Choice of biopsy devices for post-mortem CT-guided biopsy

• 5 core biopsy needle devices were compared for biopsy of the liver in a cadaver.
• Devices were both spring-loaded and vacuum-assisted.
• Parameters of assessment included ease-of-use, cost and histological quality.
• Spring-loaded devices were easiest to use and provided diagnosable specimens.

AimTo assess technical features of multiple biopsy devices for post-mortem CT-guided biopsy (PMCTB).MethodsFive different BARD® clinical biopsy devices, including spring-loaded and vacuum-assisted, were used to perform percutaneous biopsy of the liver in a deceased person using the largest gauge needle size available in each. A standard co-axial biopsy technique was used for all devices except SenoRX®. Specimens were placed on sponge in cassettes for initial fixation and then processed using routine histological techniques. The devices were assessed by a team consisting of a forensic technician, forensic radiologist and two forensic pathologists (one blinded to the type of device used). Assessment parameters included technical performance, cost of device, and specimen review under light microscopy.Results/discussionThe Max-core® and Magnum® devices were mechanically easy to load, fire and retrieve specimens. The Finesse® and Vacora® provided advanced technical features. On histological review the tissue sample from the Vacora® was judged to be of higher quality. Due to the permanent needle attachment to the vacuum machine, the SenoRX® was deemed impractical. Histological artefacts identified included stretch-crush cellular damage likely from the use of vacuum-assisted devices, and tissue breakage from the use of cassette sponges.ConclusionThe 2 spring-loaded biopsy devices are considered the most appropriate for PMCTB tissue sampling based on ease-of-use, lowest cost and provision of diagnosable biopsy specimens.