Page 36 - textbook5chapters
P. 36
126 Ultrasonography in Gynaecological Cancers
Figure 13. Performance of ultrasound guided tru-cut biopsy. Specimen from a biopsy (A). Disposable endocavitary needle guide
is attached to the endovaginal probe, the bioptic needle is inserted in an automatic gun device (B). Disposable needle guide for
transabdominal approach is attached on the lateral edge of transabdominal probe, the bioptic needle is inserted in an automatic gun
device (C).
Ultrasound guided tru-cut biopsy can be performed References
transvaginally, transrectally and/or transabdominally
(Figure 13). The procedure can be done in one session 1. Kaijser J, Vandecaveye V, Deroose CM, Rockall A,
after completion of ultrasound staging, because it Thomassin-Naggara I, Bourne T, Timmerman D. Imaging
does not require any special preparation of the patient techniques for the pre-surgical diagnosis of adnexal
or fasting. It is only necessary to exclude a higher risk tumours. Best practice & research Clinical obstetrics &
of bleeding (the level of platelets >10 x 109/l, INR gynaecology. 2014;28(5):683-95.
[International Normalized Ratio] <1.4). The biopsy is
performed on an outpatient basis and without general 2. Fischerova D, Burgetova A. Imaging techniques for the
anesthesia. The result in most cases is available within 48 evaluation of ovarian cancer. Best practice & research
hours after the procedure. Ultrasound guidance allows us Clinical obstetrics & gynaecology. 2014;28(5):697-720.
to obtain samples which are 95% adequate for histological
processing. Histological examination of the biopsy is 3. Epstein E, Blomqvist L. Imaging in endometrial cancer.
accurate in 98% of cases. The risk of complications Best practice & research Clinical obstetrics & gynaecology.
(bleeding from the lesion after biopsy which required 2014;28(5):721-39.
surgical revisions) is less than 1% (6, 7).
4. Testa AC, Di Legge A, De Blasis I, Moruzzi MC, Bonatti M,
Conclusion Collarino A, et al. Imaging techniques for the evaluation of
cervical cancer. Best practice & research Clinical obstetrics
Ultrasound is a reliable imaging modality, which is & gynaecology. 2014;28(5):741-68.
commonly available, non-invasive, inexpensive, and
free of risk for the patient. Results of a numerous 5. Testa AC, Di Legge A, Virgilio B, Bonatti M, Manfredi R,
studies published within the last five years, including Mirk P, et al. Which imaging technique should we use in
international multicenter trials, show that ultrasound the follow up of gynaecological cancer? Best practice &
is an accurate procedure in diagnostics and clinical research Clinical obstetrics & gynaecology. 2014;28(5):769-
staging of pelvic gynaecological malignancies. Its role in 91.
gynaecological oncology should be broadly reconsidered
and financial and logistic resources should be allocated 6. Fischerova D, Cibula D, Dundr P, Zikan M, Calda P,
for the training of future experts. Freitag P, et al. Ultrasound-guided tru-cut biopsy in
the management of advanced abdomino-pelvic tumors.
Acknowledgements International journal of gynecological cancer: official
journal of the International Gynecological Cancer Society.
This work was supported by the Internal Grant Agency of 2008;18(4):833-7.
the Ministry of Health (grant NT 13070), by the research
project RVO-VFN64165, and by Charles University in 7. Zikan M, Fischerova D, Pinkavova I, Dundr P, Cibula
Prague (UNCE 204024 and PRVOUK-P27/LF1/1). Many D. Ultrasound-guided tru-cut biopsy of abdominal and
thanks to Adam Preisler from the Faculty of Architecture, pelvic tumors in gynecology. Ultrasound in obstetrics
Czech Technical University in Prague, for providing the & gynecology: the official journal of the International
illustrations and tables. Society of Ultrasound in Obstetrics and Gynecology.
2010;36(6):767-72.
8. Timmerman D, Van Calster B, Testa AC, Guerriero S,
Fischerova D, Lissoni AA, et al. Ovarian cancer prediction in
adnexal masses using ultrasound-based logistic regression
models: a temporal and external validation study by the
IOTA group. Ultrasound in obstetrics & gynecology: the
official journal of the International Society of Ultrasound
in Obstetrics and Gynecology. 2010;36(2):226-34.
