Comprehensive Cytopathology: Expert Consult: Online by Marluce Bibbo & David Wilbur

Author:Marluce Bibbo & David Wilbur [Bibbo, Marluce]
Language: eng
Format: azw3
ISBN: 9780323265768
Publisher: Elsevier Health Sciences
Published: 2014-09-04T16:00:00+00:00

21

Imaging Techniques

Christopher R.B. Merritt

Contents

Introduction

Imaging Methods

Conventional Radiography and Fluoroscopy

Computed Tomography

Magnetic Resonance

Ultrasound

Positron Emission Tomography/Image Fusion

Complications of Image-guided FNAB

Image-guided FNAB of Specific Organs

Thyroid, Peripheral Lymph Nodes, Salivary Gland, and Superficial Soft Tissue Masses

Breast

Lungs and Pleura

Mediastinum

Abdominal and Pelvic Organs

Concluding Remarks

Introduction

Although modern imaging and laboratory methods permit precise identification of the presence and location of disease throughout the body, cytologic or histologic examination of tissue remains an essential step in establishing a definitive diagnosis and in planning patient management. Tissue sampling by excision or biopsy, coupled with modern methods of tissue processing and examination for specific immunohistochemical markers, plays an important role in the differentiation of benign and malignant disease, and in optimizing therapy for malignancy. The widespread availability of modern imaging equipment has given rise to the adoption of minimally invasive diagnosis of pathology, using the combined skills of the imager, interventionalist, and cytopathologist. Image-guided fine-needle aspiration biopsy (FNAB) can be quickly accomplished with minimal risk and discomfort, avoiding more invasive, risky, and costly procedures for definitive diagnosis.

Image-guided FNAB ideally involves the active participation of a cytopathologist to evaluate the adequacy of specimens as they are obtained. This assures that sufficient cells for diagnosis are obtained with the minimum number of samples, reducing patient risk and discomfort and the inconvenience and anxiety of returning for additional samples if the initial attempts are unsuccessful.

Indications for image-guided percutaneous needle biopsy include, but are not limited to, the following:

1. To establish the benign or malignant nature of a lesion

2. To obtain material for microbiologic analysis in patients with known or suspected infections

3. To stage patients with known or suspected malignancy when local spread or distant metastasis is suspected

4. To determine the nature and extent of certain diffuse parenchymal diseases.

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