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Il Giornale Italiano di Radiologia Medica 2018 Marzo-Aprile;5(2):185-9

DOI: 10.23736/S2283-8376.18.00055-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

The role of contrast-enhanced ultrasound in ultrasound-guided biopsy of soft tissue tumors

Giuseppe RUSSO 1 , Paolo BALOCCO 2, Simona POZZA 2, Paola DE PETRO 2, Alda BORRÈ 2, Alessandra LINARI 3, Michele BOFFANO 4, Armanda DE MARCHI 2

1 Sezione di Diagnostica per Immagini, Dipartimento di Scienze della Salute (DISSAL), IRCCS AOU San Martino-IST, Genova, Italia; 2 Dipartimento di Diagnostica per Immagini, Ospedale C.T.O., AOU Città della Salute e della Scienza, Torino, Italia; 3 Dipartimento di Qualità e Sicurezza dei Percorsi Diagnostici e delle Cure, Ospedale Ostetrico Ginecologico S. Anna, AOU Città della Salute e della Scienza, Torino, Italia; 4 Dipartimento di Ortopedia, Traumatologia e Riabilitazione, Ospedale C.T.O., AOU Città della Salute e della Scienza, Torino, Italia


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BACKGROUND: The aim of this article is to illustrate the role of ultrasound- (US-) -guided biopsy in the treatment of soft tissue tumors, and to show the advantages of contrast-enhanced ultrasound (CEUS) by cases analysis of our center.
METHODS: All patients treated for soft tissue tumors that have undergone US-guided biopsy using CEUS at a national reference center for the treatment of these diseases (C.T.O. Hospital Città della Salute e della Scienza, Turin, Italy) from January 2012 to December 2015 were analyzed. A total of 623 patients were identified. Patients were classified according to the anatomical site of the US-guided biopsy: AS1 (soft tissue of the shoulder, clavicle, humerus, elbow), AS2 (soft tissues of radio, ulna, hand), AI1 (gluteus, thigh, knee), AI2 (soft tissues of tibia, ankle, foot), B (soft tissue of pelvis, sacrum, pubis), R (soft tissues of the spine), SD (soft tissue of scapula and dorsal region), A (abdomen), M (biopsy performed in more than one site) and other (biopsies not included in the above mentioned locations). According to the histological report of the biopsy material, the cases were classified as: benign, malignant, borderline (tumors with benign histology but with aggressive behavior), metastases, non-tumor (inflammatory, necrotic tissue, arteriovenous malformations), non-diagnostic (normal tissue, not evidence of lesion, insufficient material, unsuitable material), other (not classifiable in the previous categories).
RESULTS: A total of 356 US-guided biopsies with CEUS were performed during the period under study at the AI1 anatomical site (57.14%), 37 in AI2 (5.94%), 93 in AS1 (14.93%), 29 in AS2 (4.65%), 39 in B (6.26%), 11 in R (1.77%), 40 in SD (6.42%), 14 in A (2.25%), 2 M (0.32%), and 2 other (0.32%). Of these US-guided biopsies with CEUS 109 are of benign histotype (17.50%), 271 malignant (43.50%), 51 borderline (8.19%), 36 metastases (5.78%), 79 non-diagnostic (12.68%), 74 non-tumor (11.88%), 3 other (0.48%).
CONCLUSIONS: The use of CEUS during ultrasound-guided biopsy of soft tissue tumors allows to obtain biopsy material that is suitable for histopathological diagnosis in 87.32%. A certain histopathological diagnosis avoids the use of surgical biopsy and allows a correct therapeutic planning.


KEY WORDS: Contrast media - Ultrasonography - Image-guided biopsy - Soft tissue neoplasms

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