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Positive immunostaining with MLuC1 of bone marrow aspirate predicts poor outcome in patients with small-cell lung cancer.

BACKGROUND: Immunocytochemistry has been proven able to identify tumor cells in bone marrow aspirate (BMA) of patients with SCLC. However, few data exist about the clinical significance of the procedure. PATIENTS AND METHODS: 108 BMA taken from 60 patients were incubated with the MoAb MLuC1 (cluster 6) and stained by the APAAP (alkaline phosphatase-antialkaline phosphatase) method. The serum levels of LDH, TPA, NSE and CEA were also studied in relation to bone marrow involvement by means of discriminant analysis. RESULTS: Immunocytochemistry of the aspirate with MLuC1 detected positive cells in 23 patients (38%) (38 of 108 samples) vs. 13% of the conventional biopsies studied without MLuC1 (P < 0.001). With respect to bone marrow positivity, three groups of patients were identified: those with no positive cells in the aspirate and negative biopsy (group A); those with less than 10 positive cells in the aspirate and negative biopsy (group B); and those with more than 10 positive cells or clumps in the aspirate or positive biopsy (group C). Group C patients had poorer median survivals than those in the other two groups (5.5 vs. 11 months, respectively, P = 0.01). Discriminant analysis showed that the four serum markers were poor discriminators of the degree of bone marrow involvement, with only 55% of grouped cases being correctly classified. CONCLUSIONS: These results show that detection of bone marrow involvement i) can be improved by the use of MLuC1 ii) is not predictable by conventional tumor markers, and iii) is related to poor outcome.

Antibodies, Monoclonal↗

Low multiple pregnancy rates and reduced frequency of cancellation after ovulation induction with gonadotropins, if eventual supernumerary follicles are aspirated to prevent polyovulation.

PURPOSE: Our purpose was to demonstrate the feasibility of the routine aspiration of supernumerary follicles in infertile patients with imminent polyovulation after ovulation induction with gonadotropins and to examine its effect on the frequency of cycle cancellation and on the (multiple) pregnancy rate. METHODS: The data on 796 treatment cycles, performed between 1989 and 1996 on 410 infertile couples, were analyzed retrospectively. From October 1992, whenever necessary, supernumerary ovarian follicles were selectively aspirated transvaginally under ultrasound guidance to prevent the ovulation of more than three follicles. Thereafter, intrauterine insemination was performed. RESULTS: After the adoption of transvaginal ultrasound-guided aspiration of supernumerary follicles into the treatment protocol in October 1992, the number of canceled cycles (P < 0.0001) and the multiple pregnancy rate (P < 0.01) were significantly reduced compared to those previously. The overall pregnancy rate remained stable. No ovarian hyperstimulation syndrome requiring hospitalization was noted, and no complications resulting from the follicle aspiration were registered. CONCLUSIONS: Transvaginal ultrasound-guided aspiration of supernumerary ovarian follicles increases both the efficacy and the safety of ovulation induction with gonadotropins. Because of the limited equipment required, this method represents an alternative for conversion of overstimulated cycles to more costly alternatives such as in vitro fertilization.

Adult↗

Confirmation of the utility of fine needle aspiration biopsy of the renal allograft.

Allograft immunobiologic theory would predict that analysis of immunocompetent cells infiltrating the renal transplant would be most instructive. Recently a new aspiration biopsy technique has been developed to permit such analysis in patients which can be safely and repetitively performed. The clinical utility of such a technique has been tested utilizing a randomized prospective trial in which an aspirate was obtained every other day from the third post-operative day until discharge. Analysis included examination of adequacy criteria and the capacity of pathologic diagnosis to corroborate clinical diagnosis from coded specimens. Ninety-six aspirates from 21 consenting transplant recipients were obtained and analyzed. In 94 instances a clinical diagnosis could be made; 80 aspirates fulfilled adequacy criteria. We found the technique to be highly sensitive (greater than or equal to 90%) and highly specific (greater than or equal to 90%) for the clinical diagnoses of acute allograft rejection, post-operative acute renal failure, cyclosporine toxicity, and normal function. We conclude that the fine needle aspiration technique is an important adjunct to analysis of clinical renal transplantation and offers a major advantage to the clinical scholar in understanding transplant biology.

Acute Kidney Injury↗

Acoustic cues to place of articulation and the McGurk effect: the role of release bursts, aspiration, and formant transitions.

