Real time 3D (4D) ultrasound-guided percutaneous biopsy of solid tumours

Purpose: The aim of the current study was to investigate the feasibility of real-time 3D (4D) ultrasound-guided biopsy. Materials and Methods: Between 2003 and 2005, 53 patients with suspicious lymph nodes or solid tumours under-went 4D ultrasoundguided core needle biopsy using a 4D US-System (Voluson 730, GE/Kretztechnik, Austria). The results were documented prospectively and compared to a matched series of 53 conventional 2D ultrasound-guided core biopsies. Results: 4D ultrasoundguided biopsy can be performed using multiplanar views or a combination of cross-sectional and rendered images. Assessment of additional 3D images during the biopsy procedure was helpful in 34% of the cases. in the differentiation of malignant and benign lesions, 4D ultrasound guided biopsy yielded 35 true-positive results, 12 true-negative results and 5 false-negative results. The sensitivity and specificity for the diagnosis of malignancy was 87.5% and 94.4%, respectively (control group: 89.5% and 94.4%). There was one case of insufficient tissue sampling in the 4D targeting group and 2 cases in the control group. No complications were observed related to the biopsy procedure. Conclusions: 4D ultrasound-guided biopsy is feasible and can improve visualisation of biopsy procedures by multiplanar display or 3D rendering. Although the accuracy is comparable to that of conventional 2D biopsy, this technique may be helpful for biopsy of lesions with close relation to relevant anatomical structures.