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At least 19 recordsLinked to original sources
PubMed1995

[CT-assisted needle biopsy in pulmonary and mediastinal space-occupying lesions. The effect of spiral CT and various biopsy needles on results].

The efficacy of percutaneous CT-guided needle biopsies was investigated in 68 patients with pulmonary lesions and in 65 patients with mediastinal masses. In comparison with conventional multisectional CT, the time needed for the localization of the needle tip could be reduced by use of spiral CT. Comparing aspiration and cutting biopsy needle we achieved a higher accuracy of 94% in case of mediastinal masses and of 90% by using cutting needles. The rate of complications, such as pneumothoraces, is relatively low.

Adult↗
PubMed1991

Prostatic needle biopsy using an Iowa trumpet biopsy needle guide during standard digital rectal examination: a comparison with ultrasound controlled biopsy.

A new method of transrectal biopsy of the prostate using an Iowa trumpet is introduced. This method allows the urologist to biopsy what he or she palpates during a standard digital rectal examination. The methodology of using this biopsy guide is explained. Among 66 patients with a palpable prostatic abnormality 31 cancers were diagnosed with this new method, while only 15 cancers could be diagnosed with standard ultrasound guided biopsy techniques. However, of these 31 cancers 8 would have been missed without the aid of ultrasound. No unusual complications were noted with this new biopsy method.

Biopsy, Needle↗
PubMed1993

Percutaneous ultrasound-guided biopsy. Fine needle biopsy, cutting needle biopsy, or both?

The results of 155 US-guided cutting needle biopsies, mainly of abdominal and transthoracic lesions, were reviewed to assess the diagnostic accuracy of the method. A fine needle biopsy (FNB) was additionally performed in 99 of the patients. Sufficient material for histologic and cytologic analysis was obtained in 88% (137/155) and 98% (97/99), and a correct benign or malignant diagnosis was made in 87% and 88%, respectively. Among the 99 combined biopsies the corresponding figures were 100% and 97%, respectively. The proportions of inconclusive and false-negative results among histologic samples were 0% and 4% (2/57), in FNBs 7% (7/99) and 5% (3/56), and in combined examinations 3% (3/99) and 0%. One major complication, Streptococcus faecalis sepsis, occurred. The combined use of FNB and histologic biopsy increases the proportion of correct diagnoses about 10% without increasing the complications.

Abdominal Neoplasms↗
PubMed1987

Comparison of CT-guided and stereotaxic cranial diagnostic needle biopsies.

Needle biopsy of the brain utilizing computerized tomography (CT) scan data is an accepted diagnostic technique that has been performed both with and without the aid of stereotaxic frames. Experience with both techniques has resulted in a specific procedure for CT-guided free-hand biopsy which is performed in the CT suite under local anesthesia. Over the last 6 years the authors have performed 64 CT-guided free-hand biopsies and 13 stereotaxic biopsies with the Brown-Roberts-Wells system. Nonspecific gliosis, tumor, infection, radiation necrosis, or vascular malformation, were diagnosed in all but one biopsy, for a clinically accurate diagnostic yield of 92%. A comparison of diagnostic yield, morbidity, and mortality has shown no significant difference between the free-hand and the stereotaxic techniques. The time required for the procedures and their cost have been compared and have been found to be significantly less for the free-hand biopsy group. Thus, CT-guided free-hand biopsy may still represent the method of choice for histological diagnosis of many intracranial lesions.

Adolescent↗
PubMedDate not supplied

Diagnosis of lymphoma by image-guided needle biopsies: fine needle aspiration biopsy, core biopsy or both?

