The safety of image-guided biopsy and its impact on patient care: the first Ethiopian experience

Background: The introduction of image-guided biopsy has revolutionized the quality of patient care by avoiding open and complications associated with it and the use anesthesia. Even though Ethiopian radiological training dates back to more than two decades, interventional radiology is a very recent introduction. This study reports the safety and significance of image guided biopsy on patient care.Patients and methods: This study was a prospective study carried out to assess the impact and safety of doing image-guided biopsy in a tertiary care teaching Hospital in Addis Ababa, Ethiopia.Results: A total of 117 patients, their age ranging from 3 to 80years and a mean age of 41 were evaluated; 6.8% of them were children below the age of 10. Around two-thirds of the cases had intra-abdominal indications for biopsy followed by mediastinal pathologies. Ultrasound was used as a guide in about 85% of the cases. Except for one case that developed massive hemoptysis following fine needle aspiration of a middle mediastinal mass and treated conservatively, there was no major complication. A few minor complications, like mild pain and minor hemorrhage, required only close observation.Conclusion: On the whole, our study indicates that image-guide biopsy improves the existing medical care.Moreover, institutions particularly those providing training in radiology should promote the establishment of interventional radiology for better patient diagnosis and improved planning of subsequent treatment

Sensitivity of computed tomography-guided transthoracic biopsies in a Nigerian tertiary institution

Introduction: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography-guided (CT-guided) biopsy, thoracoscopy or video-assisted thoracoscopy, and bronchoscopy. CT-guided percutaneous lung biopsy was first reported in 1976. Aim of Study: The aim of the study is to report our experience with CT-guided transthoracic biopsy. Materials and Methods: Patients with clinical and radiological evidence of intrathoracic mass were counseled and consent obtained for the procedure. They were positioned in the gantry, either supine or prone. A scout scan of the entire chest was taken at 5 mm intervals. The procedure was carried out by the consultants and senior registrar. Following visualization of the lesion, its position in terms of depth and distance from the midline was measured with the machine in centimeter to determine the point of insertion of the trucut needle (14­18-G). The presumed site of the lesion was indicated with a metallic object held in place with two to three strips of plasters after cleaning the site with Povidone-iodine. After insertion, repeat scans were performed to confirm that the needle was within the mass. A minimum of 3 core cuts was taken to be certain that the samples were representative. The results were analyzed by the determination of means and percentages. Results: Twenty-six patients underwent this procedure between 2011 and 2015. There were 15 males and 11 females (M:F = 1.4:1). The age range was between 30 and 99 years with a mean of 55 years. Histological diagnosis was obtained in 24 of the patients giving sensitivity of 92.3%. There were 3 mild complications giving a rate of 11.5%. The complications included a case of mild hemoptysis and two patients who had mild pneumothoraces which did not require tube thoracostomy. Conclusion: CT-guided biopsy is a reliable procedure for obtaining deep-seated intrathoracic biopsies with high sensitivity and minimal complication rate

La ponction biopsie hépatique écho-guidée en ambulatoire à Ouagadougou : indications, apport diagnostique et complications

Objectif : Déterminer l'apport diagnostique de la ponction biopsie hépatique par voie per cutanée sous guidage échographique.Matériel et méthodes : étude rétrospective descriptive réalisée de mars 2013 à mars 2017. Ont été inclus tous les patients ayant bénéficié d'une biopsie hépatique sous guidage échographique. Les variables recueillies ont été le sexe, l'âge, l'indication, le nombre de carottes biopsiques, les complications et le diagnostic anatomopathologique.Résultats. 53 patients ont été colligés. Il y avait 37 hommes (69,81%) et 16 femmes (30,18 %) soit un sex ratio de 2,31. L'âge moyen était de 45,79 ans avec des extrêmes de 15 et de 82 ans. Les indications étaient principalement représentées par l'exploration des nodules dans 49 cas (92,24%) et des hépatopathies chroniques dans 4 cas (7,76%). Le diagnostic anatomopathologique était essentiellement dominé par le CHC dans 33 cas (63,46%). Une douleur modérée passagère, était notée chez 37,73% des patients au passage de la capsule. Aucune complication majeure n'était retrouvée.Conclusion. La réalisation des PBH sous guidage échographique était fiable et réalisable en ambulatoire, pour peu que le bilan d'hémostase, l'utilisation d'une prémédication et d'une aiguille fine avec un système coaxial soit respecté