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Biopsy Procedures
Jennifer R. Buckley, MD, MBA; Brandt C. Wible, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Definitions

              • Biopsy: Tissue acquisition from organ/lesion using large-gauge needle for microbiologic &/or pathologic analysis
                • Nonfocal (random) biopsy: Biopsy of organ parenchyma to assess diffuse disease
                • Focal (targeted) biopsy: Biopsy of discrete lesion
              • Fine-needle aspiration (FNA): Aspiration of cells from target lesion using small-gauge needle for cytologic analysis

            PREPROCEDURE

            • Indications

              • Contraindications

                • Preprocedure Imaging

                  • Getting Started

                    PROCEDURE

                    • Patient Position/Location

                      • Equipment Preparation

                        • Procedure Steps

                          • Findings and Reporting

                            • Alternative Procedures/Therapies

                              POST PROCEDURE

                              • Things to Do

                                • Things to Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      • Expected Outcomes

                                        Selected References

                                        1. Adnan A et al: Image-guided percutaneous biopsy of the liver. Tech Vasc Interv Radiol. 24(4):100773, 2021
                                        2. Quencer KB et al: Kidney tissue biopsy. Tech Vasc Interv Radiol. 24(4):100775, 2021
                                        3. Seicean A et al: Performance of the standard 22G needle for endoscopic ultrasound-guided tissue core biopsy in pancreatic cancer. J Gastrointestin Liver Dis. 25(2):213-8, 2016
                                        4. Gellert LL et al: The diagnostic accuracy of percutaneous renal needle core biopsy and its potential impact on the clinical management of renal cortical neoplasms. Arch Pathol Lab Med. 138(12):1673-9, 2014
                                        5. Marshall D et al: The changing face of percutaneous image-guided biopsy: molecular profiling and genomic analysis in current practice. J Vasc Interv Radiol. 24(8):1094-103, 2013
                                        6. Winokur RS et al: Percutaneous lung biopsy: technique, efficacy, and complications. Semin Intervent Radiol. 30(2):121-7, 2013
                                        7. Lorenz JM: Updates in percutaneous lung biopsy: new indications, techniques and controversies. Semin Intervent Radiol. 29(4):319-24, 2012
                                        8. Fassina A et al: Role and accuracy of rapid on-site evaluation of CT-guided fine needle aspiration cytology of lung nodules. Cytopathology. 22(5):306-12, 2011
                                        9. Kim GR et al: CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol. 21(2):232-9, 2011
                                        10. Atwell TD et al: Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol. 194(3):784-9, 2010
                                        11. Gupta S et al: Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol. 21(7):969-75, 2010
                                        12. Priola AM et al: Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: a study based on the experience of the cytopathologist. Acta Radiol. 51(5):527-33, 2010
                                        13. Gupta S et al: Image-guided percutaneous needle biopsy in cancer diagnosis and staging. Tech Vasc Interv Radiol. 10(2):88-101, 2007
                                        14. Dalal T et al: Extraadrenal pheochromocytoma: a rare cause of tachycardia and hypertension during percutaneous biopsy. AJR Am J Roentgenol. 185(2):554-5, 2005
                                        15. Gupta S et al: Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations. Radiographics. 24(1):175-89, 2004
                                        16. Gupta S: New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol. 27(2):91-104, 2004
                                        17. Arellano RS et al: Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. Curr Probl Diagn Radiol. 32(1):3-10, 2003
                                        18. Arellano RS et al: The difficult biopsy: let's make it easier. Curr Probl Diagn Radiol. 32(5):218-26, 2003
                                        19. Cardella JF et al: Quality improvement guidelines for image-guided percutaneous biopsy in adults. J Vasc Interv Radiol. 14(9 Pt 2):S227-30, 2003
                                        20. Ohno Y et al: CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 180(6):1665-9, 2003
                                        21. Titton RL et al: Sonography and sonographically guided fine-needle aspiration biopsy of the thyroid gland: indications and techniques, pearls and pitfalls. AJR Am J Roentgenol. 181(1):267-71, 2003
                                        22. Lucey BC et al: Percutaneous nonvascular splenic intervention: a 10-year review. AJR Am J Roentgenol. 179(6):1591-6, 2002
                                        23. Ko JP et al: Factors influencing pneumothorax rate at lung biopsy: are dwell time and angle of pleural puncture contributing factors? Radiology. 218(2):491-6, 2001
                                        24. O'Neill MJ et al: Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 21(3):657-72, 2001
                                        25. Klein JS et al: Transthoracic needle biopsy. Radiol Clin North Am. 38(2):235-66, vii, 2000
                                        26. Yang PC: Ultrasound-guided transthoracic biopsy of the chest. Radiol Clin North Am. 38(2):323-43, 2000
                                        27. Wood BJ et al: Imaging guided biopsy of renal masses: indications, accuracy and impact on clinical management. J Urol. 161(5):1470-4, 1999
                                        28. Boiselle PM et al: Routine addition of an automated biopsy device to fine-needle aspiration of the lung: a prospective assessment. AJR Am J Roentgenol. 169(3):661-6, 1997
                                        Related Anatomy
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Preprocedure

