Image-Guided Tumor Biopsies Are Effective Method to Obtain Molecular Screening Samples

Percutaneous image-guided core needle biopsies in tumor >2 cm are safe and effective in obtaining tumour genetic material, according to a study published in the European Journal of Cancer.

The study looked at procedural data recorded prospectively between December 2011 and March 2016 for a total of 877 core biopsies performed for the MOSCATO-01 clinical trial. Data included patient demographics, tumor characteristics, procedural outcomes, and complications.

Tumor locations included the liver (n = 363), lungs (n = 229), lymph nodes (n = 138), bones (n = 15) and other miscellaneous sites (n = 124). Biopsies were performed under computed tomography (38.4%) or ultrasound guidance (61.6%).

A mean of 4.4 samples were harvested from each biopsy. There was an adequate tumor yield for genomic analysis in 95.3% of cases. In 89 cases (10.1%), procedural complications occurred, with minor grade I complications in 59 (66.3%); grade II in 16 (18%) and grade III in 14 (15.7%).

Pneumothorax (51/89, 57.3%), hemorrhage (24/89, 27%), and pain (8/89, 8.9%) were the most common complications. Predictive factors for complications by univariate analysis included biopsied organ (lung vs other), sample number, prone position, lesion size, lesion depth and biopsy approach. By multivariate analysis, only pulmonary biopsy was a significant risk factor (odds ratio = 27.23 [4.93-242.76], P < 0.01).

The authors concluded that percutaneous image-guided core needle biopsies of tumor >2 cm for the acquisition of tumor genetic material is effective and safe with low procedure-associated morbidity.

“An increased number of samples (>4) does not demonstrate an increased procedural risk and can improve the genomic yield. Finally, lung lesions should be avoided when alternative targets are available because of increased procedural risks for pneumothorax and haemorrhage requiring a minimally invasive intervention. Should lung lesions provide the only option for sampling, then adequate tissue sampling is possible and overall risk is low without prolonged sequelae,” the authors said.