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15.01.2024 | Head and Neck

CT-guided core needle biopsies of head and neck tumors: a comprehensive monocenter analysis of safety and outcomes

verfasst von: Thomas Joseph Vogl, Heinrich Johannes Ketelsen, Scherwin Mahmoudi, Jan-Erik Scholtz, Vitali Koch, Leon David Grünewald, Peter Wild, Timo Stoever, Simon Bernatz

Erschienen in: European Radiology | Ausgabe 8/2024

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Abstract

Background

Although core needle biopsy is an important tool in minimally invasive tissue sampling and diagnostics for head and neck masses, comprehensive data about safety and outcomes is lacking.

Purpose

To retrospectively evaluate the diagnostic performance and safety of computed tomography (CT)-guided percutaneous core needle biopsy of head and neck masses.

Material and methods

This retrospective single-center study included patients from 04/2007 to 12/2021, and a total of 156 core needle biopsies were evaluated. The initial histopathological results were compared with the long-term final diagnosis to evaluate the diagnostic yield of CT-guided core needle biopsies. The patients’ age, sex, and history of malignancy, as well as procedural complications and radiation exposure were collected.

Results

A total of 156 biopsies of 150 patients (mean age 56 years ± 17; 89 men) were evaluated. 57.3% (86/150) of patients had a history of malignancy. 55.1% (86/156) of the lesions were accessed by an infrahyoid needle approach. 92.9% (145/156) of biopsies yielded conclusive results. There were no false positives and 4 false negatives, resulting in a total false negative rate of 2.7% (4/145) and a total diagnostic yield of 90.4% (141/156). There were nine puncture-related complications (9/156–5.7%). None of the complications required further reintervention. The average dose length product was 311.3 mGy × cm.

Conclusion

CT-guided core needle biopsies of head and neck masses showed excellent results with high diagnostic yield and clinical safety.

Clinical relevance statement

General anesthesia for open biopsy carries a higher risk for elderly patients, and fine needle aspiration has a poor reputation in terms of its diagnostic yield. This study focuses on safety and diagnostic yield of CT-guided core needle biopsies.

Key Points

• CT-guided core needle biopsy in head and neck tumors was a reliable and safe procedure.

• The most common cause for an inconclusive biopsy result was a shortage of tissue collected during the biopsy.

• During our study period of nearly 15 years, the radiation exposure of head and neck biopsies decreased.

Nur mit Berechtigung zugänglich

Sung H, Ferlay J, Siegel RL et al (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 71:209–49. https://doi.org/10.3322/caac.21660CrossRefPubMed

Dittberner A, Friedl B, Wittig A et al (2020) Gender disparities in epidemiology, treatment, and outcome for head and neck cancer in Germany: a population-based long-term analysis from 1996 to 2016 of the Thuringian Cancer Registry. Cancers 12. https://doi.org/10.3390/cancers12113418

Klussmann JP (2017) Head and neck cancer - new insights into a heterogeneous disease. Oncol Res Treat 40:318–319. https://doi.org/10.1159/000477255CrossRefPubMed

Pynnonen MA, Gillespie MB, Roman B et al (2017) Clinical practice guideline: evaluation of the neck mass in adults executive summary. Otolaryngol Head Neck Surg 157:355–71. https://doi.org/10.1177/0194599817723609CrossRefPubMed

Aiken AH (2020) Image-guided biopsies in the head and neck: practical value and approach. AJNR Am J Neuroradiol 41:2123–2125. https://doi.org/10.3174/ajnr.A6855CrossRefPubMedPubMedCentral

Vahl JM, Wigand MC, Denkinger M et al (2021) Increasing mean age of head and neck cancer patients at a German Tertiary Referral Center. Cancers 13. https://doi.org/10.3390/cancers13040832

Cadoni G, Giraldi L, Petrelli L et al (2017) Fattori prognostici del tumore testa-collo: un’analisi retrospettiva monocentrica di 10 anni. Acta Otorhinolaryngol Ital 37:458–466. https://doi.org/10.14639/0392-100X-1246CrossRefPubMedPubMedCentral

Hillen TJ, Baker JC, Long JR, Friedman MV, Jennings JW (2020) Percutaneous CT-guided core needle biopsies of head and neck masses: technique, histopathologic yield, and safety at a single academic institution. AJNR Am J Neuroradiol 41:2117–2122. https://doi.org/10.3174/ajnr.A6784CrossRefPubMedPubMedCentral

Wu E-H, Chen Y-L, Wu Y-M, Huang Y-T, Wong H-F, Ng S-H (2013) CT-guided core needle biopsy of deep suprahyoid head and neck lesions. Korean J Radiol 14:299–306. https://doi.org/10.3348/kjr.2013.14.2.299CrossRefPubMedPubMedCentral

10.

