CT-guided percutaneous core biopsy of deep face and skull-base lesions

Abstract

To evaluate the diagnostic accuracy of deep face and skull-base computed tomography (CT)-guided core biopsy. Seventeen patients underwent CT-guided percutaneous core biopsies of deep face and skull-base lesions. One biopsy was repeated due to a non-diagnostic sample so 18 biopsy procedures were evaluated. The 17 lesions were centred within the central skull base (n=2), parapharyngeal (n=3), retropharyngeal spaces (n=4), masticator (n=3), pterygopalatine fossa (n=1), and deep lobe of parotid (n=4). Subzygomatic (n=7), retromaxillary (n=9), suprazygomatic (n=1), and transparotid (n=1) needle approaches were used. The diagnostic accuracy was either assessed by a positive histological result from the operative specimen or based on treatment response and clinical follow-up. No immediate or delayed procedural complications were encountered. A histological diagnosis was obtained in 16 of the 18 biopsies (89% diagnostic yield). The pathological diagnosis was confirmed by surgical excision (5/18 biopsies) and by predicted treatment response or clinical follow-up (10/18 biopsies). Diagnosis could not be confirmed for three of the 18 biopsies. The diagnostic accuracy of core biopsy was 13 of 15 (87%) for all samples. CT-guided percutaneous deep face core biopsy is a safe technique with good diagnostic accuracy, allowing diagnosis of benign disease and classification of malignant disease.