Angulated fluoroscopy for needle biopsy localization

Aspiration needle biopsy is a well established, safe means of obtaining tissue samples for cytologic and bacteriologic examination. Several methods for localizing the needle tip and mass lesion have been described including fluoroscopy [1 ], biplane fluoroscopy [2], fluoroscopy combined with angiography [3] or endoscopic retrograde cholangiopancreatography (ERCP) [4], sonography [5], and computed tomography (CT) [6]. We angled the overhead tube of a remote control fluoroscopic unit to obtain near right-angle views of the needle tip and target lesion, assuring that the needle tip is located at or near the center of the fluoroscopically visible mass. side as the needle hub (fig. 3B), the needle tip was judged to be superficial to the mass. The needle was then advanced, and the tube movement was repeated until the needle tip image remained in the center of the mass image regardless of tube angulation (fig. 3C). Conversely, if the needle tip projected off the center of the mass on the side opposite to that of the needle hub, the needle tip was deep to the center of the mass, and the needle was partially withdrawn.