Soft Tissue Sarcoma Biopsy: A Safe, Well-tolerated Technique with a High Diagnostic Yield. A 5-year Review of More Than 800 Cases

Purpose or Learning Objective: To assess the diagnostic yield, accuracy, and complication rate of the ultrasonography (US)-guided core needle biopsy technique for suspected soft tissue sarcomas and review the findings against other published standard practices.

Methods or Background: A retrospective study was performed of consecutive US-guided percutaneous biopsy of suspected soft tissue sarcomas over a 5-year period, with 815 planned procedures in 799 patients (average age: 57.8 years; range: 15–95 years; 54.7% male). Overall diagnostic yield was recorded as positive for a tissue sample that allowed differentiation of benign and malignant lesions. Diagnostic accuracy was recorded as the correlation between the histologic grade on biopsy and the surgical specimen. Documented immediate and late complications were reviewed. The patient procedure experience was recorded via a departmental questionnaire.

Results or Findings: The overall diagnostic yield positive rate was 751 of 778 (96.5%) with no immediate short- or long-term complications. Of 815 planned biopsies, 778 core biopsies were obtained; 708 of 778 cases (91%) had either two or three cores obtained. A 16G biopsy needle was the most commonly used in 81.7% of biopsies with an 18G needle used in 10.3% of cases. Of the 37 biopsy cases where tissue was not obtained, 9 were not performed due to patient factors, and a further 28 could not be obtained for other technical reasons (e.g., the lesion was too hard to penetrate or too painful to core). Twenty-seven of 778 (3.5%) of biopsies were nondiagnostic, and of these 27, 9 patients were followed up clinically, 13 biopsies were repeated, and 5 patients were excised surgically without a further biopsy attempt. US core needle biopsy was concordant with the surgical specimen in 93.4% of those excised.

Conclusion: The described US-guided percutaneous core needle biopsy technique of suspected soft tissue sarcomas demonstrates a high diagnostic yield and low complication rate. The diagnostic yield appears comparable with data published by other institutions with more invasive techniques.

Publication History

Article published online:
02 June 2022