Diagnostic Accuracy and Safety of Ultrasound Guided Omental Biopsy: Single Center Experience

Abstract

Aim: Omental biopsy has conventionally been performed using a surgical approach. The thickened omentum can serve as a useful target for ultrasonography guided percutaneous biopsy, in clinical practice. The objective of our study was to determine the diagnostic value and safety of ultrasound guided percutaneous biopsy of omental thickening. Additionally, we aim to investigate the correlation of biopsy results with the paracentesis fluid cytology. Methods: This retrospective study included 49 patients (33 women and 16 men; mean age, 64 ± 13.9 [SD] years) who underwent ultrasound guided omental biopsy between 2014 and 2022 at a single institution at which US served as the first-line modality for omental biopsy guidance. Post-biopsy clinical follow-up were reviewed for each patient. We compare the outcomes of biopsy and paracentesis fluid cytology results. Results: Total 49 patients were included in our study. US-guided biopsy was diagnostic in 46/49 (93.8%) of patients. There were total 36 (73.4%) malignant cases, 5 (10.2%) chronic inflammation suggestive of tuberculosis, while 2 (4.1%) were chronic peritoneal infection. In 3 patients, the result of core biopsy was benign and reported as Ig4-related inflammatory pseudotumor, desmoid fibromatosis and fat necrosis-foreign body reaction. Out of 36 malignant cases, majority 17 (47.2%) had ovarian cancer. There were no major complications. In 21 of 25 patients (%84) who underwent paracentesis fluid sampling, cytology results (malign or bening cytology) were found to be consistent with omental biopsy results. The ascitic cytological evaluation was favourable for malignancy in 16/25 (64%) patients. Conclusions: Ultrasound-guided percutaneous biopsy of omentum is less expensive, safe and effective method with a high diagnostic accuracy. Paracentesis fluid cytology results are highly sensitive in patients with omental thickening.