The McGurk effect demonstrates that the perceived place of articulation of an auditory consonant (such as/bi/) can be influenced by the simultaneous presentation of a videotape of a talker saying a conflicting consonant such as /gi/. Usually, such a presentation is perceived by observers as "di" or "delta i" (known as fusion responses). The reverse pairing (auditory /gi/ paired with a visual /bi/) results in "bgi." percepts. These are known as combination responses. In the current study, three experiments examined how acoustic information about place of articulation contained within the release bursts, aspiration, and voiced formants and transitions of a consonant contribute to the McGurk effect. In the first experiment, the release bursts and aspiration were deleted from the acoustic signal. This manipulation resulted in a smaller impact on McGurk "fusion" tokens relative to the McGurk "combination" tokens. This asymmetry may be related to the perceptual salience of the release bursts and aspiration for velar compared to the bilabial tokens used in this experiment and their importance for obtaining the combination percept. In Experiment 2, the release bursts and aspiration were increased in amplitude. Results revealed either no effect or a stronger McGurk effect for the manipulated tokens than for the intact tokens. This findings suggests that the McGurk effect for fusion tokens does not occur simply because the release bursts and aspiration are weak. In Experiment 3, low-pass filtering the second and higher formants and transitions was associated with the largest overall impact on the McGurk effect. This suggests that dynamic information contained within these formants is of primary importance in obtaining the McGurk effect. These cues are, however, context-dependent and vary as a function of talker and vowel context.

Acoustic Stimulation↗

Fine needle aspiration in plastic surgery outpatients: a retrospective study.

A survey suggested that fine needle aspiration cytology of masses in plastic surgery outpatient clinics was suboptimal. A cytopathologist gave training in the technique and the effectiveness of this intervention was audited. A total of 236 aspirates were taken from 147 patients in the earlier time period and 215 from 149 in the later period. The overall inadequate aspirate rate remained constant at 43%. The most common reasons for poor aspirates were excess blood, unrepresentative adipose tissue and insufficient cellular material. When the specimen was adequate after training, the sensitivity and specificity of the investigation were 96% and 100%, respectively. We present methods for sample optimization. Alternative strategies may be to limit aspiration to one clinician or to refer the patient to a cytopathologist experienced in the technique.

Biopsy, Fine-Needle↗

Clinical usefulness of KRAS mutational analysis in the diagnosis of pancreatic adenocarcinoma by means of endosonography-guided fine-needle aspiration biopsy.

AIM: To establish the usefulness of KRAS mutational analysis in the diagnosis of pancreatic adenocarcinoma by comparing this technique with conventional cytology in aspirates obtained by endosonography-guided fine-needle aspiration. METHODS: All consecutive patients with pancreatic focal lesions undergoing endosonography-guided fine-needle aspiration were included. Samples were obtained with the concurrence of an attendant cytopathologist. Detection of codon-12 KRAS mutations was performed by the restriction fragment length polymorphism-polymerase chain reaction method. The effectiveness of conventional cytology, KRAS mutational analysis and their combination was established with respect to the definitive diagnosis. A cost-effectiveness analysis was also performed. RESULTS: Thirty-three patients had pancreatic adenocarcinoma and 24 patients had other lesions. A total of 136 samples was obtained. In patients in whom specimens were adequate (93% for cytology; 100% for mutational analysis), the specificity of both techniques was 100%, whereas the sensitivity favoured cytology (97% vs. 73%). When inadequate samples were considered as misdiagnosed, a combination of both techniques reached the highest overall accuracy (cytology, 91%; mutational analysis, 84%; combination of both, 98%). CONCLUSIONS: Cytology from aspirates obtained by endosonography-guided fine-needle aspiration is the most precise single technique for the diagnosis of pancreatic adenocarcinoma. However, when adequate specimens are not available to reach a cytological diagnosis, the addition of KRAS mutational analysis represents the best strategy.

Adenocarcinoma↗

Semiquantitative reverse transcription polymerase chain reaction analysis for detection of bcr/abl rearrangement using RNA extracts from bone marrow aspirates compared with glass slide smears after 0, 2 and 4 d of storage.

