Victor H Gerbaudo, Christina M Feeley, Paul B Shyn, Stuart G. SilvermanAbstract:Abstract Purpose To develop a technique for guiding Percutaneous biopsies of abdominal masses in a positron emission tomography (PET)/computed tomography (CT) scanner, and test its feasibility and safety in patients. Materials and Methods The authors conducted a prospective study in 12 patients who were in need of both a diagnostic 18 F-fluoro-deoxy-D-glucose (FDG) PET/CT scan and a Percutaneous Biopsy of an abdominal mass, located in the liver ( n = 7), presacral soft tissue ( n = 2), lymph node ( n = 2), and kidney ( n = 1). After completion of the PET/CT scan, with the patient remaining on the table, a one-table-position PET/CT scan was obtained with a radiopaque grid in place, and the Biopsy procedure was planned. Then, a Biopsy needle was placed into the mass using one-table-position CT scan registered to the planning PET scan. Masses were sampled after confirming accurate positioning of the needle tips with a final one-table-position PET/CT scan. Negative results were confirmed independently with follow-up imaging. Results All Biopsy procedures yielded diagnostic results; nine were positive for malignancy, and three were negative (fibrosis, steatosis, and Escherichia coli infection). One non–FDG-avid mass Biopsy yielded a malignant result. Seven masses were either invisible or poorly depicted with unenhanced CT scan, and two masses contained FDG avidity in only a portion of the mass. There were no complications. Conclusions Although our data are preliminary, this initial experience suggests that abdominal masses can undergo successful Biopsy in a PET/CT scanner. PET/CT guidance may be helpful when performing Biopsy on FDG-avid masses that are either not visible with unenhanced CT or are FDG avid in only a portion.
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Usefulness of Percutaneous Biopsy in diagnosing benign renal masses that mimic malignancy
Abdominal Imaging, 2010Co-Authors: V. Anik Sahni, Amy Ly, Stuart G. SilvermanAbstract:Percutaneous Biopsy has long been used to diagnose malignancies of the kidney. It is an established technique with multiple indications. Percutaneous Biopsy now can be used to diagnose benign conditions that may mimic a malignancy and lead to unnecessary treatments. Advances in cytological techniques such as immunocytochemistry and cytogenetics have allowed for an increased diagnostic yield. In this review, various benign entities that may present as a renal mass are discussed and the vital role of Percutaneous Biopsy detailed.
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renal masses in the adult patient the role of Percutaneous Biopsy
Radiology, 2006Co-Authors: Stuart G. Silverman, Koenraad J Mortele, Kemal Tuncali, Edmund S CibasAbstract:Although Percutaneous renal mass Biopsy with cross-sectional imaging guidance has long been considered to be safe and accurate, there have been recent advances in imaging, interventional, and cytologic techniques that have increased the role of Percutaneous Biopsy in the diagnosis of renal masses. Today, Biopsy plays a fundamental role in the care of patients with a renal mass. Biopsy results are used to confirm the diagnosis of renal cancers, metastases, and infections, and there is increasing evidence to suggest that Biopsy can help subtype and grade many primary renal cancers. Because a considerable fraction of small solid renal masses are benign and do not need treatment, there is an increasing need to diagnose them. Biopsy after a full imaging work-up can help prevent unnecessary and potentially morbid surgical and ablation procedures in a substantial number of patients. Although more data are needed to understand the overall accuracy of Biopsy for the diagnosis of benign lesions, many can be diagnos...
