Ultrasound-Guided Percutaneous Breast Biopsy

Slides:

Advertisements

Similar presentations

POSITIONING TERMINOLOGY

Advertisements

ULTRASOUND GUIDED CENTRAL VENOUS CANNULATION By Dr Sunil Chhajwani (MD. Anaesthesia)

European Journal of Radiology

S. Vaid, N. Vaid, S. Rawat, A.T. Ahuja Clinical Radiology

Sonography of the Breast Part III Lecture 12 Invasive Procedures

Hiroshi Ohuchi, M. D. , Ph. D. , Rolando Junior L. Torres, M. D

Jay Smith, MD, Mark-Friedrich B. Hurdle, MD

Air Pollution and Chest Disease

Navin K. Jain, MD, Thiam H. Lie, MD, FCCP CHEST

Cavitary Lung Disease with Skin Lesions

Transradial-Guided Percutaneous Transaxillary Intra-aortic Balloon Pump Insertion Samual Hayman, MBBS, MSc, FRACP, Shahar Lavi, MD, FRCPC, FACC, Ryan.

James S. Davitt, MD, David L. Rothberg, MD

A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer Ajay Dhakal, MBBS, Hongbin Chen, MD, PhD,

Stereotactic Breast Biopsy: Pitfalls and Pearls

Mammography and Breast Localization for the Interventionalist

Hiroshi Ohuchi, M. D. , Ph. D. , Rolando Junior L. Torres, M. D

Get the Lead off Our Backs!

The Eyes Have It Techniques in Vascular & Interventional Radiology

Hasan Yerli, MD, Secil Yucel Eksioglu, MD

Jay Smith, MD, Mark-Friedrich Hurdle, MD, Adam J

Hiren J. Mehta, MD, Tan-Lucien Mohammed, MD, Michael A. Jantz, MD

Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study C. Luyet, U. Eichenberger, R. Greif, A. Vogt,

Thoracoscopic Lung Volume Reduction Surgery

Breast Ultrasound for the Interventionalist

Jeong Mi Park, MD, Limin Yang, MD, PhD, Archana Laroia, MD, Edmund A

Amanda D. Ingram, MD, Mary C. Mahoney, MD

Richard J. Myung, MD, Michael E. Halkos, MD, John D. Puskas, MD

Biopsy of musculoskeletal tumors

Technologies for Ablation of Hepatocellular Carcinoma

Priscilla J. Slanetz, MD, MPH, FACR, Shieh-Pei Wu, MD, Jeffrey B

Mammography and Breast Localization for the Interventionalist

G. Reusz, P. Sarkany, J. Gal, A. Csomos British Journal of Anaesthesia

Surgical Management of the Infected Sternoclavicular Joint

Mark R. Nehler, MD, W. Andrew Lawrence, MD, Thomas A

Block for uniportal video-assisted thoracoscopic surgery: an ultrasound-guided, single- penetration, double-injection approach Y.-J. Lee, C.-C. Chung,

Breast Anatomy for the Interventionalist

Magnetic Resonance Imaging-guided Breast Biopsies: Tips and Tricks

Robotic Segmentectomy

Avoiding Pitfalls in Mammographic Interpretation

Jeong Mi Park, MD, Limin Yang, MD, PhD, Archana Laroia, MD, Edmund A

Breast Magnetic Resonance Imaging for the Interventionalist: Magnetic Resonance Imaging–Guided Vacuum-Assisted Breast Biopsy Sandra B. Brennan, MD Techniques.

Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model

Priscilla J. Slanetz, MD, MPH, FACR, Shieh-Pei Wu, MD, Jeffrey B

Artificial Pneumothorax With Position Adjustment for Computed Tomography-Guided Percutaneous Core Biopsy of Mediastinum Lesions Zheng-Yu Lin, MD, Yin-Guan.

Mathieu Thaunat, M. D. , Jean Marie Fayard, M. D. , Tales M

Ultrasound-guided infraclavicular brachial plexus block

Ultrasound-Guided Portal Placement for Hip Arthroscopy

Sharma A. , Bodenham A.R. , Mallick A. British Journal of Anaesthesia

Minimally Invasive Quadriceps Tendon Harvest and Graft Preparation for All-Inside Anterior Cruciate Ligament Reconstruction Harris S. Slone, M.D., William.

