EFFICACY OF SONOGRAPHY AS A GUIDANCE TECHNIQUE FOR BIOPSY OF ABDOMINAL, PELVIC, AND RETROPERITONEAL LYMPH-NODES

OBJECTIVE. In the United States, CT is generally considered the guidan ce technique of choice for biopsy of abdominal, pelvic, and retroperit oneal lymph nodes. The aim of this study was to evaluate the efficacy of sonography for this purpose. SUBJECTS AND METHODS. We attempted 26 sonographically guided biopsies of five abdominal, six pelvic, and 12 retroperitoneal lymph nodes in 23 patients. The patients included 19 w omen and four men who were 26-76 years old (mean, 50 years old). The n odes were less than 2 cm in 16 patients, 2-3 cm in four patients, and greater than 3 cm in three patients. Biopsies were considered successf ul if the nodes could be visualized and biopsied using sonographic gui dance and the pathologist's final report indicated that the tissue spe cimens obtained were adequate for diagnosis. The length of the procedu res and the number of complications were recorded. RESULTS. Lymph bode s were visualized and biopsied with sonographic guidance in 23 (88%) o f the 26 attempts. Three biopsies could not be performed with sonograp hy because of poor visualization of the nodes. Adequate tissue for cyt ologic or histologic evaluation was obtained in 21 (91%) of the 23 son ographically guided procedures. In the 21 successful procedures, clini cal and imaging follow-up showed no evidence of false-negative diagnos es. The time from the placement of the patient in the interventional s onography room to completion of the procedure ranged from 25 to 60 min (mean, 35 min) for sonographically guided biopsies. We had no procedu re-related complications. CONCLUSION. Sonography is an accurate and sa fe guidance technique for lymph node biopsies in the abdomen, pelvis, and retroperitoneum. This technique is efficacious for deep nodes as s mall as 1 cm in diameter. The advantages of sonography over CT include no need for ionizing radiation, portability, shorter procedure time, and real-time visualization of the needle throughout the procedure. Th ese advantages, and the fact that sonography costs less than CT, sugge st that sonography is a more appropriate guidance technique in this er a of cost containment.