Safety Profile and Technical Success of Imaging-Guided Percutaneous Fiducial Seed Placement With and Without Core Biopsy in the Abdomen and Pelvis

OBJECTIVE. The purpose of this study is to determine whether complications associated with combining biopsy and percutaneous fiducial seed placement in the abdomen and pelvis exceeds that of either procedure alone or prohibits completion of the combined procedure. MATERIALS AND METHODS. A retrospective review was performed of 188 consecutive patients who underwent CT- or ultrasound-guided placement of fiducial seeds in the abdomen or pelvis, either alone (group 1, n = 117) or with concomitant biopsy (group 2, n = 71), from October 2005 through April 2010. Complications classified according to the Society of Interventional Radiology guidelines were compared between both groups using the Z test for proportions, as were the number of seeds per patient and seed migration and technical success rates. RESULTS. One hundred eighty-eight patients underwent percutaneous placement of 533 fiducial seeds in the abdomen and pelvis. Eight patients (4.3%) had complications. Five were minor (four small hematomas and one pneumothorax) and three were major (two cases of bleeding and one of sepsis). There was no significant difference between groups with respect to minor complication rates, number of seeds placed per patient (p = 0.85), or technical success (p = 0.33). Significantly more major complications (p = 0.04) occurred in group 2, but the rate was similar to that for percutaneous biopsy alone as reported in the literature. Group 2 also had more seed migration (p = 0.02). CONCLUSION. Biopsy and fiducial seed placement in the abdomen and pelvis can be performed in the same session rather than separately, with a high rate of technical success and without an increased risk of complications when compared with either procedure alone.