The polymerase chain reaction (PCR) is an established tool for the detection of specific chromosomal aberrations in different haematological malignancies. Owing to fast degradation of RNA, the immediate processing of samples is thought to have a major influence on the reliability of results. Any delay caused by transport may be an obstacle to reverse transcription PCR (RT-PCR)-based methods in multicentre studies. However, as air-dried bone marrow smears are usually available, we have improved a method to use smears as a source for routine RT-PCR investigations. We studied whether this source of RNA could overcome problems caused by delayed transport of samples. The aim of the present study was (i) to investigate the influence of a storage period of up to 4 d before processing of a specimen by nested bcr/abl RT-PCR, and (ii) to compare bone marrow aspirates with bone marrow smears stored at room temperature in parallel. Bone marrow aspirates and smears were taken from 11 patients with Ph-positive chronic myeloid leukaemia (CML). PCR results were semiquantified using a limiting dilution assay. We observed a loss of sensitivity < 1 log in stored bone marrow aspirates, even after 96 h. Results obtained from air-dried unstained glass slide smears were similar to investigations performed on approximately 1 x 10(5) cells of a bone marrow aspirate. We conclude that a storage period of up to 96 h has little influence on the detection of a bcr/abl fusion transcript in CML at diagnosis. Glass slide smears were equivalent to bone marrow aspirates in 8 out of 11 cases as a source for RT-PCR analysis when nested PCR was performed.

Bone Marrow Cells↗

Percutaneous aspiration for bacteriological studies in patients with necrotizing pancreatitis.

BACKGROUND: Percutaneous computed tomography (CT)-guided aspiration of abdominal collections is performed in necrotizing pancreatitis to detect infection of necrosis, which is an adverse prognostic factor and requires surgical drainage. However, in the case of sterile aspirates, the outcome and the optimum management are subject to debate. This study examined the clinical and bacteriological outcome of patients with severe acute pancreatitis with initially sterile necrosis and assessed the efficiency of percutaneous drainage in this setting. METHODS: Seventeen patients hospitalized for necrotizing pancreatitis with a septic course underwent a preliminary sterile CT-guided aspiration. Eight patients underwent simultaneous percutaneous drainage of the punctured collection. Supportive therapy was continued unless severe clinical deterioration or proven secondary infection of necrosis indicated the need for necrosectomy and drainage. RESULTS: Secondary infection of necrosis was observed in two patients of nine who had only fine-needle aspiration cytology of the collection, and in seven of eight it was drained percutaneously (P = 0.01). Only one patient drained percutaneously recovered without surgery. Surgical drainage was required in 12 patients. The hospital mortality rate was 29 per cent and was not significantly affected by the bacteriological status of necrosis. CONCLUSION: Percutaneous drainage of sterile collections predisposed to secondary infection of the necrosis and did not cure the patients. A first sterile percutaneous aspiration did not predict a favourable course and surgery frequently remains necessary.

Adult↗

Role of ultrasonographically guided fine-needle aspiration cytology in the diagnosis of infected pancreatic necrosis.

BACKGROUND: Early detection of infected pancreatic necrosis has a major impact on further management and outcome in acute pancreatitis. The aim of this study was to evaluate the clinical value of ultrasonographically guided fine-needle aspiration cytology (FNAC) in patients with necrotizing pancreatitis over an 8-year period. METHODS: From January 1988 to September 1996 193 (mean 2.0 (range 1-9) aspirations per patient) prospectively assessed FNACs guided ultrasonographically were performed in 98 patients with necrotizing pancreatitis proven by contrast-enhanced computed tomography. Aspirates were considered infected if either Gram stain and/or culture revealed micro-organisms. RESULTS: Ultrasonographically guided FNAC correctly diagnosed infection in 29 of 33 patients with infected necrosis a median of 13 days after onset of symptoms. Of 61 patients with sterile necrosis 55 were identified correctly as sterile by FNAC. There were six false-positive and four false-negative aspirates of which nine occurred during the first week of the disease. In four patients who did not undergo operation FNAC revealed Gram-negative organisms; however, in the absence of repeated aspirations, the positive results remained unconfirmed. An overall sensitivity of 88 per cent and a specificity of 90 per cent was obtained. No difference was found in biochemical and clinical parameters indicating systemic inflammatory response syndrome before each FNAC between patients with proven sterile or infected necrosis. All patients tolerated the procedure well and no major complications were observed. CONCLUSION: Ultrasonographically guided FNAC is a fast and reliable technique for the diagnosis of infected necrosis. As complication rates are very low, the procedure can be repeated at short intervals to improve the diagnostic accuracy. Ultrasonographically guided FNAC is recommended for all patients with necrotizing pancreatitis in whom systemic inflammatory response syndrome persists beyond the first week after onset of symptoms.

