Which imaging modalities should be used to guide biopsy of suspected synovial sarcoma?

Updated: Mar 02, 2019
  • Author: Michael J Duh, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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The choice of the imaging modality for biopsy guidance depends on the availability of the equipment, the expertise of the radiologist, and the characteristics of the lesion. CT scanning guidance is optimal for the biopsy of small lesions or those lesions that are near neurovascular bundles or other critical structures. Fluoroscopy is a real-time imaging modality that can be used for the biopsy of larger lesions that are easily seen on 2-dimensional radiographs. Ultrasonography can be used in select cases in which the lesion is more superficial and easily visible on real-time images. [21, 22, 23]

The advantages of ultrasonography over CT scanning include the following: (1) continuous real-time visualization of the needle, (2) the ability to assess regions of viable tissue by using color-flow Doppler imaging, (3) the lack of ionizing radiation, (4) the availability of ultrasound scanners, (5) the reduced procedural time, and (6) overall cost-effectiveness. In some cases in which the tumor is not easily seen on CT scans or in which visualization of the tumor in several planes is desired, MRI-guided biopsy can be performed. [21, 22, 23]

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