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Sonographically Guided Biopsy of Focal Lesions: A Comparison of Freehand and Probe-Guided Techniques Using a Phantom

Pramit M. Phal1, Duncan M. Brooks1 and Rory Wolfe2

1 Department of Radiology, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, Melbourne, Victoria 3084, Australia.
2 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.



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  		Fig. 1. —Sonogram of phantom shows stuffed olive appearing as target lesion with hypoechoic center (arrows). Coffee stirrers ("ribs," arrow) are echogenic with posterior shadowing.

 


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  		Fig. 2. —Sagittal CT scan of phantom shows olive deep in relation to layer with ribs. Olives were at a mean depth of 38 mm below surface. Depth of phantom is 80 mm.

 


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  		Fig. 3. —Photograph shows needle and probe are aligned manually for freehand method of biopsy.

 


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  		Fig. 4. —Sonogram of phantom shows echogenic needle (top arrow) approaching target (bottom arrow).

 


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  		Fig. 5. —Photograph shows operator using probe-guided method. Needle guide is fixed to ultrasound probe and keeps the needle within plane of sonographic image as it is advanced toward biopsy target.

 


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  		Fig. 6. —Sonogram of phantom shows guide lines (arrows) that are displayed on sonography screen to show the path of the needle. Echogenic needle tip is in olive.

 


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  		Fig. 7. —Graph shows ratio of probe-guide time to freehand time plotted against time averaged over probe-guided and freehand techniques for all 80 targets. Horizontal line indicates a ratio of 1—that is, equal time for freehand and probe-guided techniques. Points below line are targets for which operator was quicker using probe guide, and points above line are targets for which operator was quicker using freehand method.

 

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