From the Guidelines
Ultrasound-guided biopsy is a crucial diagnostic procedure that significantly reduces complications and improves diagnostic yield, and its use is highly recommended, especially in high-risk patients or when targeting focal liver lesions. The role of ultrasound-guided biopsy in diagnostic procedures is well-established, with numerous studies demonstrating its safety and efficacy [ 1 , 1 ].
Key Benefits of Ultrasound-Guided Biopsy
- Reduces bleeding complications, as demonstrated in a randomized trial that showed a significant reduction in complications when using ultrasound guidance for double-pass liver biopsy [ 1 ]
- Improves diagnostic yield by allowing for precise targeting of small lesions, which is particularly important in the biopsy of focal liver lesions [ 1 ]
- Provides real-time visualization, enabling the doctor to visualize the needle path and avoid adjacent structures, thereby reducing minor and major complications [ 1 ]
- Can be performed on an outpatient basis with local anesthesia, reducing the need for hospitalization and minimizing recovery time [ 1 ]
Clinical Applications
- Biopsy of focal liver lesions, where image guidance with real-time ultrasound, CT, or MRI is necessary to place the needle accurately at the site of the lesion [ 1 ]
- Liver biopsy, where ultrasound guidance can help direct the biopsy needle away from the gallbladder, large vascular structures, colon, and lung, reducing the risk of complications [ 1 ]
- Other applications, such as breast, thyroid, prostate, kidney, and lymph node biopsies, where ultrasound guidance offers several advantages, including reduced radiation exposure and improved diagnostic accuracy [ 1 , 1 ]
Recommendations
- Ultrasound-guided biopsy should be considered the standard of care for high-risk patients or when targeting focal liver lesions, given its proven safety and efficacy [ 1 , 1 ]
- For patients with cirrhosis, the use of ultrasound guidance is recommended to reduce the risk of bleeding complications, as demonstrated in the EASL clinical practice guidelines [ 1 ]
- The choice of imaging modality, such as ultrasound, CT, or MRI, should be based on the specific clinical scenario and the availability of resources [ 1 ]
From the Research
Role of Ultrasound-Guided Biopsy
The role of ultrasound-guided biopsy in diagnostic procedures is multifaceted, offering several advantages over other imaging techniques. Some of the key aspects include:
- Safety and Accuracy: Ultrasound-guided biopsies are considered safe and accurate methods for obtaining tissue samples from various organs and masses, including those in the abdomen and pelvis 2.
- Real-Time Imaging: The use of real-time imaging allows for precise guidance of the biopsy needle, enabling the collection of adequate tissue samples even from small lesions 2, 3.
- Minimally Invasive: Ultrasound-guided biopsies are minimally invasive, reducing the risk of complications and promoting faster recovery times compared to more invasive procedures 2, 4.
- Diagnostic Accuracy: Studies have shown high diagnostic accuracy rates for ultrasound-guided core needle biopsies, particularly in the diagnosis of soft tissue tumors and gynecologic malignancies 3, 4.
Applications of Ultrasound-Guided Biopsy
Ultrasound-guided biopsy has a wide range of applications, including:
- Abdominal and Pelvic Organs: It is commonly used for biopsies of the liver, kidney, and other abdominal and pelvic organs 2.
- Soft Tissue Tumors: Ultrasound-guided core needle biopsy is effective in diagnosing soft tissue tumors, with high concordance rates between biopsy and resection specimens 3.
- Gynecologic Malignancies: Transvaginal ultrasound-guided biopsy is a valuable tool in the diagnosis of gynecologic malignancies, providing adequate tissue samples for histological analysis 4.
- Musculoskeletal Soft-Tissue Lesions: Ultrasound-guided core needle biopsy is also used in the diagnosis of musculoskeletal soft-tissue lesions, with guidelines available for its practical application 5.