Wagner JM, Monfore N, McCullough AJ et al (2019) Ultrasound-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses: comparison of diagnostic performance in treated squamous cell cancer versus all other lesions. J Ultrasound Med 38:2275–2284. https://doi.org/10.1002/jum.14918CrossRefPubMed

11.

Choi SH, Baek JH, Ha EJ et al (2016) Diagnosis of metastasis to the thyroid gland: comparison of core-needle biopsy and fine-needle aspiration. Otolaryngol Head Neck Surg 154:618–25. https://doi.org/10.1177/0194599816629632CrossRefPubMed

12.

Han F, Xu M, Xie T et al (2018) Efficacy of ultrasound-guided core needle biopsy in cervical lymphadenopathy: a retrospective study of 6,695 cases. Eur Radiol 28:1809–1817. https://doi.org/10.1007/s00330-017-5116-1CrossRefPubMed

13.

Amoedo MK, Tyng CJ, Barbosa PNVP et al (2021) Computed tomography-guided percutaneous biopsy of head and neck masses: techniques, outcomes, and complications. Radiol Bras 54:295–302. https://doi.org/10.1590/0100-3984.2020.0100CrossRefPubMedPubMedCentral

14.

Jordan RW, Shlapak DP, Benson JC et al (2022) Percutaneous CT-guided core needle biopsies of head and neck masses: review of 184 cases at a single academic institution, common and special techniques, diagnostic yield, and safety. AJNR Am J Neuroradiol 43:117–124. https://doi.org/10.3174/ajnr.A7348CrossRefPubMedPubMedCentral

15.

Song IH, Song JS, Sung CO et al (2015) Accuracy of core needle biopsy versus fine needle aspiration cytology for diagnosing salivary gland tumors. J Pathol Transl Med 49:136–143. https://doi.org/10.4132/jptm.2015.01.03CrossRefPubMedPubMedCentral

16.

Zbären P, Triantafyllou A, Devaney KO et al (2018) Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy? Eur Arch Otorhinolaryngol 275:2609–13. https://doi.org/10.1007/s00405-018-5131-0CrossRefPubMed

17.

Lan L, Luo Y, Zhou M et al (2020) Comparison of diagnostic accuracy of thyroid cancer with ultrasound-guided fine-needle aspiration and core-needle biopsy: a systematic review and meta-analysis. Front Endocrinol 11:44. https://doi.org/10.3389/fendo.2020.00044CrossRef

18.

Gupta S, Henningsen JA, Wallace MJ et al (2007) Percutaneous biopsy of head and neck lesions with CT guidance: various approaches and relevant anatomic and technical considerations. Radiographics 27:371–90. https://doi.org/10.1148/rg.272065101CrossRefPubMed

19.

Cunningham JD, McCusker MW, Power S et al (2015) Accessible or inaccessible? Diagnostic efficacy of CT-guided core biopsies of head and neck masses. Cardiovasc Intervent Radiol 38:422–429. https://doi.org/10.1007/s00270-014-0922-1CrossRefPubMed

20.

Wu E-H, Chen Y-L, Toh C-H, Ko S-F, Lin Y-C, Ng S-H (2013) CT-guided core needle biopsy of deep suprahyoid head and neck lesions in untreated patients. Interv Neuroradiol 19:365–369. https://doi.org/10.1177/159101991301900315CrossRefPubMedPubMedCentral

21.

Ahn D, Lee GJ, Sohn JH, Jeong JY (2018) Fine-needle aspiration cytology versus core-needle biopsy for the diagnosis of extracranial head and neck schwannoma. Head Neck 40:2695–2700. https://doi.org/10.1002/hed.25520CrossRefPubMed

22.

Skelton E, Jewison A, Okpaluba C et al (2015) Image-guided core needle biopsy in the diagnosis of malignant lymphoma. Eur J Surg Oncol 41:852–858. https://doi.org/10.1016/j.ejso.2015.04.015CrossRefPubMed

23.

Cuenca-Jimenez T, Chia Z, Desai A et al (2021) The diagnostic performance of ultrasound-guided core biopsy in the diagnosis of head and neck lymphoma: results in 226 patients. Int J Oral Maxillofac Surg 50:431–436. https://doi.org/10.1016/j.ijom.2020.07.005CrossRefPubMed

24.

Loevner LA (2008) Image-guided procedures of the head and neck: the radiologist’s arsenal. Otolaryngol Clin North Am 41:231–50, viii. https://doi.org/10.1016/j.otc.2007.10.013CrossRefPubMed

Titel: CT-guided core needle biopsies of head and neck tumors: a comprehensive monocenter analysis of safety and outcomes
verfasst von: Thomas Joseph Vogl
Heinrich Johannes Ketelsen
Scherwin Mahmoudi
Jan-Erik Scholtz
Vitali Koch
Leon David Grünewald
Peter Wild
Timo Stoever
Simon Bernatz
Publikationsdatum: 15.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2024
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10541-2

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CT-guided core needle biopsies of head and neck tumors: a comprehensive monocenter analysis of safety and outcomes