Core Biopsy with Curved Needle Technique
Ajay K. Singh1,2,
Joshua Leeman1,
Sridhar Shankar1 and
Joseph T. Ferrucci1
1 Department of Radiology, University of Massachusetts Memorial Medical Center,
Worcester, MA.
2 Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Boston,
MA 02114.
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Fig. 1A —Curved needle biopsy technique. Schematic shows curved core
biopsy needle (arrowhead) passing through coaxial needle into oval
target. Coaxial needle is suboptimally positioned at edge of lesion. Straight
needle biopsy through this coaxial needle would have resulted in suboptimal
tissue sampling.
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Fig. 1B —Curved needle biopsy technique. Schematic shows firing of
biopsy gun resulting in straightening of inner core needle. Configuration of
targeted lesion changes as curved core biopsy needle (arrows)
straightens.
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Fig. 2A —64-year-old man undergoing curved core needle biopsy of lymph
node metastatic lesion from renal cell carcinoma. Unenhanced axial CT scan
shows tip of coaxial core needle (curved arrow) placed through
paravertebral access adjacent to enlarged retrocaval lymph node (straight
arrow). Straight needle biopsy through this position of coaxial needle
would have missed lymph node.
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Fig. 2B —64-year-old man undergoing curved core needle biopsy of lymph
node metastatic lesion from renal cell carcinoma. Unenhanced axial CT scan
shows curved core biopsy needle (arrowhead) passing through coaxial
needle into retrocaval lymph node for acquisition of core biopsy sample.
Primary renal cell carcinoma (arrow) also was biopsied.
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Fig. 3 —47-year-old woman undergoing curved core needle biopsy of
thick-walled renal cortical cyst. Unenhanced axial CT scan shows oblique entry
of curved core biopsy needle (arrowhead) into wall of thick-walled
cyst, resulting in larger core of tissue than with right-angle entry of
straight core biopsy needle. Final diagnosis was chronic inflammation with
fibrosis and no evidence of malignancy.
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Fig. 4A —40-year-old woman undergoing curved core needle biopsy of
large pelvic lymph node mass. Unenhanced axial CT scan shows coaxial needle in
right pelvic mass (arrow) through which curved needle has been passed
for acquisition of tissue sample from posterior aspect of mass.
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Fig. 4B —40-year-old woman undergoing curved core needle biopsy of
large pelvic lymph node mass. Unenhanced axial CT scan shows curved needle
obtaining sample of more anterior aspect of right pelvic lymph nodal mass
(arrow) than in A. No repositioning of coaxial needle was
needed to obtain samples from geographically different parts of lymph node
mass secondary to lymphoma.
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Fig. 5A —82-year-old woman undergoing curved core needle biopsy of
non–small cell cancer of right upper lobe. Unenhanced axial CT scan
shows coaxial needle (curved arrow) anterior to right upper lobe
nodule (straight arrow).
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Fig. 5B —82-year-old woman undergoing curved core needle biopsy of
non–small cell cancer of right upper lobe. Unenhanced axial CT scan
obtained during procedure shows curved core biopsy needle (arrowhead)
entering central portion of nodule.
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Fig. 6 —56-year-old woman undergoing curved needle biopsy of benign
focal pleural thickening. Unenhanced axial CT scan shows curvature of core
biopsy needle (arrowhead) along long axis of focal pleural thickening
(arrow), resulting in sampling of lesion without puncture of lung
parenchyma. Straight needle biopsy through coaxial needle almost definitely
would have caused needle tip to enter adjacent lung parenchyma.
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Copyright © 2008 by the American Roentgen Ray Society.
