The value of contrast-enhanced ultrasound in percutaneous biopsy of retroperitoneal masses

Ehsan Safai Zadeh; Mathis Görg; Christian Görg; Helmut Prosch; Corinna Trenker; Christina Carolin Westhoff; Christoph F. Dietrich; Nils Raab; Amjad Alhyari; Katharina Huber; Svitlana Pochepnia; Michael Weber; Hajo Findeisen

doi:10.1055/a-2282-2353

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

CC BY-NC-ND 4.0 · Ultraschall Med 2025; 46(01): 66-72
DOI: 10.1055/a-2282-2353

Original Article

The value of contrast-enhanced ultrasound in percutaneous biopsy of retroperitoneal masses

Der Stellenwert des kontrastverstärkten Ultraschalls bei der perkutanen Biopsie retroperitonealer Raumforderungen

Ehsan Safai Zadeh

¹Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria (Ringgold ID: RIN27271)

²Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany (Ringgold ID: RIN61061)

,

Mathis Görg

²Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany (Ringgold ID: RIN61061)

,

Christian Görg

²Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany (Ringgold ID: RIN61061)

,

Helmut Prosch

¹Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria (Ringgold ID: RIN27271)

,

Corinna Trenker

³Haematology, Oncology and Immunology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany (Ringgold ID: RIN61061)

,

Christina Carolin Westhoff

⁴Institute of Pathology, University Hospital of Giessen and Marburg, Campus Marburg, Philipps-University of Marburg, Marburg, Germany

,

Christoph F. Dietrich

⁵Department General Internal Medicine, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland

,

Nils Raab

⁶General internal medicine and gastroenterology, Westmecklenburg Klinikum Helene von Bulow GmbH, Ludwigslust, Germany (Ringgold ID: RIN543192)

,

Amjad Alhyari

²Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Giessen and Marburg Campus Marburg, Marburg, Germany (Ringgold ID: RIN61061)

,

Katharina Huber

⁷Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany

,

Svitlana Pochepnia

¹Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria (Ringgold ID: RIN27271)

,

Michael Weber

¹Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria (Ringgold ID: RIN27271)

,

Hajo Findeisen

⁸Department for Internal Medicine, Red Cross Hospital Bremen, Bremen, Germany (Ringgold ID: RIN39539)

› Author Affiliations

Abstract

Purpose To evaluate the diagnostic yield of contrast-enhanced ultrasound (CEUS)-guided biopsy of retroperitoneal masses (RMs).

Materials and Methods Between 2006 and 2023, 87 patients presented at our US center for biopsy of an RM. In all biopsies, CEUS was performed prior to the intervention. The technical success rate of biopsy, the presence of diagnostic tissue in solid tumor biopsy samples, the accuracy of the biopsy and the occurrence of post-interventional complications were evaluated.

Results A US-guided biopsy could be conducted in 84/87 cases (96.6%). In 3/87 cases (3.4%), US-guided biopsy was impossible because the planned needle path was obstructed by vital structures. Of 84 lesions, 80 (95.2%) were solid lesions, and 4 (4.8%) were lesions containing fluid. In all solid tumors, 80/80 (100%), diagnostic vital tissue was successfully obtained. CEUS-guided biopsy showed a sensitivity of 93.2%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 72.2%, and a diagnostic accuracy of 94.2% for the differentiation between malignant and benign RMs. In one of the 84 cases (1.2%), there was a complication of postinterventional abdominal pain.

Conclusion Percutaneous CEUS-guided biopsy is a safe procedure with a high diagnostic yield and a low complication rate.

Zusammenfassung

Ziel Evaluierung des diagnostischen Stellenwerts der CEUS-geführten Biopsie (CEUS: kontrastverstärkter Ultraschall) von retroperitonealen Massen (RMs).

Material und Methoden Zwischen 2006 und 2023 stellten sich 87 Patienten in unserem Ultraschallzentrum zur Biopsie einer RM vor. Bei allen Biopsien wurde vor dem Eingriff eine CEUS durchgeführt. Die technische Erfolgsrate der Biopsie, das Vorhandensein diagnostisch vitalen Gewebes in den Biopsieproben bei soliden Tumoren, die Treffsicherheit der Biopsie und das Auftreten von Komplikationen nach der Intervention wurden evaluiert.

Ergebnisse Eine ultraschallgeführte Biopsie konnte in 84 von 87 Fällen (96,6%) durchgeführt werden. In 3 von 87 Fällen (3,4%) war eine ultraschallgeführte Biopsie aufgrund von vorgelagerten lebenswichtigen Strukturen auf dem geplanten Punktionsweg nicht möglich. Von 84 Läsionen waren 80 (95,2%) solide Läsionen und 4 (4,8%) flüssigkeitsgefüllte Läsionen. Bei allen soliden Tumoren (80/80; 100%) wurde erfolgreich diagnostisch vitales Gewebe gewonnen. Die CEUS-geführte Biopsie zeigte eine Sensitivität von 93,2%, eine Spezifität von 100%, einen positiven prädiktiven Wert von 100%, einen negativen prädiktiven Wert von 72,2% und eine diagnostische Treffsicherheit von 94,2% für die Unterscheidung zwischen malignen und benignen RMs. In einem Fall (1,2%) kam es zu einer Komplikation in Form von postinterventionellen abdominellen Schmerzen.

Schlussfolgerung Die perkutane CEUS-geführte Biopsie stellt ein sicheres Verfahren dar – mit hoher diagnostischer Treffsicherheit und geringer Komplikationsrate.

Keywords

ultrasound - retroperitoneal masses - CEUS - biopsy - intervention

Full Text

References

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