Kim Learned MD, Presenter: Nothing to Disclose

Anna Sarah Lev-Toaff MD, Abstract Co-Author: Nothing to Disclose

Jill Eve Langer MD, Abstract Co-Author: Consultant, BioClinica, Inc

Laurie A. Loevner MD, Abstract Co-Author: Nothing to Disclose

To review practical considerations for patient selection and optimizing the ultrasound-guided biopsy technique of head and neck masses.  Role of preprocedural imaging, lesion localization, and differential diagnosis in selecting good candidates and ultrasound technique for obtaining tissue will be addressed.

1) Patient selection & preparation a. Review of diagnostic cross-sectional CT, MRI, PET-CT Anatomical location of mass Distance from skin surface (up to 4 cm) Differential diagnoses b. Preprocedural preparation No blood work, intravenous access 2) Selection of US transducer for high definition of biopsy area a. Linear high-frequency transducers provide optimal US imaging up to 5 cm in depth b. Small footprints, wide sector view of the curved-array transducers allow access to lesion deep to narrow acoustic window, at steep angle or uneven skin surface 3) Technique: fine needle aspiration, core needle biopsy 4) Added value of a head and neck neuroradiologist's expertise a. Spatial relationship of the lesion and surrounding structures on neck imaging, especially in surgically-altered or irradiated neck, and applying this knowledge to real time US scanning to ensure accurate targeting for biopsy b. Differential diagnoses determine biopsy technique, need for additional laboratory testing, and followup  

http://abstract.rsna.org/uploads/2014/14014146/14014146_72jv.pdf

Learned, K, Lev-Toaff, A, Langer, J, Loevner, L, Ultrasound-guided Biopsy of the Neck Lesions: The Perspective of the Head and Neck Neuroradiologist.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014146.html