Computed Tomography Fluoroscopy-guided Core Needle Biopsy of Abdominal Para-aortic Lesions: A Retrospective Evaluation of the Diagnostic Yield and Safety

PURPOSE: To retrospectively evaluate the diagnostic yield and safety of computed tomography (CT) fluoroscopy-guided biopsy of abdominal para-aortic lesions. MATERIAL AND METHODS: CT fluoroscopy-guided biopsy was performed for 30 lesions (median long diameter 2.4 cm; range, 1.3-12.4 cm) in 30 patients (11 women and 19 men; median age 64.5 years; age range 37-90 years) using 18- and/or 20-gauge needles. The median length of the biopsy needle tracts was 9.3 cm (range, 5.5-13.0 cm). The median number of biopsy fires was 3 (range, 2-6). The median duration of the procedures was 33 min (range, 14-80 min). The diagnostic yield and adverse events (AEs) were retrospectively evaluated. The AEs were categorized using the Society of Interventional Radiology classification system. Technical success was determined by the acquisition of a sufficient number of specimens for pathological diagnosis. Diagnostic yield was defined as the match between the pathological and final diagnoses. RESULTS: In all 30 procedures, CT fluoroscopy-guided biopsies of the abdominal para-aortic lesions were technically successful. Twenty-six lesions were malignant (9 malignant lymphomas and 17 lymph node [LN] metastases) and four were benign (one schwannoma, one granular cell tumor, and two normal LNs). One case was insufficiently diagnosed as a B-cell lymphoma; thus, the diagnostic yield of the biopsy was 96.7%. AEs occurred in seven procedures (23.3%), including six cases of class A hemorrhage and one case of class B vasovagal reaction. CONCLUSIONS: CT fluoroscopy-guided biopsy of abdominal para-aortic lesions is a safe procedure and provides a high diagnostic yield.