This study's aim is to review Gosford Hospital’s interventional radiology (IR) department's imaging-guided percutaneous needle biopsy diagnostic rate and determine factors contributing to diagnostic yield.

We retrospectively collated and analysed all ultrasound (US) and computed tomography (CT) guided percutaneous core needle biopsies and fine needle aspirations (FNA) performed by Gosford Hospital's IR department over a 7 month period from November 2020 to June 2021 through reviewing the department's RIS-PACS system. Specimen adequacy and final diagnosis were deterimined based on review of histopathological and cytological analysis reports.Work-up imaging, planning imaging, procedural reports and pathology reports of non-diagnostic biopsies were reviewed to identify factors that may have contributed to the outcome.

The review identified a total of 106 biopsies during the 7 month period. Of these, 8 (7.5%) were non-diagnostic, leading to a diagnostic yield of 92.5%. Of the non-diagnostic biopsies, there were: 4 lymph nodes, 1 lung, 1 mediastinal mass, 1 thyroid and 1 bone biopsy. Based on review of the pathology reports, non-diagnostic biopsies were the result of either inadequate sample amount (3 cases) or biopsy of surrounding normal tissues i.e., missed biopsies (5 cases). Although there were inconsistencies in documentation and limited sample...

Our institution's diagnostic yield is 92.5%, which is similar to other institutions [1, 2]. Most factors found to contribute towards a non-diagnostic biopsy were due to lesion characteristics, such as small lesions (Fig. 1, 2 and 3), mobile lesions (Fig. 2), lesions that were difficult to localise (Fig. 1 and 3) or lesions that were in difficult places to access (Fig. 4). At the current time, there are limited means to address the lesion characteristics itself. However, technical and equipment factors may be modified to...

1. Loh SE, Wu DD, Venkatesh SK et al. CT-guided thoracic biopsy: Evaluating diagnostic yield and complications. Ann. Acad. Med. Singap. 2013; 42(6):285-90. 2. Beland MD, Mayo-Smith WW, Dupuy DE, Cronan JJ, DeLellis RA. Diagnostic yield of 58 consecutive imaging-guided biopsies of solid renal masses: Should we biopsy all that are indeterminate? AJR Am. J. Roentgenol. 2007; 188: 792-797.