Contrast-enhanced ultrasonography guided core needle biopsy of soft tissue tumors: a retrospective study

Einleitung und Fragestellung In patients with soft tissue tumors (STT), treatment planning depends on tumor entity. Core needle biopsy (CNB) is the diagnostic standard. Contrast-enhanced ultrasonography (CEUS) has provided promising results but is still not widely used in the evaluation of STT, especially when located in the abdomen or retroperitoneum. The purpose of this study was to evaluate the role of CEUS in diagnosing STT.

Material und Methodik This is a retrospective study of 25 patients (12 males and 13 females) subjected to CEUS-guided CNB treated from Dec 2021 to Dec 2022 at the Sarcoma Center of the University Medical Center Goettingen. US and CEUS were performed with the Logiq S8 XDClear (GE, USA) and using sulfur hexafluoride microbubbles (SonoVue, Bracco, Italy) as contrast medium. The masses biopsied were located in the abdomen (n=1), abdomen+retroperitoneum (n=1), retroperitoneum (n=3), retroperitoneum+upper leg (n=1), upper leg (n=10), groin (n=1), neck (n=1), upper arm (n=1), back (n=2), shoulder (n=1), thorax (n=2) and lower leg (n=1).

Ergebnisse The patients` age ranged from 23 to 87 years. Accuracy of US-guided CNB after CEUS was determined by comparing the histology of the biopsy with the definitive diagnosis in 14 surgically resected samples. In these samples the histopathological diagnosis as well the grading classification correlated in 100% concordance with a sensitivity and specificity of 100%. The median tumor volume calculated by US was 204,6 cm³. Correlating the dignity with the tumor size, a cut off value higher than 206,40 cm³ turned out to be associated with malignancy (p=0,000387). No peri- or postinterventional complications occurred.

Zusammenfassung CEUS-guided CNB is safe and has proven to be a promising method in guiding bioptic sampling of STT, directing the needle to the most significant areas of the tumor. Sensitivity and specificity are extremely high in determining the histopathological diagnosis. This study evaluates to our best knowledge for the first time the role of CEUS in STT located in the abdomen and retroperitoneum.

Publication History

Article published online:
29 August 2023