0:00

So let's talk about interabdominal biopsies and some success

0:03

and complication rates.

0:06

So when we look at bone biopsies in general,

0:09

there's success and errors and

0:12

everything in between. So when we achieve

0:15

technical success, that's our ability to sort of

0:18

get in there and actually take a sample a nice

0:21

sample where we can look and see there's tissue actually

0:24

in the bone biopsy needle.

0:27

So we've achieved a sample of the intended site.

0:30

But now the question is that sample that we have after

0:33

we put it in our sample fluid media

0:36

whether that be saline or cytofluid or

0:39

formalin when we send that to

0:42

the lab now, the question is does the lab come back and say

0:45

Thumbs up you have a diagnostic sample in which

0:48

case you have an effective success, but sometimes our

0:51

technical success doesn't equal

0:54

an effective success. So what are some errors we

0:57

can have a non-diagnostic biopsy specimen?

1:00

Of course, we talked about situations where the sample

1:03

itself is actually necrotic and

1:06

we would have known that if we've had a pet scan,

1:09

for example, all we would have known that actually the

1:12

site wasn't metabolically active in which

1:15

case it's actually not a sample that is going

1:18

to yield any diagnostic tissue.

1:21

or perhaps

1:22

it's just discordant with what was ultimately resected

1:25

by the surgeon.

1:27

Or perhaps there is an incorrect histologic grade of

1:30

differentiation. So when we are achieving nice

1:33

diagnostic examples effective success

1:36

the more likely in the case of metastases than

1:39

in primary tumors or infections. So just

1:42

keep that in mind.

1:43

So when it comes to complication rates for image guided bone

1:46

biopsies typically much lower than for open biopsy, which is why

1:49

we as diagnosing an Interventional radiologist offer

1:52

them 1% versus 16% of

1:55

course as a patient.

1:57

Nice lower complication rate in order to share that

2:00

with them in the informed consent, which is

2:03

why we're choosing this particular procedure when it comes to complications. They

2:06

do vary by site, but they can include pain pain is

2:09

something that is not considered a complication but it's something

2:12

that you want to make sure the patient is aware of that. It's

2:15

not going to be just because they don't feel the biopsy during

2:18

the case with their Conscious Sedation or general

2:21

anesthesia on board. They will likely feel pain after

2:24

the fact so it's something that should be in anticipated consequence

2:27

of the procedure. Now infection is

2:30

not anticipated. We want to make sure we have a sterile

2:33

technique to prevent this we're gonna make sure that bleeding as we

2:36

talked about hematoma formation is something that's anticipated

2:39

in mitigated very procedurally. We're

2:42

going to think about track seeding seeding of the site from

2:45

the site when it comes of infection or to the

2:48

site in terms of infection or seeding of

2:51

malignancy when it comes to lesions that

2:54

are Regional to the lungs.

2:56

And plural IE the rib

2:59

lesions, we're going to make sure that we don't injure compromise

3:02

or violate the plural in which case in pneumothorax

3:05

can develop. We also want to be mindful of

3:08

nerves that are in that region of our

3:11

biopsy site.