Abstract
ObjectiveTo assess the technique, efficacy, and safety of computed tomography (CT)-guided percutaneous biopsies of head and neck masses.Materials and MethodsThis was a retrospective, single-center study of CT-guided percutaneous core-needle biopsies of head and neck masses. For the analysis of diagnostic accuracy, biopsy results were compared with the final diagnosis, which was determined by histological examination and clinical follow-up.ResultsWe evaluated 74 biopsies performed in 68 patients. The mean age of the patients was 55.6 years. Most of the lesions (79.7%) were located in the suprahyoid region, and the maximum diameter ranged from 11 mm to 128 mm. The most common approaches were paramaxillary (in 32.4%), retromandibular (in 21.6%), and periorbital (in 14.9%). Five patients (6.8%) developed minor complications. The presence of a complication did not show a statistically significant association with any clinical, radiological, or procedure-related factor. Sufficient material for histological analysis was obtained in all procedures. Thirty-eight biopsies (51.4%) yielded a histological diagnosis of malignancy. There was a false-negative result in three cases (8.3%), and there were no false-positive results. The procedure had a sensitivity of 92.7%, a specificity of 100%, and an accuracy of 96.0%.ConclusionOur results demonstrate that CT-guided percutaneous core-needle biopsy of head and neck lesions is a safe, effective procedure for obtaining biological material for histological analysis.
Highlights
Percutaneous biopsies of head and neck masses have been considered safe and effective when the target is in a superficial location
Sufficient material for histological analysis was obtained in all cases
We have reported the results of 74 computed tomography (CT)-guided percutaneous core-needle biopsies performed in patients with suspicious masses in the deep spaces of the head and neck, a sample larger than those evaluated in previous studies[1,10,11,12]
Summary
Percutaneous biopsies of head and neck masses have been considered safe and effective when the target is in a superficial location. Ultrasound is the imaging method of choice for the guidance of biopsies of superficial head and neck lesions, such as those located in the thyroid gland or salivary glands. Fine-needle aspiration (FNA) is often the procedure of choice for the diagnosis of head and neck masses. One of the few studies comparing the two techniques showed that, for the diagnosis of malignant lesions, the accuracy of coreneedle biopsy was 100%, significantly higher than the 93% found for FNA[6]. Little data are available in the literature, core-needle biopsy of head and neck masses has become established as a safe, effective technique for obtaining representative tissue samples[1]. CTguided head and neck biopsies account for only 1% of all CT-guided interventions and many of these procedures are canceled or aborted due to the lack of a safe window[7]
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