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Percutaneous Biopsy of renal masses sensitivity and negative predictive value stratified by clinical setting and size of masses
American Journal of Roentgenology, 2003Co-Authors: Frank J Rybicki, Edmund S Cibas, Julia R Fielding, E Vansonnenberg, Stuart G. SilvermanAbstract:OBJECTIVE. The purpose of our retrospective study was to evaluate the sensitivity and negative predictive value of Percutaneous Biopsy of renal masses stratified by clinical setting and the size of the mass.MATERIALS AND METHODS. We categorized 115 consecutive Percutaneous biopsies of renal masses in 113 patients into four clinical settings and three groups of mass sizes. The sensitivity and negative predictive value were computed (with 95% confidence intervals [CI]) for each clinical setting and for each size group.RESULTS. For all procedures (n = 115), the sensitivity and negative predictive value were 90% (95% CI, 81-95%) and 64% (95% CI, 44-81%), respectively. For patients with a known malignancy who presented with a renal mass (n = 55), the sensitivity and negative predictive value were 90% (95% CI, 78-96%) and 38% (95% CI, 10-74%), respectively. For patients with no known malignancy and suspected unresectable tumor (n = 36), the sensitivity and negative predictive value were 92% (95% CI, 76-98%) and...
C Coulange - One of the best experts on this subject based on the ideXlab platform.
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accuracy and clinical role of fine needle Percutaneous Biopsy with computerized tomography guidance of small less than 4 0 cm renal masses
The Journal of Urology, 2004Co-Authors: Yann Neuzillet, E Lechevallier, M Andre, Laurent Daniel, C CoulangeAbstract:ABSTRACTPurpose: We evaluated the accuracy and clinical role of fine needle Percutaneous Biopsy of solid renal masses 4.0 cm or smaller with helical computerized tomography (CT) guidance.Materials and Methods: In 88 consecutive patients (mean age 61 years) 88 biopsies were performed. Median tumor size was 2.8 cm. Tumor Biopsy was performed with an 18 gauge needle using helical CT guidance in an outpatient setting. At least 2 whole cores per tumor were obtained.Results: Biopsy material was insufficient for analysis in 3 (3.4%) procedures. Median tumor size of failed biopsies was 3.0 cm. There were 5 (5.6%) biopsies which revealed fibrosis and were considered inconclusive. A benign lesion was found in 14 (15.9%) biopsies. In the 66 biopsies positive for malignancy there were 65 cases of renal cell carcinoma and 1 lymphoma. A total of 62 patients underwent surgery. Biopsy changed tumor management in 42 (47.8%) patients who avoided radical nephrectomy, 13 of whom had a lesion which did not require surgery, 1 ...
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fine needle Percutaneous Biopsy of renal masses with helical ct guidance
Radiology, 2000Co-Authors: E Lechevallier, M Andre, David Barriol, Laurent Daniel, C Eghazarian, Marc De Fromont, D Rossi, C CoulangeAbstract:PURPOSE: To evaluate the feasibility, accuracy, and clinical role of fine-needle Percutaneous Biopsy of renal masses, with helical computed tomographic (CT) guidance. MATERIALS AND METHODS: In 63 patients (mean age, 62 years), 73 biopsies were performed. The median tumor size was 4.0 cm. Tumor Biopsy was performed with an 18-gauge needle by using helical CT guidance in an outpatient setting. Two to four cores per tumor were obtained. RESULTS: Biopsy material was insufficient for analysis in 15 (21%) procedures. The median tumor size of failed or successful biopsies was 3.0 or 4.8 cm, respectively (P = .03). A benign lesion was found at eight biopsies. Two samples were suspicious for renal cell carcinoma (RCC). RCC was found in 38 Biopsy samples. The remainder were transitional cell carcinoma, metastasis, lymphoma, or sarcoma. Twenty-six patients underwent nephrectomy. The accuracies of Biopsy for histopathologic and Fuhrman nuclear grade evaluation were 89% and 78%, respectively. For tumors of 3.0 cm or s...
Ronald S. Arellano - One of the best experts on this subject based on the ideXlab platform.
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hydrodissection assisted image guided Percutaneous Biopsy of abdominal and pelvic lesions experience with seven patients
American Journal of Roentgenology, 2015Co-Authors: Nazanin H Asvadi, Ronald S. ArellanoAbstract:OBJECTIVE. The purpose of this study was to evaluate the effectiveness of retroperitoneal organ displacement for image-guided Percutaneous Biopsy. CONCLUSION. Organ displacement using 0.9% saline or 5% dextrose in water (D5W) can create safe access routes for targeted abdominal and pelvic biopsies.
