Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles

Figure 1 A 67-year-old man with a pancreatic mass who had no safe route for approaching the target lesion during biopsy. A: Contrast-enhanced axial computed tomography (CT) scan shows a mass lesion (white arrow) in the pancreatic head; B: The patient was in the supine position, with opaque catheters placed on the abdominal wall as reference lines; C: Noncontrast CT image shows a 17-gauge coaxial introducer needle perpendicularly penetrating the gastric wall and the needle tip positioned at the edge of the target lesion; D: Noncontrast CT image shows an 18-gauge biopsy needle tip in the pancreatic mass.