Effectiveness and safety of image-directed biopsies: Coaxial technique versus conventional fine-needle aspiration

Background. We compared the effectiveness and safety of image-guided biopsies done with coaxial guides versus fine-needle aspiration done without coaxial guides. Methods. With the use of hospital computer records and chart reviews, all image-guided biopsies done during a 4-year period at our institution were assessed for adequacy and complications. For each biopsy, the use of a coaxial guide, the site, and the imaging modality were recorded. Adequacy of the biopsy and complications were compiled. Success rates were calculated for conventional and coaxial biopsies and by modality and site. Results. Coaxial technique reduced the number of unsatisfactory biopsies compared with conventional technique in extrathoracic sites. The decrease was statistically significant. No major complications occurred from extrathoracic biopsies with either technique. No difference was found in success rates or complication rates between ultrasound-guided and CT-guided biopsies using coaxial technique. Conclusion. Coaxial technique reduces the number of inadequate biopsies in extrathoracic sites, without a detectable increase in complications.