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Feasibility and effectiveness of image-guided Percutaneous Biopsy of the urinary bladder
Abdominal Imaging, 2015Co-Authors: Selim R. Butros, Anuradha S. Shenoy-bhangle, Colin J. Mccarthy, Ali Devrim Karaosmanoglu, Ronald S. ArellanoAbstract:To evaluate the indications, technique, results, and complications of image-guided Percutaneous Biopsy of the urinary bladder. This retrospective study included 15 patients (10 male, 5 female) who underwent image-guided Percutaneous Biopsy of the urinary bladder between January 1999 and December 2013. The medical records, imaging studies, procedural details, and long-term follow-up of each patient were reviewed in detail to assess the feasibility of Percutaneous bladder Biopsy. Ten patients had focal bladder masses and 5 patients had asymmetric or diffuse bladder wall thickening. Eleven patients had either negative or unsatisfactory cystoscopies prior to the Biopsy. Percutaneous biopsies were performed under computed tomography guidance in 12 patients and ultrasound in 3 patients. All procedures were technically successful and there were no procedural complications. Malignancy was confirmed in 8 patients, among whom 6 had transitional cell carcinoma, 1 cervical cancer, and 1 prostate cancer metastasis. Seven patients had a benign diagnosis, including 3 that were later confirmed by pathology following surgery and 2 patients with a false-negative result. The overall sensitivity was 80% and accuracy was 87%. Image-guided Percutaneous Biopsy of the urinary bladder is a safe and technically feasible procedure with a high sensitivity and accuracy rate. Although image-guided bladder Biopsy is an uncommon procedure, it should be considered in selected cases when more traditional methods of tissue sampling are either not possible or fail to identify abnormalities detected by cross-sectional imaging.
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Computed tomography-guided Percutaneous Biopsy of isoattenuating focal liver lesions
Abdominal Imaging, 2014Co-Authors: Nisha I. Sainani, Peter F. Hahn, Debra A. Gervais, Christopher L. Schlett, Peter R. Mueller, Ronald S. ArellanoAbstract:Purpose The purpose of this study was to evaluate the efficacy of CT-guided Percutaneous Biopsy of isoattenuating liver lesions using anatomic landmarks (ALs) to guide needle placement and added value of intravenous (IV) contrast.
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Percutaneous Biopsy of focal lesions of the gastrointestinal tract
Abdominal Imaging, 2013Co-Authors: Rocio Perez-johnston, Peter F. Hahn, Anuradha S. Shenoy-bhangle, Martin J. Shelly, Debra A. Gervais, Ronald S. ArellanoAbstract:Purpose To evaluate the technical success and diagnostic accuracy of image-guided Percutaneous Biopsy of the gastrointestinal (GI) tract.
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Image-Guided Percutaneous Biopsy
Non-Vascular Interventional Radiology of the Abdomen, 2010Co-Authors: Ronald S. ArellanoAbstract:Image-guided Percutaneous Biopsy is a commonly performed interventional radiological procedure that plays an important role in patient care and management. It is a safe and effective procedure that is less invasive than surgical Biopsy and can be performed using a variety of imaging modalities available to most radiologists. Increasingly, referring physicians rely on the expertise and skill of the interventional radiologist to obtain tissue specimens from organ systems within the abdomen and pelvis. Image-guided Percutaneous Biopsy is associated with low morbidity and mortality, and therefore it can be applied to patients who are too ill to undergo an operation. This chapter reviews the basic principles of image-guided Percutaneous Biopsy.
Sanjay Gupta - One of the best experts on this subject based on the ideXlab platform.
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Safety and diagnostic accuracy of Percutaneous Biopsy in upper tract urothelial carcinoma.
