Piotr Roman Obara MD, Presenter: Nothing to Disclose

Paul J. Chang MD, Abstract Co-Author: Co-founder, Koninklijke Philips Electronics NV Medical Adivsory Board, Vital Images, Inc Medical Adivsory Board, Amirsys, Inc Medical Adivsory Board, Koninklijke Philips Electronics NV

David M. Paushter MD, Abstract Co-Author: Nothing to Disclose

Michael Walter Vannier MD, Abstract Co-Author: Board of Directors, Vital Images, Inc Speakers Bureau, General Electric Company Research grant, Koninklijke Philips Electronics NV

Aytekin Oto MD, Abstract Co-Author: Nothing to Disclose

Brian S. Funaki MD, Abstract Co-Author: Book contract, Thieme Medical Publishers, Inc Book contract, Springer Science+Business Media Deutschland GmbH Data Monitoring Safety Board, FoxHollow Technologies, Inc Editor, Thieme Medical Publishers, Inc

Richard L. Baron MD, Abstract Co-Author: Nothing to Disclose

Abraham H. Dachman MD, Abstract Co-Author: Consultant, E-Z-EM, Inc Consultant, iCAD, Inc Research support, iCAD, Inc Consultant, General Electric Company Research support, Koninklijke Philips Electronics NV

et al, Abstract Co-Author: Nothing to Disclose

A PACS-integrated database system to compile biopsy data was implemented and tested to assess its feasibility and potential impact on clinical practice quality and evaluation of improvement.

Entry of image-guided biopsy scheduling, procedural details and results was done using a PACS integrated web form, followed by periodic review of practice for quality improvement. Biopsy data for the following searchable categories was entered: radiology department section, radiologist, resident, ordering physician, imaging modality, target site, biopsy type, needle size, number of needle passes, complications, sample adequacy, and final pathology. Using the database search categories, we reviewed biopsies of 190 consecutive patients performed by six radiologists in the abdominal section of our institution.

190 patients underwent 205 biopsies during a 54-week period. The most frequently targeted sites were: thyroid (39%), liver (27%), lymph node (18%), and kidney (5%). 91 patients had an FNA, 89 had a core biopsy, and 10 had both. The sample acquired was diagnostic in 163 cases (85%) and non-diagnostic in 27 cases (14%). The 27 non-diagnostic cases were distributed among the following target sites: 16 thyroid, 7 lymph node, 1 kidney, 1 liver, 1 adrenal, 1 abdominal mass, and 1 mediastinal mass. US was used as the guidance modality far more frequently than CT (88% US vs. 12% CT). Of the 163 diagnostic cases, 93 patients had benign final pathology and 69 patients had a malignancy. There was 1 (0.5%) immediate bleeding complication.

Using the PACS integrated biopsy database, we showed satisfactory success and complication rates (85% and 0.5%, respectively) for biopsies performed at our institution. This type of database can generate quality improvement information while maintaining workflow efficiency.

Quality control is essential for monitoring an image guided biopsy practice, and electronic integration of this process with PACS may improve compliance, and timeliness and completeness of reports.

Obara, P, Chang, P, Paushter, D, Vannier, M, Oto, A, Funaki, B, Baron, R, Dachman, A, et al, , Biopsy Performance Assessment Using a PACS-integrated Quality Improvement Database.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010993.html