Skip to main content
SpringerLink
Log in

Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Tissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.

Methods

All consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.

Results

Sixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.

Conclusions

The use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E (2010) Cancer statistics. CA Cancer J Clin 60(5):277–300

    Article  PubMed  Google Scholar 

  2. Debnam JM, Guha-Thakurta N (2012) Retropharyngeal and prevertebral spaces: anatomic imaging and diagnosis. Otolaryngol Clin North Am 45(6):1293–1310

    Article  PubMed Central  PubMed  Google Scholar 

  3. Gupta S, Madoff DC (2007) Image-guided percutaneous needle biopsy in cancer diagnosis and staging. Tech Vasc Interv Radiol 10(2):88–101

    Article  PubMed  Google Scholar 

  4. Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, Boyle P (2008) Tobacco smoking and cancer: a meta-analysis. Int J Cancer 122(1):155–164

    Article  CAS  PubMed  Google Scholar 

  5. Hashibe M, Brennan P, Benhamou S et al (2007) Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. J Natl Cancer Inst 99(10):777–789

    Article  PubMed  Google Scholar 

  6. Abemayor E, Ljung BM, Ward PH, Larsson S, Hanafee W (1985) CT directed fine needle aspiration biopsies of masses in the head and neck. Laryngoscope 95(11):1382–1386

    Article  CAS  PubMed  Google Scholar 

  7. DelGaudio JM, Dillard DG, Albritton FD, Hudgins P, Wallace VC, Lewis MM (2000) Computed tomography-guided needle biopsy of head and neck lesions. Arch Otolaryngol Head Neck Surg 126(3):366–370

    Article  CAS  PubMed  Google Scholar 

  8. Sack MJ, Weber RS, Weinstein GS, Chalian AA, Nisenbaum HL, Yousem DM (1998) Image-guided fine-needle aspiration of the head and neck: five years’ experience. Arch Otolaryngol Head Neck Surg 124(10):1155–1161

    Article  CAS  PubMed  Google Scholar 

  9. Sherman PM, Yousem DM, Loevner LA (2004) CT-guided aspirations in the head and neck: assessment of the first 216 cases. AJNR Am J Neuroradiol 25(9):1603–1607

    PubMed  Google Scholar 

  10. Gibson MK, Forastiere AA (2004) Multidisciplinary approaches in the management of advanced head and neck tumors: state of the art. Curr Opin Oncol 16(3):220–224

    Article  PubMed  Google Scholar 

  11. Chin D, Boyle GM, Porceddu S, Theile DR, Parsons PG, Coman WB (2006) Head and neck cancer: past, present and future. Expert Rev Anticancer Ther 6(7):1111–1118

    Article  PubMed  Google Scholar 

  12. Bradford CR (2013) The care of the head and neck cancer patient is a team sport. JAMA Otolaryngol Head Neck Surg 139(4):337–339

    Article  PubMed  Google Scholar 

  13. Gupta S, Henningsen JA, Wallace MJ et al (2007) Percutaneous biopsy of head and neck lesions with CT guidance: various approaches and relevant anatomic and technical considerations. Radiographics 27(2):371–390

    Article  PubMed  Google Scholar 

  14. Kobayashi K, Bhargava P, Raja S, Nasseri F, Al-Balas HA, Smith DD, George SP, Vij MS (2012) Image-guided biopsy: what the interventional radiologist needs to know about PET/CT. Radiographics 32(5):1483–1501

    Article  PubMed  Google Scholar 

  15. Klaeser B, Mueller MD, Schmid RA, Guevara C, Krause T, Wiskirchen J (2009) PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences. Eur Radiol 19(7):1780–1785

    Article  PubMed  Google Scholar 

  16. Bluman LG, Mosca L, Newman N, Simon DG (1998) Preoperative smoking habits and postoperative pulmonary complications. Chest 113(4):883–889

    Article  CAS  PubMed  Google Scholar 

  17. Hawn MT, Houston TK, Campagna EJ, Graham LA, Singh J, Bishop M, Henderson WG (2011) The attributable risk of smoking on surgical complications. Ann Surg 254(6):914–920

    Article  PubMed  Google Scholar 

  18. Jones R, Nyawo B, Jamieson S, Clark S (2011) Current smoking predicts increased operative mortality and morbidity after cardiac surgery in the elderly. Interact CardioVasc Thorac Surg 12(3):449–453

    Article  PubMed  Google Scholar 

  19. Sakuma LM, Machado FS, Martins Mde A (2010) Independent association of smoking with postoperative cardiac events and thirty-day mortality. Arq Bras Cardiol 94(5):625–632

    Article  PubMed  Google Scholar 

  20. Gourgiotis S, Aloizos S, Aravosita P, Mystakelli C, Isaia EC, Gakis C, Salemis NS (2011) The effects of tobacco smoking on the incidence and risk of intraoperative and postoperative complications in adults. Surgeon 9(4):225–232

    Article  PubMed  Google Scholar 

  21. Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL (1999) Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology 90(1):42–53

    Article  CAS  PubMed  Google Scholar 

  22. Blot WJ, McLaughlin JK, Winn DM et al (1988) Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 48(11):3282–3287

    CAS  PubMed  Google Scholar 

  23. Hashibe M, Brennan P, Chuang SC et al (2009) Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomark Prev 18(2):541–550

    Article  CAS  Google Scholar 

  24. Thanos L, Mylona S, Kalioras V, Pomoni M, Batakis N (2005) Potentially life-threatening neck abscesses: therapeutic management under ct-guided drainage. Cardiovasc Intervent Radiol 28(2):196–199

    Article  CAS  PubMed  Google Scholar 

  25. Walker AT, Chaloupka JC, Putman CM, Abrahams JJ, Ross DA (1996) Sentinel transoral haemorrhage from a pseudoaneurysm of the internal maxillary artery: a complication of CT-guided biopsy of the masticator space. AJNR Am J Neuroradiol 17(2):377–381

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

All authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland

    Jane D. Cunningham, Mark W. McCusker, Sarah Power, Joanna PearlyTi, John Thornton, Paul Brennan, Michael J. Lee, Alan O’Hare & Seamus Looby

Authors
  1. Jane D. Cunningham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark W. McCusker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarah Power
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joanna PearlyTi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John Thornton
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul Brennan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael J. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alan O’Hare
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seamus Looby
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jane D. Cunningham.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cunningham, J.D., McCusker, M.W., Power, S. et al. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses. Cardiovasc Intervent Radiol 38, 422–429 (2015). https://doi.org/10.1007/s00270-014-0922-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-014-0922-1

Keywords

Search

Navigation