BJUI, 2014Co-Authors: Steven Y. Huang, Michael J. Wallace, Kamran Ahrar, Sanjay Gupta, Joe Ensor, Savitri Krishnamurthy, Surena F. MatinAbstract:Objective To assess the diagnostic accuracy and safety of Percutaneous Biopsy for upper tract urothelial carcinoma (UTUC). Patients and Methods From 2002 to 2013, 26 upper tract lesions in 24 patients (20 men; median [range] age 67.8 [51.7–85.9] years) were Percutaneously biopsied. Analysis was separated based on lesion appearance: (i) mass infiltrating renal parenchyma, (ii) filling defect in the collecting system, (iii) urothelial wall thickening. We tracked immediate complications and tract seeding on follow-up imaging. Results Of the 26 upper tract lesions, 15 (58%) were masses infiltrating the renal parenchyma (mean [range] size 5.4 [1.1–14.0] cm), six (23%) were urothelial wall thickenings (mean [range] size 0.8 [0.4–1.1] cm), and five (19%) were filling defects within the renal pelvis or calyx (mean [range] size 2.7 [1.0–4.6] cm). Definitive diagnosis of UTUC was made by Biopsy in 22 of 26 lesions (85%). Biopsy characterised 14 of 15 infiltrative masses and five of five filling defects; Biopsy characterised three of six cases of urothelial wall thickening. CT follow-up was available for 19 patients (73%) at a median (range) of 13.6 (1.0–98.9) months. Three patients (11%) developed recurrence in the nephrectomy bed at 5.6, 9.7, and 29.0 months after Biopsy; none were attributed to tract seeding after independent review, because recurrence was remote from the Biopsy site. Conclusion Percutaneous Biopsy is effective for diagnosis of UTUC, providing tissue diagnosis in 85% of cases. While case reports cite a risk of tract seeding, no cases of recurrence were definitely attributable to Percutaneous Biopsy. Thus, for upper tract urothelial lesions, which are not amenable to endoscopic Biopsy, Percutaneous Biopsy is a safe and effective technique.
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Percutaneous Biopsy of the Pancreas
Percutaneous Image-Guided Biopsy, 2013Co-Authors: Sanjay GuptaAbstract:Image-guided Percutaneous needle Biopsy has been shown to be a safe and accurate technique for obtaining samples for pathologic diagnosis in patients presenting with undiagnosed pancreatic masses. Percutaneous needle Biopsy is also used for determining the cause of graft dysfunction after pancreatic transplantation. Percutaneous Biopsy of the pancreas is generally performed with ultrasound or computed tomography guidance. Pancreatic lesions can be accessed via anterior, posterior, or lateral needle Biopsy approaches. An anterior approach is generally preferred, but the presence of intervening structures (such as the small and large bowel and mesenteric blood vessels) often precludes this approach. If a safe anterior approach is not available, a posterior approach can be used for needle Biopsy of pancreatic lesions. A posterior approach with the needle traversing the inferior vena cava has been safely used for lesions involving the head and uncinate process of the pancreas. Although fine-needle aspiration Biopsy is the most common technique for performing biopsies of pancreatic masses, biopsies using small-caliber (18- to 20-gauge) core needles also have shown to be safe, and studies suggest that core-Biopsy samples can increase the overall accuracy of Percutaneous Biopsy. The diagnostic accuracy of image-guided Percutaneous pancreatic Biopsy ranges from 45 to 100 %. The reported complication rate for pancreatic biopsies ranges between 0.5 and 3 %, with acute pancreatitis being the most frequent complication.
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Percutaneous Biopsy of head and neck lesions with CT guidance: Various approaches and relevant anatomic and technical considerations
Radiographics, 2007Co-Authors: Sanjay Gupta, Joy A. Henningsen, Michael J. Wallace, David C. Madoff, Frank A. Morello, Kamran Ahrar, Ravi Murthy, Marshall E HicksAbstract:Deep-seated head and neck lesions, which traditionally were evaluated by surgical means, are now accessible with less invasive computed tomography-guided Percutaneous needle Biopsy techniques. Major vessels, the trachea, and osseous structures like the maxilla, mandible, and vertebrae often preclude direct access to these lesions. It is important to understand the anatomy relevant to safe access route planning and the techniques, advantages, and limitations associated with various approaches used for Percutaneous Biopsy of head and neck lesions. For Biopsy of suprahyoid head and neck lesions, including those of the skull base and upper cervical vertebrae, various approaches such as the subzygomatic, retromandibular, paramaxillary, submastoid, transoral, and posterior approaches can be used. Lesions in the infrahyoid portion of the neck and lower cervical vertebrae can be accessed with the anterolateral approach (between the airways and the carotid sheath), posterolateral approach (posterior to the carotid sheath), and direct posterior approach. The location and extent of the lesions and their relationship to adjacent structures influence the choice of the trajectory to use. Careful planning of the procedure and considerable familiarity with head and neck anatomy are necessary for a Biopsy that is both precise and safe. ©RSNA, 2007.
