-
Medical journals
- Career
ESGO/ISUOG guidelines for needle biopsies in gynecologic oncology – the adapted version
Authors: R. Poncová; D. Fischerová; F. Frühauf
Authors‘ workplace: Klinika gynekologie, porodnictví a neonatologie 1. LF UK a VFN v Praze
Published in: Ceska Gynekol 2026; 91(2): 157-165
Category:
doi: https://doi.org/10.48095/cccg2026157Overview
The aim of this article is to summarize current knowledge on performing biopsies using a core needle, which have become a routine method in gynecologic oncology. The text is based on international guidelines focusing on the selection of imaging techniques for navigation, selection of approach, indications, and contraindications of this method. Additionally, the article addresses recommendations to minimize the risk of bleeding, proper management of anticoagulant or antiplatelet therapy, and provides an overview of the biopsy technique. Finally, it includes recommendations for the required expertise of physicians performing biopsies to ensure maximum safety.
Keywords:
core needle biopsy – tru-cut biopsy – core-cut biopsy – fine needle aspiration – ultrasound guidance
Sources
1. Madariaga A, Bhat G, Wilson MK et al. Research biopsies in patients with gynecologic cancers: patient-reported outcomes, perceptions, and preferences. Am J Obstet Gynecol 2021; 225 (6): 658.e1–658.e9. doi: 10.1016/j.ajog.2021.06.071.
2. Zikan M, Fischerova D, Pinkavova I et al. Ultrasound‐guided tru‐cut biopsy of abdominal and pelvic tumors in gynecology. Ultrasound Obstet Gynecol 2010; 36 (6): 767–772. doi: 10.1002/uog.8803.
3. Harrison RF, Cantor SB, Sun CC et al. Cost-effectiveness of laparoscopic disease assessment in patients with newly diagnosed advanced ovarian cancer. Gynecol Oncol 2021; 161 (1): 56–62. doi: 10.1016/j.ygyno.2021.01.024.
4. Lee M, Kim SW, Paek J et al. Comparisons of surgical outcomes, complications, and costs between laparotomy and laparoscopy in early-stage ovarian cancer. Int J Gynecol Cancer 2011; 21 (2): 251–256. doi: 10.1097/IGC.0b013e318208c71c.
5. Sidhu P, Brabrand K, Cantisani V et al. EFSUMB guidelines on interventional ultrasound (INVUS), Part II–diagnostic ultrasound-guided interventional procedures (Long Version). Ultraschall Med 2015; 36 (06): E15–E35. doi: 10.1055/s-0035-1554036.
6. Fischerova D, Cibula D, Dundr P et al. Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors. Int J Gynecol Cancer 2008; 18 (4): 833–837. doi: 10.1111/j.1525-1438.2007.01015.x.
7. Tacher V, Le Deley M, Hollebecque A et al. Factors associated with success of image-guided tumour biopsies: Results from a prospective molecular triage study (MOSCATO-01). Eur J Cancer 2016; 59 : 79–89. doi: 10.1016/j.ejca.2016. 02.006.
8. Hewitt M, Anderson K, Hall GD et al. Women with peritoneal carcinomatosis of unknown origin: efficacy of image‐guided biopsy to determine site‐specific diagnosis. BJOG 2007; 114 (1): 46–50. doi: 10.1111/j.1471-0528.2006.01176.x.
9. Wood EJ, Pickhardt PJ, Elissa M et al. Ultrasound-guided transvaginal biopsies of pelvic lesions: diagnostic yield, safety profile, and technical considerations over a 20-year experience. Abdom Radiol (NY) 2023; 48 (3): 1154–1163. doi: 10.1007/s00261-022-03792-y.
10. Giede C, Toi A, Chapman W et al. The use of transrectal ultrasound to biopsy pelvic masses in women. Gynecol Oncol 2004; 95 (3): 552–556. doi: 10.1016/j.ygyno.2004.08.039.
11. Hoffmann P, Balik M, Hoffmannova M et al. Long-term experience with percutaneous biopsies of pelvic lesions using CT guidance. Sci Prog 2021; 104 (4): 00368504211058555. doi: 10.1177/0036850421158555.
12. Galgano SJ, Calderone CE, Xie C et al. Applications of PET/MRI in abdominopelvic oncology. Radiographics 2021; 41 (6): 1750–1765. doi: 10.1148/rg.2021210035.
13. Takeshita J, Masago K, Kato R et al. CT-guided fine-needle aspiration and core needle biopsies of pulmonary lesions: a single-center experience with 750 biopsies in Japan. Am J Roentgenol 2015; 204 (1): 29–34. doi: 10.2214/AJR.14.13151.
14. Lengyel D, Vereczkey I, Köhalmy K et al. Transvaginal ultrasound-guided core biopsy – experiences in a comprehensive cancer centre. Cancers 2021; 13 (11): 2590. doi: 10.3390/cancers13112590.
15. Lin SY, Xiong YH, Yun M et al. Transvaginal ultrasound‐guided core needle biopsy of pelvic masses. J Ultrasound Med 2018; 37 (2): 453–461. doi: 10.1002/jum.14356.
16. Mascilini F, Quagliozzi L, Moro F et al. Role of transvaginal ultrasound-guided biopsy in gynecology. Int J Gynecol Cancer 2020; 30 (1): 128–132. doi: 10.1136/ijgc-2019-000734.
17. Buonomo F, Bussolaro S, de Almeida Fiorillo C et al. Ultrasound-guided tru-cut biopsy in gynecological and non-gynecological pelvic masses: a single-center experience. J Clin Med 2022; 11 (9): 2534. doi: 10.3390/jcm11092534.
