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At least 235 records · Page 13Linked to original sources

Evaluation of digitally guided fine needle aspiration cytology versus fine needle core biopsy for the diagnosis of recurrent rectal cancer.

The clinical value of transrectally digitally guided fine needle aspiration cytology (FNAC) was compared with fine needle core biopsy (FNCB), FNAC was performed with a 21G and FNCB with a 18G needle. No prophylactic antibiotic was given. In the first part of the study 100 patients (20 primary/80 recurrences, 17 benign/83 cancers) were studied by both techniques. In 93% a definite diagnoses was given in FNAC specimen versus 96% of the FNCB cases. There were no false positive cancer diagnoses. The sensitivity of the FNAC was 88% versus 68% of the FNCB specimens. This difference was statistically significant. In a second part of the study 142 specimens of recurrent cases were examined by FNAC including 78 of the patients of the first part. The negative predictive value was around 60% for FNAC versus around 40% for FNCB. Both techniques were without any major complications. For the diagnosis of a palpable recurrent pelvic tumour a digitally guided puncture may be tried before proceeding to CT or US guided examination. In our hands FNAC seems preferable to FNCB.

Aged↗

Transrectal needle aspiration versus transperineal needle biopsy in diagnosis of carcinoma of prostate.

Transrectal needle aspiration of the prostate was compared to transperineal biopsy in 28 patients with suspected carcinoma of the prostate. This technique was found to have a high sensitivity and specificity for diagnosing carcinoma of the prostate, and no complications were seen. The addition of Nuclear Flow DNA analysis may give further prognostic information from needle aspiration and core biopsy specimens. Transrectal needle aspiration of the prostate is a safe, inexpensive, and accurate method of diagnosing carcinoma of the prostate.

Biopsy, Needle↗

Comparison of transrectal fine-needle aspiration cytology and core needle biopsy in diagnosis of prostate cancer.

One hundred sixty-nine transrectal fine-needle aspirations of the prostate gland were performed in 166 patients over a two-year period. The results were compared with simultaneous core needle biopsy performed in all but 4 patients. Forty-seven (28%) aspirations were either unsatisfactory or inconclusive. Of the remaining 122 (72%) patients in whom a cytologic diagnosis could be made, core biopsy was available in 120. Aspiration cytology was 87 percent sensitive and 96 percent specific with an overall agreement of 93 percent with core biopsy. No major complications occurred. We conclude that fine-needle aspiration of the prostate is accurate, safe, and cost-effective, and greater application of this technique is encouraged.

Biopsy, Needle↗

CT-guided transthoracic needle biopsy: a comparison between automated biopsy gun and fine needle aspiration.

AIMS: We retrospectively investigated the diagnostic accuracy and complication rate of transthoracic core biopsy using an automated biopsy gun and compared the findings with those of aspiration needle biopsy. PATIENTS AND METHODS: Seventy-three patients underwent 74 core biopsy procedures and 50 patients underwent 52 aspiration biopsy procedures. Of these, a final diagnosis was obtained in 107 lesions with surgery or clinical course. Fifteen patients in which a final diagnosis was not obtained were excluded from the study on diagnostic accuracy. Thus, in the study of diagnostic accuracy, 63 core biopsy procedures for 62 lesions are included. Core biopsy was performed with an 18 G cutting needle using an automated biopsy gun. Aspiration biopsy was performed with a 20 G aspiration needle. RESULTS: Core biopsy yielded sufficient material in 57/63 procedures (90.5%). A correct diagnosis was obtained in 36 procedures (85.7%) for malignant leisons and a specific benign diagnosis was obtained in 11 procedures (52.4%). Aspiration biopsy yielded a correct diagnosis in 26 procedures (81.3%) for malignant leisons and in seven (46.7%) for benign lesions. The overall correct diagnosis were 75.8% and 71.7% with core biopsy and aspiration biopsy, respectively. Core biopsy gave a higher predictive rate than that of aspiration biopsy for both benign and malignant lessons (P < 0.02). Pneumothorax occurred in 18/74 (24.3%) patients with core biopsy and in 18/45 (40.0%) patients with aspiration biopsy. Of these, three with core biopsy and two with aspiration biopsy needed tube drainage. The other complication was haemoptysis, which occurred in six patients following core biopsy and in three after aspiration biopsy. All nine cases subsided spontaneously. There were no fatal complications. CONCLUSIONS: Core biopsy with a biopsy gun increase the diagnostic accuracy with a higher histologic predictive rate and no obvious additional risk of complications.

