Non-invasive diagnosis of abdomino-pelvic masses: role of multimodality imaging

Recent advances in radiology have greatly increased the ability to make highly accurate diagnosis. Biopsy of many commonly seen lesions is no longer performed as the radiological findings are pathognomonic. This gives rise to the concept of 'virtual biopsy', a term coined on the lines of other imaging techniques such as virtual colonoscopy. Virtual biopsy is not a new imaging technique but a new concept which refers to the use of existing imaging modalities to evaluate the morphological features of tumors and arriving at a non-invasive diagnosis with a high degree of confidence obviating the need for true biopsy. Elements of virtual biopsy have already been incorporated into some evidence-based guidelines, and it is expected that with further technological advancements, an increasing number of tumors may be diagnosed and managed accordingly. A wider acceptance of virtual biopsy could further reduce the need for invasive biopsies and its attendant costs and risks. In this review article, we use index cases to further emphasize this concept.