CT-guided core-needle biopsy in omental pathology

Our plain-English summary of CT-guided core-needle biopsy in omental pathology, by F. Pombo, E. Rodriguez, R. Martin, et al (Acta Radiologica, 1997).

The study

• Authors: F. Pombo, E. Rodriguez, R. Martin, M. Lago
• Journal: Acta Radiologica
• Published: 1997;38(6):978-81
• Cited by: 36 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology.

Material And Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n = 2) or diffuse (n = 23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n = 15), laparoscopic biopsy (n = 3), endoscopic biopsy (n = 1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n = 6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0-1.8-mm Surecut core-needles.

Results: In 16 patients, the final diagnosis was metastatic adenocarcinoma--with the primary tumor sites in the ovary (n = 3), stomach (n = 1), appendix (n = 2), and unknown (n = 10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n = 16) or cytological (n = 8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications.

Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology.

In plain English

This retrospective study from a radiology department in La Coruña, Spain, looked at CT-guided core-needle biopsies of the omentum, a layer of fatty tissue in the abdomen. It covered 25 patients with omental lesions found between 1988 and 1995. Biopsy results were compared with each patient's final diagnosis. Of the 25 patients, 19 had cancer and 6 had benign disease. One patient's final diagnosis was mesothelioma, and the biopsy identified it specifically. The article does not describe that patient further and does not mention asbestos. The biopsy correctly found cancer in 17 of the 19 patients with cancer (89.5%). All 6 benign cases were correctly read as not cancer. Overall, the biopsy had a sensitivity of 89.5%, a specificity of 100% and an accuracy of 92%. For cancer, accuracy was 100% in biopsies of 'omental cakes' (masses in the omentum) and 83.3% when the omentum looked 'smudged'. No complications were seen. The authors concluded the procedure is safe, useful and highly accurate for diagnosing malignant omental disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: retrospective review of CT-guided percutaneous core-needle biopsies, compared with final diagnoses
• Who was studied: 25 patients (7 men, 18 women; mean age 56.16 years, range 23-84) with omental lesions found between 1988 and 1995, Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain
• Exposure: Not applicable. The study evaluated a biopsy procedure, not asbestos or any other exposure. Asbestos is not mentioned.
• Main results:
  • Of the 25 patients, 19 had a final diagnosis of cancer and 6 of benign disease (tuberculosis in 5, actinomycosis in 1)
  • Enough biopsy material for diagnosis was obtained in 24 of 25 cases (96%)
  • Among the 19 patients with cancer, the biopsy correctly diagnosed cancer in 17 (89.5%) and gave a specific diagnosis in 15. The one patient with mesothelioma was among those given a specific diagnosis.
  • All 6 patients with benign disease had true-negative biopsy results
  • For diagnosing cancer across all 25 patients, sensitivity was 89.5%, specificity 100% and accuracy 92%
  • For cancer, accuracy was 100% in biopsies of omental cakes (all cakes, with no separate figure by thickness) and 83.3% in biopsies of smudged omenta
  • No complications were seen during 24-hour monitoring
• The authors' conclusion: The authors concluded that CT-guided percutaneous core-needle biopsy is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology

Topics

Medical terms in this study, explained in our Lexicon: Needle Biopsy, Pathology, Laparotomy, Biopsy, Adenocarcinoma, Carcinoma, Mesothelioma, Omentum.

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• Surgical biopsy studies of omental and peritoneal nodules — D.B. Walsh, G. Williams (1971)
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• Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma — M. Sperandeo, L. Dimitri, et al. (2014)

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