CT-GUIDED CORE-NEEDLE BIOPSY IN OMENTAL PATHOLOGY

Purpose: To assess the accuracy and clinical usefulness of CT-guided c ore-needle biopsy in the diagnosis of omental pathology. Material and Methods: We retrospectively reviewed the results of CT-guided percutan eous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) o mental pathology. These results were compared to the final diagnoses a s determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscop ic biopsy (n=1), or by the results of percutaneous biopsy and clinical -radiological and bacteriological modalities (n=6). The final diagnose s showed 4 patients with isolated omental pathology and 21 with widesp read peritoneal involvement. The CT-guided biopsies were performed wit h 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 cytolo gical (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; t he specimen was insufficient for diagnosis in 1 case. In differentiati ng benign from malignant disease, CT-guided biopsy showed a sensitivit y, specificity and accuracy of respectively 89.5%, 100% and 92%. It ga ve a specific diagnosis in 78.9% (15/19) of patients with malignant co nditions and in 50% (3/6) of patients with benign disorders. There wer e no biopsy-related complications. Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurat e procedure for diagnosing malignant omental pathology.