                                            • Procedure

                                              • Post Procedure

                                                • Outcomes

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Biopsy: Tissue acquisition from organ/lesion using large-gauge needle for microbiologic &/or pathologic analysis
                                                      • Nonfocal (random) biopsy: Biopsy of organ parenchyma to assess diffuse disease
                                                      • Focal (targeted) biopsy: Biopsy of discrete lesion
                                                    • Fine-needle aspiration (FNA): Aspiration of cells from target lesion using small-gauge needle for cytologic analysis

                                                  PREPROCEDURE

                                                  • Indications

                                                    • Contraindications

                                                      • Preprocedure Imaging

                                                        • Getting Started

                                                          PROCEDURE

                                                          • Patient Position/Location

                                                            • Equipment Preparation

                                                              • Procedure Steps

                                                                • Findings and Reporting

                                                                  • Alternative Procedures/Therapies

                                                                    POST PROCEDURE

                                                                    • Things to Do

                                                                      • Things to Avoid

                                                                        OUTCOMES

                                                                        • Problems

                                                                          • Complications

                                                                            • Expected Outcomes

                                                                              Selected References

                                                                              1. Adnan A et al: Image-guided percutaneous biopsy of the liver. Tech Vasc Interv Radiol. 24(4):100773, 2021
                                                                              2. Quencer KB et al: Kidney tissue biopsy. Tech Vasc Interv Radiol. 24(4):100775, 2021
                                                                              3. Seicean A et al: Performance of the standard 22G needle for endoscopic ultrasound-guided tissue core biopsy in pancreatic cancer. J Gastrointestin Liver Dis. 25(2):213-8, 2016
                                                                              4. Gellert LL et al: The diagnostic accuracy of percutaneous renal needle core biopsy and its potential impact on the clinical management of renal cortical neoplasms. Arch Pathol Lab Med. 138(12):1673-9, 2014
                                                                              5. Marshall D et al: The changing face of percutaneous image-guided biopsy: molecular profiling and genomic analysis in current practice. J Vasc Interv Radiol. 24(8):1094-103, 2013
                                                                              6. Winokur RS et al: Percutaneous lung biopsy: technique, efficacy, and complications. Semin Intervent Radiol. 30(2):121-7, 2013
                                                                              7. Lorenz JM: Updates in percutaneous lung biopsy: new indications, techniques and controversies. Semin Intervent Radiol. 29(4):319-24, 2012
                                                                              8. Fassina A et al: Role and accuracy of rapid on-site evaluation of CT-guided fine needle aspiration cytology of lung nodules. Cytopathology. 22(5):306-12, 2011
                                                                              9. Kim GR et al: CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol. 21(2):232-9, 2011
                                                                              10. Atwell TD et al: Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol. 194(3):784-9, 2010
                                                                              11. Gupta S et al: Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol. 21(7):969-75, 2010
                                                                              12. Priola AM et al: Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: a study based on the experience of the cytopathologist. Acta Radiol. 51(5):527-33, 2010
                                                                              13. Gupta S et al: Image-guided percutaneous needle biopsy in cancer diagnosis and staging. Tech Vasc Interv Radiol. 10(2):88-101, 2007
                                                                              14. Dalal T et al: Extraadrenal pheochromocytoma: a rare cause of tachycardia and hypertension during percutaneous biopsy. AJR Am J Roentgenol. 185(2):554-5, 2005
                                                                              15. Gupta S et al: Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations. Radiographics. 24(1):175-89, 2004
                                                                              16. Gupta S: New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol. 27(2):91-104, 2004
                                                                              17. Arellano RS et al: Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications. Curr Probl Diagn Radiol. 32(1):3-10, 2003
                                                                              18. Arellano RS et al: The difficult biopsy: let's make it easier. Curr Probl Diagn Radiol. 32(5):218-26, 2003
                                                                              19. Cardella JF et al: Quality improvement guidelines for image-guided percutaneous biopsy in adults. J Vasc Interv Radiol. 14(9 Pt 2):S227-30, 2003
                                                                              20. Ohno Y et al: CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 180(6):1665-9, 2003
                                                                              21. Titton RL et al: Sonography and sonographically guided fine-needle aspiration biopsy of the thyroid gland: indications and techniques, pearls and pitfalls. AJR Am J Roentgenol. 181(1):267-71, 2003
                                                                              22. Lucey BC et al: Percutaneous nonvascular splenic intervention: a 10-year review. AJR Am J Roentgenol. 179(6):1591-6, 2002
                                                                              23. Ko JP et al: Factors influencing pneumothorax rate at lung biopsy: are dwell time and angle of pleural puncture contributing factors? Radiology. 218(2):491-6, 2001
                                                                              24. O'Neill MJ et al: Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 21(3):657-72, 2001
                                                                              25. Klein JS et al: Transthoracic needle biopsy. Radiol Clin North Am. 38(2):235-66, vii, 2000
                                                                              26. Yang PC: Ultrasound-guided transthoracic biopsy of the chest. Radiol Clin North Am. 38(2):323-43, 2000
                                                                              27. Wood BJ et al: Imaging guided biopsy of renal masses: indications, accuracy and impact on clinical management. J Urol. 161(5):1470-4, 1999
                                                                              28. Boiselle PM et al: Routine addition of an automated biopsy device to fine-needle aspiration of the lung: a prospective assessment. AJR Am J Roentgenol. 169(3):661-6, 1997