Diagnostic Value of Image-Guided Percutaneous Biopsy of Omental and Peritoneal Lesions

Abstract

Introduction: The peritoneum and omentum are frequently involved in both malignant and inflammatory conditions, many of which demonstrate overlapping imaging features. Image guided percutaneous biopsy has emerged as a minimally invasive alternative to surgical sampling for histopathological confirmation.
Methods: A prospective observational study was conducted in the Department of Radiology at Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Adults (≥18 years) undergoing image-guided percutaneous biopsy of peritoneal or omental lesions with available histopathology were included. Forty-three patients were enrolled consecutively. Procedures were performed under ultrasound or CT guidance using core needle biopsy or fine-needle aspiration cytology. Data were analyzed in SPSS v27 and expressed as mean ± standard deviation and frequency.
Results: The mean age of participants was 52.40 ± 13.20 years, with females comprising 58.1% of the study population. The average lesion size was 4.20 ± 1.60 cm. Peritoneal involvement was observed in 58.1% of cases, while 41.9% involved the omentum. Computed Tomography guidance was utilized in 72.1% of procedures, and core biopsy was performed in 86.0%. Technical success and diagnostic yield were both 97.7%. Malignancy was the most common diagnosis (67.4%), followed by tuberculous peritonitis (23.3%). Minor complications occurred in 7.0% of cases, with no major adverse events reported.
Conclusions: Image-guided percutaneous biopsy of omental and peritoneal lesions is a safe and reliable diagnostic method with high yield. It should be considered a first-line approach for tissue diagnosis, particularly in settings with a high burden of malignancy and infectious diseases.