Percutaneous Image-Guided Biopsy

Percutaneous Image-Guided Biopsy

Kamran Ahrar Sanjay Gupta Editors Percutaneous Image-Guided Biopsy

Editors Kamran Ahrar, MD, FSIR Department of Interventional Radiology Department of Thoracic and Cardiovascular Surgery The University of Texas MD Anderson Cancer Center Houston, TX USA Sanjay Gupta, MD, DNB Department of Interventional Radiology Department of Diagnostic Radiology The University of Texas MD Anderson Cancer Center Houston, TX USA Medical Illustrator David L. Bier The University of Texas MD Anderson Cancer Center ISBN 978-1-4614-8216-1 ISBN 978-1-4614-8217-8 (ebook) DOI 10.1007/978-1-4614-8217-8 Springer New York Heidelberg Dordrecht London Springer Science+Business Media New York 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Preface Percutaneous needle biopsy has largely replaced more invasive surgical methods of tissue sampling. The first image-guided biopsies were performed with fluoroscopic guidance; however, the true era of percutaneous image-guided biopsy was ushered in with the advancement of ultrasound, computed tomography, and magnetic resonance imaging technologies. Imaging guidance allows for precise targeting of lesions, resulting in high accuracy and low complication rates. Traditionally, biopsies were performed to evaluate newly discovered masses or mass-like lesions in order to establish an initial diagnosis of cancer or infection. Biopsies today, in addition to performing a diagnostic function, are commonly obtained for detecting recurrence of metastatic disease and for monitoring response to therapy. Furthermore, in the era of molecular targeted therapy and personalized cancer medicine, accurate subtyping of tumors has necessitated the procurement of larger and more frequent biopsy samples. In the future, image-guided biopsy will likely play an even larger role in drug discovery, assessment of biomarker targets, and evaluation of disease susceptibility. In light of the growing number of indications for targeted tissue acquisition, it will likely become necessary for nearly all practicing radiologists to take part in this important endeavor at some point in their professional career. Percutaneous Image-Guided Biopsy is a textbook and atlas that offers valuable information to every reader. This well-illustrated book was designed to be a practical, easy-to-use learning and state-of-the-art reference tool. Those in radiology training programs or those with limited previous experience in performing image-guided biopsies may read the entire book from cover to cover. Others may read a particular chapter in preparation for a specific upcoming procedure. Even for experienced radiologists, the book can serve as a quick reference to highlight various approaches to specific anatomic sites, list potential complications, and outline management strategies. Nearly all chapters provide detailed review of relevant anatomy with illustrations and an ample number of clinical cases to demonstrate the salient points of each section. We hope that the readers will find this book informative and useful. We wish to express our sincere appreciation to all of the authors for sharing their time, knowledge, and skills in producing this volume, which ultimately attempts to enable every radiologist to perform imageguided biopsies safely and effectively. Houston, TX, USA Houston, TX, USA Kamran Ahrar, MD, FSIR Sanjay Gupta, MD, DNB v

Contents 1 Biopsy Devices and Techniques........................................ 1 Kamran Ahrar and Sanaz Javadi 2 CT-Guided Biopsy................................................... 19 Kamran Ahrar 3 Radiation Protection During CT-Guided Interventions.................... 33 A. Kyle Jones 4 Ultrasound-Guided Biopsy............................................ 39 Judy U. Ahrar and Kamran Ahrar 5 MRI-Guided Biopsy................................................. 49 Kamran Ahrar and R. Jason Stafford 6 Fluoroscopy-Guided Biopsy........................................... 65 Kamran Ahrar 7 Advanced Tools and Devices: Navigation Technologies, Automation, and Robotics in Percutaneous Interventions.................. 73 Aradhana M. Venkatesan and Bradford J. Wood 8 Pathologic Evaluation of Tissues Obtained by Interventional Radiology Techniques................................................ 85 Savitri Krishnamurthy 9 Biopsy of Head and Neck Lesions...................................... 97 Sanjay Gupta 10 Biopsy of Mediastinal Lesions......................................... 119 Sanjay Gupta 11 Percutaneous Transthoracic Lung Biopsy............................... 141 Antonio Gutierrez, Fereidoun Abtin, and Robert D. Suh 12 Pleural Biopsy...................................................... 167 Kamran Ahrar and Sanaz Javadi 13 Liver Biopsy........................................................ 175 Ashraf Thabet and Debra A. Gervais 14 Percutaneous Biopsy of the Pancreas................................... 193 Sanjay Gupta 15 Spleen Biopsy....................................................... 207 Alda Lui Tam 16 Adrenal Gland Biopsy............................................... 213 Alda Lui Tam vii

viii Contents 17 Renal Mass Biopsy.................................................. 227 Kamran Ahrar, Sanaz Javadi, and Judy U. Ahrar 18 Percutaneous and Transjugular Kidney Biopsy........................... 257 Judy U. Ahrar, Sanaz Javadi, and Kamran Ahrar 19 Nodes and Soft Tissue Masses Involving the Retroperitoneum, Mesentery, Omentum, and Peritoneal Ligaments......................... 267 Colette M. Shaw, Bruno C. Odisio, Rony Avritscher, and David C. Madoff 20 Biopsy of Pelvic Lesions.............................................. 281 Efe Ozkan and Sanjay Gupta 21 MRI-Guided Prostate Biopsy.......................................... 297 R. Jason Stafford, Stephen E. McRae, and Kamran Ahrar 22 Biopsy of the Spine.................................................. 313 Sanjay Gupta 23 Anatomic Guidelines and Approaches for Biopsy of the Long Bones......... 335 Sendasaperumal Navakoti Sendos and Sanjay Gupta 24 Musculoskeletal Biopsies: Extremities.................................. 349 David R. Marker and John A. Carrino Index................................................................. 363

Contributors Fereidoun Abtin, MD Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA Judy U. Ahrar, MD Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Kamran Ahrar, MD, FSIR Department of Interventional Radiology, Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Rony Avritscher, MD Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA John A. Carrino, MD, MPH Radiology and Orthopaedic Surgery, Musculoskeletal Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA Debra A. Gervais, MD Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA Sanjay Gupta, MD, DNB Department of Interventional Radiology, Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Antonio Gutierrez, MD Department of Radiological Sciences, David Geffen School of Medicine at UCLA Medical Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA Sanaz Javadi, MD Department of Radiology, Baylor College of Medicine, Houston, TX, USA A. Kyle Jones, PhD Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Savitri Krishnamurthy, MD Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA David C. Madoff, MD Division of Interventional Radiology, Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA David R. Marker, MD The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Baltimore, MD, USA Stephen E. McRae, MD Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA ix

x Contributors Bruno C. Odisio, MD Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Efe Ozkan, MD Department of Radiology, The Ohio State University, Columbus, OH, USA Sendasaperumal Navakoti Sendos, MD Department of Radiology, Memorial Hermann Hospital, Houston, TX, USA Colette M. Shaw, MD Division of Interventional Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA R. Jason Stafford, PhD Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Robert D. Suh, MD Department of Radiological Sciences, David Geffen School of Medicine at UCLA Medical Center, Los Angeles, CA, USA Thoracic Imaging and Intervention, Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA Alda Lui Tam, MD, MBA, FRCPC Department of Interventional Radiology, Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Ashraf Thabet, MD Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA Aradhana M. Venkatesan, MD Department of Radiology and Imaging Sciences and Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD, USA Bradford J. Wood, MD Department of Radiology and Imaging Sciences, Center for Interventional Oncology, Interventional Radiology, NIH Clinical Center, Bethesda, MD, USA