Shaunagh McDermott FFR(RCSI), Presenter: Nothing to Disclose

Milena Petranovic MD, Abstract Co-Author: Nothing to Disclose

Carol C. Wu MD, Abstract Co-Author: Author, Reed Elsevier

Matthew David Gilman MD, Abstract Co-Author: Nothing to Disclose

Jo-Anne O. Shepard MD, Abstract Co-Author: Consultant, Agfa-Gevaert Group

Pre-procedural contrast enhanced CT or MR and PET are helpful in biopsy planning Biopsies of bronchogenic cysts or vascular lesions should be avoided Safe biopsy needle trajectory should be directed away from major vessels, the pericardium, and the heart and not cross the pleura when possible On site rapid cytology can help optimize allocation of biopsy specimen for flow cytometry or special immunological stains Core biopsy improves diagnostic yield compared to FNA alone

1. Brief introduction to differentials of mediastinal lesions and benefits of CT-guided biopsy 2. Interactive case-based quiz questions to illustrate: a) Pre-biopsy evaluation and patient selection i)Role of contrast-enhanced CT, MR, and PET ii)Do not touch lesions such as bronchogenic cyst b) Biopsy technique i)Targeting solid, FDG-avid portion of mediastinal mass ii)Needle path away from major vessels and heart iii) Avoid crossing pleura iv) Role of onsite rapid cytology v) Importance of core biopsy and flow cytometry c) Post-biopsy care i)Complications: pneumothorax, hemothorax, hemopericardium ii) Needle biopsy result and treatment options

http://abstract.rsna.org/uploads/2014/14009835/14009835_zjsw.pdf

McDermott, S, Petranovic, M, Wu, C, Gilman, M, Shepard, J, Do’s and Don’ts of CT-guided Mediastinal Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009835.html