Biopsy, Needle↗

Subcutaneous needle-tract seeding after fine needle aspiration biopsy of pancreatic liver metastasis.

A case of subcutaneous neoplastic seeding after fine needle aspiration biopsy of a pancreatic liver metastasis is reported. Neoplastic seeding is a rare complication after fine needle biopsy (FNB). The seeding appeared 3 months after the biopsy with a subcutaneous hypoechoic nodule; diagnosis was confirmed by fine needle aspiration of the nodule. The neoplastic seeding did not change the outcome of the patient.

Adenocarcinoma↗

[Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies].

PURPOSE: Comparative evaluation of specimens obtained with different MR-compatible biopsy systems and a conventional ferromagnetic system. METHODS: Biopsies of a pig liver were performed post-mortem with three different MR-compatible (Somatex; E-Z-EM; Daum) and one conventional biopsy system (Somatex), five with each device. The specimens were measured and the histopathological quality was graded on a scale from 0 (no tissue) to 9 (best). The tip of the needle was examined with an electron microscope before and after biopsy to demonstrate abrasion. RESULTS: The histopathological score between the first and fifth specimen taken with one biopsy device showed no significant difference. The conventional system yielded significantly better results in nearly all categories (p < 0.05) than the MR-compatible biopsy systems. The areas of the specimens obtained with the MR-compatible biopsy systems (4.27-5.99 mm2) were significantly smaller than those from the conventional system (9.98 mm2). The needle tip abrasion of the different biopsy systems determined by electron microscopy showed no substantial difference. CONCLUSION: Specimens obtained with MR-compatible biopsy systems compared to conventional biopsy systems are of lower histopathological quality. This might be caused by a smaller side notch of the MR-compatible biopsy devices. There was no difference in abrasion of the needle tip due to the softer, non-ferromagnetic alloys.

Animals↗

[Fluoroscopically guided percutaneous fine-needle biopsy of the lung using the ROTEX needle: results in 890 patients with focal lung lesions].

Fluoroscopically guided transthoracic fine needle biopsies were performed in 890 patients (380 female, 582 male, mean age: 56 years). In 795 patients (89.4%) the first biopsy was successful. The success rate of biopsy correlated closely with the size of the lesion and increased with larger size. Sensitivity in the diagnosis of malignant lesions was 94.6%, specificity 99.5%. Due to cytological, histological, and clinical confirmation of benign lung lesions in 300 patients (33.7% of all patients), the number of unnecessary diagnostic thoracotomies for benign disease could be reduced significantly. In 9 of 113 cases (8%) histological reclassification of the cytologic results was necessary. Reclassification was not necessary in the differentiation between benign and malignant lesions and between small cell and non-small cell carcinomas. The overall complication rate was 24.7% (220 patients). Only 36 patients (4% of all patients) required chest-tube insertion. There were no fatal complications. Percutaneous fluoroscopically guided transthoracic fine needle biopsy of the lung, performed with the Rotex needle, is a time-effective, safe, and efficient method for diagnosing focal pulmonary lesions.

Adenocarcinoma↗

Beyond needle sharing: meta-analyses of social context risk behaviors of injection drug users attending needle exchange programs.