Adolescent↗

Fine needle aspiration (FNA) cytology of adenoid cystic carcinoma and adenomyoepithelioma of breast: two lesions rich in myoepithelial cells.

Adenoid cystic carcinoma and adenomyoepithelioma are relatively rare, but well described, breast lesions. The FNA cytology features in two cases of mammary adenoid cystic carcinoma and two cases of adenomyoepithelioma are described. In both cases of adenoid cystic carcinoma, aspirates consisted of tightly cohesive clusters of cells arranged around spheres and interconnecting cylinders of acellular material. The two aspirates of adenomyoepithelioma were composed of large tightly cohesive clusters of cells associated with small amounts of stromal material. In all four aspirates a dual population of epithelial and myoepithelial cells could be identified within cellular aggregates, and numerous bare nuclei were present. Histology revealed the characteristic features of adenoid cystic carcinoma and adenomyoepithelioma. Immunohistochemical staining of histological sections for S-100 protein and alpha-smooth muscle actin confirmed the presence of large numbers of myoepithelial cells within all four lesions, providing indirect evidence that bare nuclei in breast aspirates represent myoepithelial cells. The presence of a dual population of epithelial and myoepithelial cells and of numerous bare nuclei within a breast aspirate is generally indicative of a benign lesion. This is not always the case, as adenoid cystic carcinoma is a malignant tumour, and adenomyoepithelioma, while generally exhibiting benign behaviour, is capable of local recurrence and distant metastasis.

Adenomyoma↗

Fine needle aspiration cytology of minor salivary gland tumours of the palate.

Fine needle aspiration cytology of minor salivary gland tumours of the palate This retrospective study was carried out to review aspirates from minor salivary gland tumours of the palate and to assess the problems encountered in their diagnosis, especially the cytological diagnosis of newer entities such as polymorphous low grade adenocarcinoma (PLGA). Fifty-five cases of palatal salivary gland tumours aspirated over a period of 16 years were reviewed. Histology was available in 26 cases. Pleomorphic adenoma (27 cases) was the most common benign cytodiagnosis. Eleven aspirates were malignant tumours of which eight cases were adenoid cystic carcinoma and three cases were mucoepidermoid carcinoma. Seven cases were diagnosed on fine needle aspiration as suggestive of PLGA. However histological confirmation was available in only one of these cases. Concordance between the initial and revised typings of the tumours was seen in only 28 cases (54%) in the present study. Initially 18 of the 51 tumours (35.3%) could not be typed; and after review, only three could not be typed. Three cases of oncocytoma could be diagnosed on review only. Palatal salivary gland tumours, although relatively uncommon, are difficult to diagnose cytologically. This is more so in cases of newer entities such as PLGA, as their cytological diagnosis is still not well characterized.

Adenoma, Pleomorphic↗

Traumatic arterial damage after fine-needle aspirational cytology in mammary complex sclerosing lesions.

We retrospectively reviewed 107 consecutive cases of radial scar and complex sclerosing lesions in a 54 month period seeking vascular lesions using archival H & E stained 5 micron thick sections. Eight showed vascular abnormalities, five being false aneurysms which were limited to 62 lesions > 10 mm diameter; no false aneurysm was found in 45 radial scars < or = 10 mm. All cases displayed arterial lesions, but two also showed associated venous fibrosis. Traumatic false aneurysms with loss or severe thinning of the media and intimal, medial or extravascular spindle cell proliferation were found in the arteries of five cases with histological evidence of local reaction to previous fine-needle aspirational biopsy and clinical documentation of aspiration 18 to 121 days before. The diameters of the false aneurysms correlated with the original widths of the arteries. The other lesions with mature intimal fibrosis in arteries or veins lacked such local post-aspiration expansile reactive changes, or a history of fine needle aspiration. We conclude that traumatic false aneurysms found in complex sclerosing lesions seem to be iatrogenic, resulting from fine needle aspiration. Mature fibrosis in veins or arteries are probably unrelated processes.

Aged↗

Diagnostic value of gastric aspirate smear and polymerase chain reaction in smear-negative pulmonary tuberculosis.