Volume 142, Issue 6, Pages (December 2012)

Imaging for the Management of Community-Acquired Pneumonia

Endoscopic Proximal Hamstring Repair and Ischial Bursectomy Using Modified Portal Placement and Patient Positioning Jovan R. Laskovski, M.D., Adam J.

Michael C. Maxted, M.D., Adam C. Field, B.S., Larry D. Field, M.D.

Apical axillary thoracotomy

Gray R. Lyons, MD, PhD, Bradley B. Pua, MD, FSIR

Delayed presentation of aortic injury by pedicle screws: Report of two cases and review of the literature Stavros K. Kakkos, MD, MSc, PhD, Alexander.

Jay Smith, MD, Mark-Friedrich B. Hurdle, MD

Volume 151, Issue 4, Pages e81-e84 (April 2017)

Arthroscopy of the Sternoclavicular Joint

Mark R. Nehler, MD, W. Andrew Lawrence, MD, Thomas A

Pierre Imbert, M. D. , Philippe D'Ingrado, M. D. , Maxime Cavalier, M

Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report Ryan J. Warth, M.D., Jared T. Lee, M.D., Kevin.

Ultrasound standard for lumbar plexus block

Bigeleisen P , Wilson M British Journal of Anaesthesia

Vertical Lasso and Horizontal Lasso Sutures for Repair of Horizontal Cleavage and Horizontal Oblique Meniscal Tears: Surgical Technique and Indications

Vertical ramus osteotomy for improved exposure of the distal internal carotid artery: A new technique Peter E. Larsen, DDS, William L. Smead, MD Journal.

Three-step method for ultrasound-guided central vein catheterization

Primary Care Management of Skin Abscesses Guided by Ultrasound

The Supine Position for Shoulder Arthroscopy

Presentation transcript:

Ultrasound-Guided Percutaneous Breast Biopsy Mary S. Newell, MD, Mary C. Mahoney, MD, FACR Techniques in Vascular & Interventional Radiology Volume 17, Issue 1, Pages 23-31 (March 2014) DOI: 10.1053/j.tvir.2013.12.005 Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 1 For lesions in the lateral, superior, or inferior breast, the patient is optimally positioned in the supine oblique position, with arm extended above the head. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 2 For a woman with small breasts, or in male patients, arm may be placed at side, to allow bolstering of breast tissue, increasing breast thickness. This works especially well with medial breast lesions. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 3 The biopsy may proceed with the physician holding both the transducer and the needle (A) or with the technologist scanning as the physician manipulates the needle (B), dependent on personal preference. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 4 For superficial lesions or those with a large buffer of tissue between lesion and chest wall, needle entry site can lie close to transducer and a relatively vertical needle path pursued (A). However, for more posterior lesions, the expected needle trajectory must be considered while planning entry site and needle angulation, to avoid inadvertent puncture of chest wall (B). If unsafe trajectory is suspected, skin puncture site should be migrated away from the transducer to allow a parallel approach (C). Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 5 Although there are advantages to using a coaxial system during biopsy, 1 disadvantage is the introduction of air along the needle path (arrows) as the needle is removed and replaced between passes, which can obscure portions of the introducer. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 6 Spring-loaded needle. (A) In the prefire position, needle tip (arrowhead) should be placed at the margin of most lesions (arrow), with needle parallel or near parallel to chest wall. (B) Postfire images should be documented and should definitively outline the needle traversing the lesion (arrow). The tip of the needle may lie beyond the lesion margin in some cases, depending on the size of the target (arrowhead). Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 7 Hyperechoic lines (arrows) seen in mass after needle has been removed represent air tracts and confirm that the lesion was successfully traversed. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 8 Reorientation of the needle angulation after placement in breast allows a safe, parallel approach while minimizing the distance that the needle must traverse. Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 9 Steep needle entry may hinder needle visibility, owing to angle of the incident beam (A). However, either transducer face or needle orientation can be altered in real time to correct for this phenomenon (B). Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions

Figure 10 For small lesions, placing the tip of device too close to lesion margin may result in the sampling notch being “thrown” beyond the lesion on firing, potentially resulting in undersampling (A). In these cases, the needle may be retracted slightly from lesion, such that on firing, the lesion can be expected to lie centrally in the device notch (B). Techniques in Vascular & Interventional Radiology 2014 17, 23-31DOI: (10.1053/j.tvir.2013.12.005) Copyright © 2014 Elsevier Inc. Terms and Conditions