This study gathered data from U.S. and international needle exchange programs (NEPs). Of particular interest were outcome measures of dependent variables related to behaviors within social contexts of injection drug users (IDUs), an area not well understood. Thirty-one studies, with a total of 86 separate measures of 36 dependent variables were included. Because combining all results into a single meta-analysis would be inappropriate, dependent variables were placed into five categories for five separate meta-analyses: risky contexts, injection frequency, sharing drug paraphernalia, drug preparation, and syringe use. NEP attendance was inversely related to declines in all categorical behaviors except for "risky context." NEP attenders are slightly more likely to be in a risky circumstance when injecting drugs than non-attenders. While injection frequency declined only slightly among NEP attenders, that result may be interpreted as a positive outcome, given the often-stated criticism that providing clean needles encourages increased drug use. NEP use was weakly associated with a decrease in the sharing of drug paraphernalia. Clean needles alone do not appear to be sufficient motivation to motivate major changes in contextual risk behaviors analyzed herein. Research is needed to assess the impact of interpersonal IDU relationships with other stakeholders (clinic employees, van drivers, medical personnel, nutritionists, sexual partners, etc.) on IDU drug-using behaviors at many levels.

Female↗

Comparison of preoperative simultaneous stereotactic fine needle aspiration biopsy and stereotactic core needle biopsy in ductal carcinoma in situ of the breast.

PURPOSE: To compare the preoperative results of stereotactic fine needle aspiration biopsy (S-FNAB) with stereotactic core needle biopsy (S-CNB) performed simultaneously in breast lesions with the postoperative histopathological diagnosis of ductal carcinoma in situ (DCIS) of all histological grades. MATERIAL AND METHODS: 733 consecutive stereotactic biopsies were performed between May 1993 and June 1999. In 72 patients with mammographic findings suspicious of malignancy who were subjected to breast surgery, postoperative histopathology showed DCIS. Preoperatively, S-FNAB and S-CNB had been done simultaneously in all patients, S-FNAB with spinal needle 0.7 or 0.9 mm and S-CNB was performed with an automated 2.1-mm biopsy gun. An average of 3 S-FNABs and 3 S-CNBs were performed in each patient. RESULTS: In 56 (78%) of the 72 patients S-CNB showed DCIS. In 3 patients (4%) the S-CNB revealed "probable carcinoma", in 7 patients (10%) "atypia" and in 6, the lesions were benign. In 34 (47%) of the 72 women S-FNABs showed carcinoma, not otherwise specified. In 6 cases (8%) the S-FNABs showed "probable carcinoma" and in 12 patients (17%) "atypia"; 8 lesions were benign and 12 not diagnostic. CONCLUSION: S-CNB was superior to S-FNAB in diagnosing DCIS. Only 6 patients (8%) received a benign or non-diagnostic preoperative diagnosis with S-CNB compared to 20 patients (28%) with S-FNAB. S-CNB was superior to S-FNAB for preoperative diagnosis of DCIS, but S-FNAB could further increase the sensitivity of the biopsy since it diagnosed cancer in 4 cases where S-CNB showed benign material.

Adult↗

Comparison of stereotactic fine needle aspiration cytology and core needle biopsy in 522 non-palpable breast lesions.

PURPOSE: To compare the accuracy of stereotactic fine needle aspiration cytologies (S-FNAC) and stereotactic core needle biopsies (S-CNB) in non-palpable breast lesions. MATERIAL AND METHODS: Between May 1993 and December 2000, 696 patients with mammographically detected lesions were biopsied both with S-FNAC and S-CNB. S-FNAC was performed with spinal needle 22- or 20-gauge and S-CNB with an automated 14-gauge gun. RESULTS: Of the 696 patients, 522 (75%) underwent breast surgery with postoperative histopathology. In all, 448 of these 522 women (86%) had malignant and 74 (14%) had benign lesions. S-FNAC revealed cancer in 254 (57%) and probable cancer in 48 (11%) (sensitivity 68%, specificity 99.6%) and S-CNB revealed cancer in 388 (87%) and probable cancer in 18 (4%) (sensitivity 90%, specificity 98.8%) of these 448 patients. CONCLUSION: S-CNB was more accurate than S-FNAC in the diagnosis of non-palpable breast cancer.

Biopsy, Needle↗

The value of Chiba fine-needle aspiration biopsy in the diagnosis of hepatic malignancy: a comparison with Menghini needle biopsy.