OBJECTIVE: The aim of this study was to determine the validity of acid-fast bacilli (AFB) smear and polymerase chain reaction (PCR) from gastric aspirates for the diagnosis of smear-negative pulmonary tuberculosis. METHODOLOGY: A cross-sectional study was conducted in a university hospital. One hundred and nine patients with suspected pulmonary tuberculosis in whom either sputum smears were negative or who were not producing sputum were recruited to the study. All patients underwent gastric aspiration after an overnight fast followed by standard fibreoptic bronchoscopy. Specimens were subjected to AFB smear, culture, and pathological examination. PCR was performed on culture filtrate after 1 week of incubation. RESULTS: Eight patients did not complete the follow-up schedule. Of the 101 patients with final outcomes, a diagnosis of pulmonary tuberculosis from microbiological evidence was established in 54 patients. The gastric aspirate smear, PCR, or either one of them was positive in 34, 30, and 39 tuberculosis patients, respectively. There were 13 false positive smears from 47 non-tuberculosis patients, with five resulting from non-tuberculous mycobacteria (NTM). The PCR was falsely positive in eight patients, five of whom had previous histories of tuberculosis. The overall sensitivity, specificity, positive predictive value, and negative predictive value of gastric aspirate examination by combined smear and PCR were 72, 58, 66, and 64%, respectively. CONCLUSIONS: Gastric aspiration is a useful tool for the diagnosis of smear-negative pulmonary tuberculosis warranting institution of antituberculosis treatment. Interpretation of the results should be cautious in those who have had tuberculosis in the past or who have been at risk for acquisition of NTM.

Adolescent↗

Fine needle aspiration in the management of benign thyroid cysts.

BACKGROUND: Resolution of cystic thyroid lesions after aspiration occurs in 8-45% of cases, the remainder require treatment for residual tumour or recurrent cysts. The aim of this study was to identify patient characteristics that predict cyst recurrence to enable these patients to undergo early surgery. METHODS: A retrospective analysis of 123 patients with benign thyroid cysts that were suitable for conservative management was undertaken. Demographic, clinical, ultrasound and fine needle aspiration cytology data were collated for patients who underwent surgery or were managed conservatively. Univariate and multivariate analyses were performed to identify factors predictive of cyst recurrence. RESULTS: Of the 123 patients, 43 underwent surgery consequent on cyst recurrence or persistent symptoms after aspiration, and 80 were treated by aspiration alone. There were 17 males and 106 females, of mean age 45.5 years. The mean cyst size was 27 mm. Those undergoing surgery had a significantly greater mean cyst size (P = 0.001). The only factor predicting cyst recurrence on univariate analysis was absence of follicular cells on initial aspiration (P = 0.005). Multivariate analysis confirmed absence of follicular cells as an independent characteristic predicting recurrence, the odds ratios for recurrence was 3.18 (95%CI 1.39-7.29). CONCLUSION: The present study suggests consideration of early surgery for patients with thyroid cysts with absence of follicular cells on initial cytology.

Biopsy, Fine-Needle↗

The role of fine-needle aspiration cytology of the testis in the diagnostic evaluation of infertility.

OBJECTIVE: To compare the diagnostic value of cytological smears of fine-needle aspirate with that of histological sections obtained by testicular biopsy in the evaluation of infertility. PATIENTS AND METHODS: The study included 60 patients with azoospermia or severe oligospermia (sperm counts of < 5 million/mL). A detailed history was taken and the external genitalia examined. Testicular samples were obtained by fine-needle aspiration using a 10 mL syringe and 21 G needle; the air-dried smears were stained using the May-Grunwald-Giemsa method. A testicular biopsy was taken after exploring the same tract and these sections were stained with haematoxylin and eosin. The cytological smears and histological sections were examined separately and the results compared. RESULTS: The cytological smears were divided into three groups: normal, with all spermatogenic cells present; Sertoli-cell only syndrome; and spermatogenic arrest (all spermatogenic cells present except spermatids and spermatozoa). There was a good correlation between the diagnosis on the cytological smears and histological sections in 58 of 60 patients (97%). In two patients there was scanty aspirate and few cells, giving an inaccurate diagnosis. Interstitial cells were not detected on cytological smears. In three patients, Sertoli-cell only was diagnosed on cytology, and histology revealed additional features of Leydig cell hyperplasia. CONCLUSION: Fine-needle aspiration of the testis is a simple and minimally invasive technique for diagnostic evaluation, especially in patients with obstructive azoospermia. Patients with abnormal findings on fine-needle aspiration cytology may be evaluated histologically by further biopsy.

