Core Needle Biopsy of the Abdominal Fat Pad for Diagnosis of Amyloidosis

Amyloidosis is a rare systemic disorder that is underdiagnosed and whose incidence is increasing as the population ages. The reference standard for diagnosis is endomyocardial biopsy, though its utility as a screening tool is limited. Fine needle aspiration (FNA) and surgical excisional biopsy (SEB) of the abdominal fat pad have emerged as alternatives to endomyocardial biopsy as screening tools for amyloidosis. Given concerns about the variable sensitivity of FNA and the more invasive nature of SEB, our referring providers asked our group to perform core needle biopsies (CNB) of the abdominal fat pad. While limited prior work has reviewed the performance of fat pad CNB, the technical details of this procedure have not been described in the literature. With this technical note, we hope to encourage more radiologists to offer ultrasound-guided CNB of the abdominal fat pad as an additional procedure in the toolkit of interventional radiologists.