Our current data demonstrates a 100% success rate for utilisation of an ultrasound-guided approach in cases where open surgical biopsy has been inconclusive, and thereby establishes the use of sonographically-guided biopsy as a viable practice to facilitate accurate histological diagnosis in this patient sub-cohort. The potential benefit of this approach is particularly demonstrated in the case of XMEA described above. Furthermore, excluding a single processing error, 100% of our patients had a diagnostically helpful biopsy using ultrasound guidance.
The procedure was well tolerated by patients with minimal bleeding. No complications were reported by patients. At least half of those who have previously had a surgical biopsy expressed a preference for the ultrasound guided approach and none expressed a preference for surgical biopsies.
Conclusion
In the context of establishing a neuromuscular diagnosis, we demonstrated benefit in utilising an ultrasound-guided modified Bergström needle technique to obtain viable histological samples in patients that have had an unsuccessful open biopsy procedure.
Previous studies have utilised this technique with MR-guidance, but our data shows that an ultrasound guided procedure infer additional advantages, providing comparable success rates to other techniques, and have practical, clinical, operational and patient-centred benefits compared to alternative techniques.
Furthermore, the procedure was not associated with significant complication and was well tolerated by patients with positive feedback.