Abstract No. 631 Comparison of diagnostic yield and procedural time with and without the presence of on-site pathology for image-guided percutaneous biopsies

Abstract

The aim of having on-site pathology (OSP) service for percutaneous biopsies is to maximize diagnostic yield and minimize the risk of repeat biopsies. The use of OSP is standard procedure at our institution’s main hospital where the pathology department is based, but due to resource limitations a member of the pathology team is not always available for our biopsies at our neighboring hospital where we recently started performing outpatient biopsies. Our hypothesis is that the added time and logistical difficulties of transporting a pathology representative to our neighboring hospital may not be outweighed by improved diagnostic yield. We retrospectively reviewed data from January to December 2018 for percutaneous biopsies performed at our neighboring hospital with and without OSP, only including lesional biopsies that would typically qualify for OSP. The main endpoints were diagnostic yield and procedure time. Secondary variables included target organ. Statistical analysis (chi-square and comparison of means) was performed. A biopsy was considered diagnostic if a pathologic diagnosis was determined from the provided samples in the final pathology report. Biopsies were categorized by target organ (e.g., liver, kidney, soft tissue, lymph node, etc.) and technique (US guided vs. CT guided). A total of 170 biopsies were included. 96 were with OSP present, and 74 without OSP present. Diagnostic yield was not statistically significant between the OSP and non-OSP groups (P = 0.435). Mean procedure time was longer using OSP than without OSP (41.1 vs. 36.2 minutes, P = 0.05). Mean sedation time was also longer when OSP was used than without OSP (36.7 vs. 32.7 minutes, P = 0.01). Our study shows that there is no statistically significant increase in diagnostic yield when OSP is present during lesional biopsies, and that using OSP increases procedure time and sedation time. Our results question the routine use of on-site pathology at our neighboring hospital where transporting a pathology representative is logistically challenging. Further studies are needed to identify lesional characteristics that may confer a higher risk of obtaining non-diagnostic samples.Tabled 1Diagnostic Yield with or without On-Site Pathology (P = 0.435)DiagnosticNondiagnosticPathology present906Pathology not present677 Open table in a new tab