Image-guided biopsy procedures in dentistry

Biopsy is a fundamental interventional procedure that enables tissue sampling from suspicious lesions for diagnostic purposes. Image-guided biopsies are minimally invasive approaches that increase diagnostic accuracy. Targeted tissue sampling of lesions can be performed with high success rates under the guidance of methods such as ultrasonography, computed tomography, fluoroscopy, or magnetic resonance imaging. Under the guidance of these imaging modalities, safe and controlled sampling with a low risk of complications is possible, especially in lesions involving salivary glands, cortical bone perforation, or soft tissue components. Image guidance offers advantages such as determining the entry path, avoiding surrounding neurovascular structures, assessing lesion vascularity, and providing real-time guidance during the procedure. In dentistry, fine-needle aspiration biopsy and Tru-Cut biopsy are the most commonly used biopsy methods. Fine-needle aspiration biopsy is a minimally invasive method with a low risk of complications, often preferred for fluid-containing or superficial lesions. Obtaining cellular material allows for cytological evaluation, but procedure repetition may be necessary in case of inadequate sampling. Tru-Cut biopsy, on the other hand, allows for obtaining a tissue core with thicker needles and preserves the histological structure and tissue architecture. It has higher diagnostic accuracy in solid or bone lesions, although the risk of complications is somewhat increased compared to fine-needle aspiration biopsy. This review discusses the techniques, procedural steps, advantages and disadvantages, complications, and techniques of fine-needle aspiration biopsy and Tru-Cut biopsy performed under image guidance in dentistry, in light of the literature.