Computed tomography-guided needle biopsy of head and neck lesions

Objective: To evaluate the diagnostic efficacy of computed tomography (CT)- guided needle biopsies of head and neck lesions. Design: All CT-guided needle biopsies of head and neck lesions performed be tween September 1994 and February 1999 were included. Cytopathologic and hi stologic records, along with patient clinical records, were reviewed. Setting: A tertiary care medical center. Patients: Patients referred for evaluation of lesions inaccessible to routi ne methods of needle biopsy. Results: Thirty-seven patients underwent 42 CT-guided biopsies. There were included 12 lesions in or adjacent to the skull base and 9 lesions around t he pharyngoesophageal or laryngotracheal complex; the other lesions were lo cated in the deep lobe of the parotid gland (n = 7), deep neck area (n = 12 ), and thyroid gland (n = 2). Diagnostic cytologic biopsy specimens were ob tained in 38 (91%) of 42 needle biopsy procedures. The results were support ed histologically and/or clinically in 36 cases (95%). Eighteen patients un derwent open surgical procedures. Histologic confirmation was found in 86% of cases. Nineteen patients (51%) avoided an open surgical procedure: 11 wi th benign, disease and 8 with recurrent malignancy. There were no false-pos itive or false-negative results, and no complications were identified. Conclusions: Computed tomography-guided needle biopsy is a safe and reliabl e minimally invasive technique for the diagnosis of poorly accessible or de ep-seated lesions of the head and neck. Diagnostic needle biopsies allow im proved preoperative planning and patient counseling in surgical patients an d avoidance of open surgical procedures in patients with benign disease or recurrent malignant neoplasms.