PT  - JOURNAL ARTICLE
AU  - Jordan, R.W.
AU  - Shlapak, D.P.
AU  - Benson, J.C.
AU  - Diehn, F.E.
AU  - Kim, D.K.
AU  - Lehman, V.T.
AU  - Liebo, G.B.
AU  - Madhavan, A.A.
AU  - Morris, J.M.
AU  - Morris, P.P.
AU  - Verdoorn, J.T.
AU  - Carr, C.M.
TI  - Percutaneous CT-Guided Core Needle Biopsies of Head and Neck Masses: Review of 184 Cases at a Single Academic Institution, Common and Special Techniques, Diagnostic Yield, and Safety
AID  - 10.3174/ajnr.A7348
DP  - 2022 Jan 01
TA  - American Journal of Neuroradiology
PG  - 117--124
VI  - 43
IP  - 1
4099  - http://www.ajnr.org/content/43/1/117.short
4100  - http://www.ajnr.org/content/43/1/117.full
SO  - Am. J. Neuroradiol.2022 Jan 01; 43
AB  - BACKGROUND AND PURPOSE: Percutaneous CT-guided core needle biopsies of head and neck lesions can be safely performed with vigilant planning. This largest-to-date single-center retrospective study evaluates multiple approaches with consideration of special techniques and examines the histopathologic yield.MATERIALS AND METHODS: Retrospective review of CT-guided core biopsies of head and neck lesions from January 1, 2010, to October 30, 2020, was performed. We recorded the following: patient demographics, sedation details, biopsy needle type and size, lesion location and size, approach, patient positioning, preprocedural intravenous contrast, proceduralists’ years of experience, complications, and pathology results.RESULTS: One hundred eighty-four CT-guided core biopsies were evaluated. The initial diagnostic yield was 93% (171/184). However, of 43/184 (23%) originally “negative for malignancy” biopsies, 4 were eventually positive for malignancy via rebiopsy/excision, resulting in a 2% false-negative rate and an adjusted total diagnostic yield of 167/184 (91%). Biopsies were performed by 16 neuroradiologists with variable experience. The diagnostic yield was essentially the same: 91% (64/70) for proceduralists with ≤3 years’ experience, and 90% (103/114) with >3 years’ experience. The diagnostic yield was 93% (155/166) for lesions of >10 mm. The diagnostic yield per biopsy needle gauge was the following: 20 ga, 81% (13/16); 18 ga, 93% (70/75); 16 ga, 90% (64/71); and 14 ga, 91% (20/22). There were 4 asymptomatic hematomas, with none requiring intervention.CONCLUSIONS: Percutaneous CT-guided core needle biopsies are safe procedures for superficial and deep head and neck lesions with a high diagnostic yield. Careful planning and special techniques may increase the number of lesions accessible percutaneously while minimizing the risk of complications.CNBcore needle biopsyFNAfine-needle aspirationH&Nhead and neckSCCsquamous cell carcinoma