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New Techniques in Image-Guided Percutaneous Biopsy
CardioVascular and Interventional Radiology, 2004Co-Authors: Sanjay GuptaAbstract:Image-guided Percutaneous Biopsy is a well-established and safe technique for obtaining tissue specimens from various regions of the body and plays a crucial role in patient management. Improvements in needle designs, development of new Biopsy techniques, and continual advances in image-guidance technology have improved the safety and efficacy of the procedure. Lesions previously considered relatively inaccessible can now be safely biopsied. This review looks at the recent technologic developments in image guidance for Percutaneous Biopsy procedures. Improvements in needle design and other innovations intended to enhance the diagnostic yield of Biopsy specimens are briefly discussed. Also described are some new techniques and unconventional approaches that help provide safe access to difficult-to-reach lesions.
E Lechevallier - One of the best experts on this subject based on the ideXlab platform.
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accuracy and clinical role of fine needle Percutaneous Biopsy with computerized tomography guidance of small less than 4 0 cm renal masses
The Journal of Urology, 2004Co-Authors: Yann Neuzillet, E Lechevallier, M Andre, Laurent Daniel, C CoulangeAbstract:ABSTRACTPurpose: We evaluated the accuracy and clinical role of fine needle Percutaneous Biopsy of solid renal masses 4.0 cm or smaller with helical computerized tomography (CT) guidance.Materials and Methods: In 88 consecutive patients (mean age 61 years) 88 biopsies were performed. Median tumor size was 2.8 cm. Tumor Biopsy was performed with an 18 gauge needle using helical CT guidance in an outpatient setting. At least 2 whole cores per tumor were obtained.Results: Biopsy material was insufficient for analysis in 3 (3.4%) procedures. Median tumor size of failed biopsies was 3.0 cm. There were 5 (5.6%) biopsies which revealed fibrosis and were considered inconclusive. A benign lesion was found in 14 (15.9%) biopsies. In the 66 biopsies positive for malignancy there were 65 cases of renal cell carcinoma and 1 lymphoma. A total of 62 patients underwent surgery. Biopsy changed tumor management in 42 (47.8%) patients who avoided radical nephrectomy, 13 of whom had a lesion which did not require surgery, 1 ...
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fine needle Percutaneous Biopsy of renal masses with helical ct guidance
Radiology, 2000Co-Authors: E Lechevallier, M Andre, David Barriol, Laurent Daniel, C Eghazarian, Marc De Fromont, D Rossi, C CoulangeAbstract:PURPOSE: To evaluate the feasibility, accuracy, and clinical role of fine-needle Percutaneous Biopsy of renal masses, with helical computed tomographic (CT) guidance. MATERIALS AND METHODS: In 63 patients (mean age, 62 years), 73 biopsies were performed. The median tumor size was 4.0 cm. Tumor Biopsy was performed with an 18-gauge needle by using helical CT guidance in an outpatient setting. Two to four cores per tumor were obtained. RESULTS: Biopsy material was insufficient for analysis in 15 (21%) procedures. The median tumor size of failed or successful biopsies was 3.0 or 4.8 cm, respectively (P = .03). A benign lesion was found at eight biopsies. Two samples were suspicious for renal cell carcinoma (RCC). RCC was found in 38 Biopsy samples. The remainder were transitional cell carcinoma, metastasis, lymphoma, or sarcoma. Twenty-six patients underwent nephrectomy. The accuracies of Biopsy for histopathologic and Fuhrman nuclear grade evaluation were 89% and 78%, respectively. For tumors of 3.0 cm or s...