The detection or exclusion of metastatic liver involvement is critical in the management and prognosis of patients with malignant disease. Noninvasive imaging modalities such as computed tomography, ultrasound, and technetium colloid liver scan are highly sensitive but nonspecific. Serum alkaline phosphatase is of similar value. A blind liver biopsy by the Menghini technique is often done to confirm the diagnosis, but its yield is low. We prospectively evaluated 74 patients using blind Menghini needle biopsy and concurrent Chiba fine-needle aspiration biopsy (FNAB) techniques. A positive diagnosis of malignancy was made in 30 patients (41%). In only 25 (34%) was the diagnosis made by Menghini biopsy, while Chiba FNAB confirmed the diagnosis in all 30 patients. Thus, concurrent use of both needles increased the diagnostic accuracy by 7%. Seven additional patients, considered to have one or more contraindications for the Menghini biopsy, underwent Chiba FNAB alone; the diagnosis was confirmed in all without complication. We conclude that FNAB alone or in combination with Menghini biopsy is valuable and safe in the diagnosis of metastatic liver disease.

Adult↗

Needle-track metastasis after transthoracic needle biopsy.

Metastasis along the needle track (NTM) after a transthoracic needle biopsy (TNB) is considered a very rare complication. A survey of the membership of the Society of Thoracic Radiology and a review of the English-language literature were conducted to assess the incidence of this complication and its predisposing factors and natural history. A questionnaire was sent to all radiology departments in the United States and Canada that had a senior member of the Society of Thoracic Radiology. The total number of TNB between 1978 and 1993 and occurrences of NTM were elicited. If an NTM was encountered, information on the size of the nodule, proximity to the pleura, histology, size of the biopsy needle, and the interval between biopsy and NTM and outcome of the patient was elicited. The incidence of NTM was estimated using binomial proportions. Results of the literature survey were tabulated to provide similar information. One hundred sixty-five questionnaires were mailed and 75 responses were received. Approximately 68,346 TNB were reported. Five departments reported a total of eight NTM, resulting in an incidence of 0.012%. The average interval between TNB and NTM was 2.6 months. There were no predictable risk factors. The outcome was known in only 11 patients; 4 patients died by the time of reporting (2 after 14 months and 1 each after 6 and 9 months). From the results of this survey, the incidence of NTM after TNB is approximately 0.012%. This small risk is random and unavoidable.

Biopsy, Needle↗

An evaluation of a combined spinal/epidural needle set utilising a 26-gauge, pencil point spinal needle for caesarean section.

We have conducted a prospective study into the ease of use and incidence of postdural puncture headache with the 'Portex' combined spinal/epidural set. The pack contains a 16-gauge Tuohy needle of standard 8 cm shaft length with a matching 26-gauge pencil point spinal needle. The study included 150 consecutive combined spinal/epidural anaesthetics for lower segment Caesarean section. Eighty-eight percent of the cases fulfilled the criteria as technically perfect, i.e. cerebrospinal fluid obtained at the first attempt after identifying the epidural space. There were two cases of significant postdural puncture headache requiring blood patch due to puncture by the 26-gauge spinal needle giving an incidence of 1.3%. This compares favourably with previously reported rates in obstetric patients.

Anesthesia, Epidural↗

The SMART needle. A new Doppler ultrasound-guided vascular access needle.

Central venous access is an essential part of patient management in many clinical settings. Traditionally this has been achieved by a blind, external landmark guided technique which may not correlate exactly with the location of the vessel. We have prospectively evaluated the SMART needle, a new Doppler ultrasound guided vascular access device, in 40 patients, to evaluate whether it can improve on the standard technique. The SMART needle was easy to use and reliably distinguished between arterial and venous signals. No advantage was demonstrated in 'easy' internal jugular vein cannulations. Although ease of cannulation in difficult cases was subjectively improved, the differences in time to cannulation and number of passes between the groups failed to reach statistical significance and the complication rates were similar. However, the use of the SMART needle on two occasions enabled avoidance of carotid artery puncture by correctly distinguishing the artery from the vein, so that it may have a rôle in patients in whom difficult internal jugular venous cannulation is anticipated.