18. Dupain C, Masliah-Planchon J, Gu C et al. Fine‐needle aspiration as an alternative to core needle biopsy for tumour molecular profiling in precision oncology: prospective comparative study of next‐generation sequencing in cancer patients included in the SHIVA02 trial. Mol Oncol 2021; 15 (1): 104–115. doi: 10.1002/1878-0261.12776.
19. Goyal A. Role of fine needle aspiration cytology in the diagnosis of gynecologic tumors. Acta Cytol 2023; 67 (2): 195–212. doi: 10.1159/000529364.
20. Tam AL, Lim HJ, Wistuba II et al. Image-guided biopsy in the era of personalized cancer care: proceedings from the society of interventional radiology research consensus panel. J Vasc Interv Radiol 2016; 27 (1): 8–19. doi: 10.1016/j.jvir.2015.10.019.
21. Picardi M, Giordano C, Vigliar E et al. Ultrasonography‐guided core‐needle biopsy of lymphadenopathies suspected of lymphoma: Analysis on diagnostic efficacy and safety of 1000 front‐line biopsies in a multicenter Italian study. Hematol Oncol 2023; 41 (5): 817–827. doi: 10.1002/hon.3204.
22. Seviar D, Yousuff M, Chia Z et al. Image‐guided core needle biopsy as the first‐line diagnostic approach in lymphoproliferative disorders – a review of the current literature. Eur J Haematol 2021; 106 (2): 139–147. doi: 10.1111/ejh.13532.
23. Patel IJ, Rahim S, Davidson JC et al. Society of Interventional Radiology consensus guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions – part II: recommendations: endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30 (8): 1168.e1–1184.e1. doi: 10.1016/j.jvir.2019.04.017.
24. Veltri A, Bargellini I, Giorgi L et al. CIRSE guidelines on percutaneous needle biopsy (PNB). Cardiovasc Intervent Radiol 2017; 40 (10): 1501–1513. doi: 10.1007/s00270-017-1658-5.
25. Kuo HC, Liu FL, Chen JT et al. Thromboembolic and bleeding risk of periprocedural bridging anticoagulation: a systematic review and meta‐analysis. Clin Cardiol 2020; 43 (5): 441–449. doi: 10.1002/clc.23336.
26. Education, Practical Standards Committee EFoSfUiM, Biology. Minimum training recommendations for the practice of medical ultrasound. Ultraschall Med 2006; 27 (1): 79–105. doi: 10.1055/s-2006-933605.
27. Pereira N, Hutchinson AP, Lekovich JP et al. Antibiotic prophylaxis for gynecologic procedures prior to and during the utilization of assisted reproductive technologies: a systematic review. J Pathog 2016; 2016 (1): 4698314. doi: 10.1155/2016/4698314.
28. Sekhar A, Sun MR, Siewert B. A tissue phantom model for training residents in ultrasound-guided liver biopsy. Acad Radiol 2014; 21 (7): 902–908. doi: 10.1016/j.acra.2014.03.002.
29. Shabana W, Kielar A, Vermani V et al. Accuracy of sonographically guided biopsy using a freehand versus needle‐guided technique: computed tomographic correlation study. J Ultrasound Med 2013; 32 (3): 535–540. doi: 10.7863/jum.2013.32.3.535.
30. Ghi T, Sotiriadis A, Calda P et al. ISUOG Practice Guidelines: invasive procedures for prenatal diagnosis. Ultrasound Obstet Gynecol 2016; 48 (2): 256–268. doi: 10.1002/uog.15945.
31. Navaratnam K, Alfirevic Z. Amniocentesis and chorionic villus sampling: Green‐top Guideline No. 8. BJOG 2022; 129 (1): e1–e15. doi: 10.1111/1471-0528.16821.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Article was published inCzech Gynaecology
2026 Issue 2-
All articles in this issue
- Impact of angiogenic factors and maternal endothelial dysfunction on pregnancy outcome
- Cryopreservation of oocytes to preserve female fertility
- vNOTES hysterectomy reduces laparotomy conversion rates in class III obesity – a retrospective comparative study
- Perinatal outcomes in severe preeclampsia with peritoneal ascites – a single tertiary center experience
- Epidemiology of obesity in pregnancy in the Czech Republic – demographic context and clinical implications
- Endometrioma of Bartholin’s gland
- Vulvodynia and persistent vulvar pain – diagnosis, treatment, and the role of laser vaporization
- Clinically relevant histopathological features and biomarkers in endometrial cancer
- Limits of preeclampsia screening and prevention in a population of women after assisted reproductive technologies
- Impact of selected dimensions of pelvic floor structures on the process of delivery – a review of the literature
- ESGO/ISUOG guidelines for needle biopsies in gynecologic oncology – the adapted version
- Assoc. Prof. MUDr. Jaroslav Feyereisl, MD, CSc. – former director of the Institute for Mother and Child Care, has passed away
- Czech Gynaecology
- Journal archive
- Current issue
- Online only
- About the journal
Most read in this issue- Impact of angiogenic factors and maternal endothelial dysfunction on pregnancy outcome
- Impact of selected dimensions of pelvic floor structures on the process of delivery – a review of the literature
- Cryopreservation of oocytes to preserve female fertility
- Perinatal outcomes in severe preeclampsia with peritoneal ascites – a single tertiary center experience
Login#ADS_BOTTOM_SCRIPTS#Forgotten passwordEnter the email address that you registered with. We will send you instructions on how to set a new password.
- Career