Biopsy, Needle↗

Sonographically guided aspiration: an alternative therapy for tubo-ovarian abscess.

Our objective was to evaluate the role of single-step ultrasound-guided aspiration in conjunction with intracavitary antibiotic instillation for the treatment of tubo-ovarian abscess. Ten women with the clinical and sonographic diagnosis of tubo-ovarian abscess, who failed to respond to systemic antibiotic therapy, were treated by ultrasound-guided aspiration of the abscess followed by intracavitary instillation of a combination of antibiotics. All ten women improved clinically and none required surgery. The mean time from aspiration to hospital discharge was 3.1 days with mean duration of hospitalization 7.8 days. No major complications were observed. The average time interval between aspiration of the lesion and resolution on sonographic follow-up was 9.5 weeks. In three cases, pelvic inflammatory disease recurred, but none needed surgical intervention. The average follow-up period of the patients was 12 months. One-step sonographically guided aspiration of tubo-ovarian abscess followed by intracavitary antibiotic instillation may serve as an easy and safe alternative therapy in patients in whom treatment with systemic antibiotics has failed.

Abscess↗

Biomarker assays in nipple aspirate fluid.

The noninvasive technique of nipple aspiration as a potential source of biomarkers of breast cancer risk was evaluated. The feasibility of performing mutagenesis assays, amplifying DNA, and performing protein electrophoresis on nipple aspirate fluid was explored. A tool was developed to measure the level of discomfort, if any, from this procedure. Twenty-five healthy women (20 premenopausal and 5 postmenopausal) were enrolled. Fluid was obtained using a modified breast pump. Premenopausal women were scheduled for four to six weekly aspirations, and postmenopausal women were scheduled for one to two weekly aspirations. Mutagenesis assays were performed using the Salmonella (Ames) assay. DNA amplification of several microsatellite regions was carried out using polymerase chain reaction. Protein was quantified, and two-dimensional protein electrophoresis was performed. Overall, fluid was obtained from 80% of the women, and the level of discomfort was minimal. Acid hydrolysis of one sample resulted in mutagenicity; all six nonhydrolyzed samples were not mutagenic. The ability to amplify DNA ranged from 34% to 96%, depending on length of the microsatellite region examined. The average protein concentration was 71 microg/mL. Two-dimensional protein electrophoresis was successfully performed on samples from two subjects. Nipple aspiration is a simple technique and is easily learned and well tolerated, which yields a reagent useful for a variety of investigations. This technique may facilitate the identification and application of biomarkers for future breast cancer risk assessment and chemopreventive protocols.

Adult↗

[Transjugular liver biopsy: trucut or aspiration biopsy with modified Ross needles?].

PURPOSE: The transjugular liver biopsy is performed in patients with coagulopathy to evaluate diffuse hepatopathies. Using a jugular venous access, a liver vein is cannulated and a transvascular biopsy taken. The two techniques in use are the aspiration biopsy with a modified 15G or 16G Ross needle used for TIPS and the core biopsy with a Trucut needle. The sampling is quite similar for these techniques, but the costs are significantly different. This study is a meta-analysis of data published on both techniques to search for clinical evidence that justifies the use of the more expensive Trucut needle or that finds aspiration with the less expensive Ross needle equivalent. MATERIALS AND METHODS: The study includes 16 publications that were published between 1996 and 2002 and provided reliable information on technical success rate, complications and adequate histology. The data on 1374 procedures were analyzed, comprising 436 aspiration biopsies and 938 Trucut biopsies. RESULTS: Considering both procedures together, 95.9 % of the procedures were technically successful and 92.2% of the histologic samples diagnostically adequate. The technical success rate was 96.7 % for the Trucut-biopsies and 94.4 % for the aspiration biopsies. The corresponding rates of obtaining diagnostically adequate histologic samples were 92.5 % and 91.5 %, respectively. The complication rate of the entire population studied was 0.65 % without significant difference found between the two methods. With a list price of 420 Euro, the Trucut system costs about 200 Euro more than the Ross needle, which is listed as approximately 220 Euro. CONCLUSION: In the absence of any significant differences between both techniques for transjugular liver biopsies, economic considerations make the aspiration biopsy with the modified Ross needle preferable over the Trucut needle biopsy.

Biopsy, Needle↗