Adult↗

A prospective double-blind clinical trial, comparing the sharp Quincke needle (22G) with an "atraumatic" needle (22G) in the induction of post-lumbar puncture headache.

Posture-dependent, post-lumbar puncture headache is most likely caused by continuous leakage of cerebrospinal fluid through the dura mater perforation with a consecutive downward sagging of the intracranial content and an irritation of pain-sensitive structures of meninges and blood vessels. A psychogenic co-factor may also play a role. It is generally acknowledged that the incidence and intensity of the headache correlate significantly with the diameter of the needles used. A second factor, the shape of the needle point plays a crucial role as is shown in our prospective, double-blind, clinical trial with 75 patients: employment of the "atraumatic" Sprotte needle with a rounded off point significantly reduced the incidence of post-puncture headache from 36% to 4%. Beside the discussion of pathogenic factors, remarks on a rational therapy are made.

Double-Blind Method↗

Needle-tract implantation following us-guided fine-needle aspiration biopsy of transitional cell carcinoma of the bladder, urethra, and prostate.

Localized tumor implantation of the ventral abdominal wall was found at 2, 5, and 8 months following percutaneous ultrasound-guided fine-needle aspiration biopsy (FNAB) of transitional carcinoma of the bladder, urethra, or prostate in 3 dogs. To our knowledge this complication has not been reported in dogs following FNAB. Despite the rarity of needle-tract implantation, the potential for this complication with transitional cell carcinomas is apparently not negligible and warrants consideration. We recommend traumatic urethral catheterization to obtain a cytologic diagnosis of potential transitional cell carcinomas of the lower urinary tract or prostate whenever possible until more information becomes available. However, needle-track implantation is so rare that it should not influence the decision to perform a percutaneous FNAB if the urethra cannot be catheterized.

Animals↗

Histological identification of carcinoma in 21 gauge needle tracks after fine needle aspiration biopsy of head and neck carcinoma.

Six cancer resection specimens were thoroughly sectioned and microscopically examined at areas known to have been around 21 gauge fine needle aspiration (FNA) biopsy sites, in an attempt to identify needle tracks. All cases had an interval of not less than 10 days between FNA biopsy and surgery. Foci of tumour were identified histologically in needle tracks from two patients with carcinoma. This is the first instance, outside of experimental animal models, of histologically confirmed, viable tumour spread in FNA biopsy tracks. Although this complication is not common and is of unknown clinical significance, it is one that all clinicians who undertake FNA of malignant neoplasms should be aware of.

Adenocarcinoma↗

Fine-needle aspiration biopsy versus fine-needle capillary (nonaspiration) biopsy: in vivo comparison.

PURPOSE: To evaluate, in vivo, the efficacy of fine-needle capillary (nonaspiration) biopsy (FNCB) versus fine-needle aspiration biopsy (FNAB) when performed at the same site with a coaxial technique. MATERIALS AND METHODS: In 91 patients, biopsy was performed at 140 sites in 93 lesions mostly throughout the chest and abdomen with either FNCB or FNAB, or both (98 sites). A coaxial technique with a 22-gauge needle was used. The quality of the specimen was graded by a blinded pathologist, who also made a pathologic diagnosis. RESULTS: No statistically significant difference was noted in the graded criteria performance plus diagnostic yield between the two techniques. When performed before FNAB, FNCB yielded a better quality specimen of a particular site. However, there was no difference in the graded quality of FNAB whether performed before or after FNCB. Insufficient specimens were obtained at 30 (21.4%) of 140 sites with FNCB versus only 18 (12.8%) with FNAB. CONCLUSION: FNCB is an alternative to FNAB and provides a cellular diagnostic specimen from most lesions. When a coaxial method is used and both techniques are employed, the diagnostic accuracy of these techniques is 84%.

Biopsy, Needle↗