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High-end imaging technologies have steered biopsy techniques to imaging-guided percutaneous techniques.The study will appear online and in the September print edition of "Radiology" Journal.

The emergence of computed tomography (CT), ultrasound and magnetic resonance imaging (MRI), has enabled clinicians to use advanced imaging guidance with biopsies. Imaging-guided percutaneous needle biopsies achieve greater precision in targeting lesions, resulting in high sensitivities and low complication rates.

Biopsy trends in Medicare claims data from 1997 through 2008 for 10 anatomical regions were studied. Biopsy procedures increased from 1,380 per 100,000 Medicare enrollees in 1997 to 1,945 biopsies in 2008, depicting an annual growth rate of 3%. In 2008, 67 % of all biopsies were performed percutaneously, compared to 59 % in 1997.

"We also found that the use of imaging guidance increased over this time period, most likely because the technique enables more efficient and safe targeting of lesions," said the study's lead author Sharon W. Kwan, M.D., radiology resident at the University of California in San Francisco.

With the increase in the percentage of imaging-guided percutaneous biopsies, the number of  more invasive open biopsies and non-imaging-guided percutaneous biopsies decreased. Open biopsies are more feasible for these superficial regions, and the areas of concern are more likely to be palpable and less in need of imaging guidance.

Performance of biopsies by radiologists increased from 35 % to 56 % during the study period. However, the annual rate of growth in biopsies performed by radiologists slowed from 8 % in the first half of the study period to 6 % in the second half. Dr. Kwan suggested that one contributing factor was the increasing number of imaging-guided biopsies performed by physicians of other specialties.

"There is no reason to think that one physician specialty, as a whole, is better than another at performing biopsies," Dr. Kwan said. "However, in the case of imaging-guided biopsies, radiologists, who are specifically trained in the use and interpretation of imaging, should be the most qualified to perform these procedures."

The growth in overall biopsy utilization was a modest 3 % despite rapid increases in imaging utilization in the last decade. Dr. Kwan observed the finding could assuage fears over increased imaging utilization leading to additional costly workups, including biopsies.

Source: Radiological Society of North America