OBJECTIVE: To determine whether or not concurrent core biopsy adds to results obtained from image-guided fine needle aspiration biopsy (FNAB) in cases of lymphoma. STUDY DESIGN: Twenty-eight FNABs of lymphomas with adjuvant flow cytometry (FC) and concurrent core biopsy were evaluated retrospectively. In each case, completeness of diagnosis by FNAB, including phenotyping and grading, where appropriate, was reviewed. The contribution of core biopsy to the diagnosis in cases where FNAB did not render a complete diagnosis was assessed. Prognostic information not available from the FNAB but obtained from the core biopsy was also evaluated. RESULTS: FNAB with adjuvant FC gave a complete diagnosis, including phenotype and grade, where applicable, in 23 of 28 cases (82%). Core biopsy added to the diagnosis in 3 cases. In 1 case, large B-cell lymphoma was diagnosed on core biopsy when FNAB was unsatisfactory. In the other 2 cases, grade of follicle center cell lymphoma was higher on core biopsy than on FNAB. The addition of the information obtained by core biopsy to that obtained by FNAB raised the diagnostic accuracy to 93%. Core biopsy was used to assess nodularity, which could not be determined on FNAB. Core biopsy was also used to assess prognostic markers by immunohistochemistry (Ki-67 and p53); they were not available with FC. This was done in 11 cases when requested by the oncologist. CONCLUSION: FNAB with adjuvant FC is a useful technique for diagnosing and subtyping lymphomas. However, diagnosis and subclassification are often insufficient. Core biopsy material provides opportunity for obtaining additional diagnostic and prognostic information that may not be easily derived from the FNAB. This allows optimal treatment planning in patients for whom excisional biopsy is contraindicated.

Adult↗
PubMed1999

Large needle core biopsy--avoidance of biopsy table bombardment by the biopsy needle in stereotactic guided breast biopsy.

Table bombardment by automated biopsy needle is an occasional technical problem during stereotactic core biopsy of the breast. It is most commonly encountered in small breasts and when lesions are close to the biopsy table. A reference chart is devised for stereotactic core biopsy using an add-on erect stereotactic biopsy table and automated spring-loaded biopsy gun. The chart serves as a reference for pre-biopsy assessment of the feasibility of core biopsy in the vertical approach due to the constraints of lesion depth and breast thickness. It allows easy and quick reference for the required needle length input for the stereotactic system to prevent table bombardment.

Biopsy, Needle↗
PubMedDate not supplied

Coarse needle biopsy versus fine needle aspiration biopsy in the diagnosis of focal lesions of the liver. Ultrasonically guided needle biopsy in suspected hepatic malignancy.

In 55 patients with ultrasonically demonstrated suspected hepatic malignancy, a fine needle aspiration biopsy and a coarse needle biopsy of the same focal lesion were performed under ultrasonic guidance. In 41 of 48 cases with proven malignancy, both biopsies were positive. In the remaining seven cases, only the fine needle aspiration biopsy yielded malignant cells. Tumor typing was possible in 2 primary and 33 metastatic tumors by examination of either the cytologic or the histologic specimen; an additional 6 metastatic tumors could be typed only by evaluation of the histologic specimen. Grading of six adenocarcinomas was performed with higher accuracy in the histologic than in the cytologic specimen. Exact determination of the primary site was not possible in metastatic tumors by use of either type of needle biopsy specimen. Since the less traumatic fine needle aspiration biopsy requires fewer prebiopsy precautions and has other advantages, the coarse needle biopsy should be restricted to the few cases in which the former does not yield sufficient information.

Adenocarcinoma↗
PubMed2006

[Histopathologic quality of prostate core biopsy specimens: comparison of an MR-compatible biopsy needle and a ferromagnetic biopsy needle used for ultrasound-guided prostate biopsy].

PURPOSE: The histopathologic quality of core biopsy specimens obtained via MRI-guided prostate biopsy using a 16G MR-compatible needle was compared to that of biopsies obtained via ultrasound-guided biopsy using a conventional 18G stainless steel biopsy needle. MATERIAL AND METHODS: A retrospective analysis was performed for a total of 247 transrectal prostate biopsy specimens obtained from 32 patients. A total of 117 tissue cores were obtained from 15 patients (PSA of 10.8 ng/ml, age 64 years) who underwent an MRI-guided prostate biopsy using a 16G (1.7 mm) MR-compatible biopsy needle made of titanium alloy. The remaining 130 tissue cores were obtained from 17 patients (PSA of 6.7 ng/ml, age 68 years) who underwent a transrectal ultrasound-guided prostate biopsy using an 18G (1.3 mm) ferromagnetic stainless steel biopsy needle. The length and width of the histologic sections prepared from the tissue cores were measured to calculate the area. The histopathologic quality of the specimens was assessed microscopically using tissue fragmentation, the presence of crush artifacts, and the overall accessibility as criteria. Each of these features was assigned a score from 0 to 3. All 3 features contributed equally to the overall score which ranged from 0 (no tissue) to 9 (optimal quality). RESULTS: The overall quality scores assigned to the biopsies obtained with a 16G MR-compatible needle and an 18G ferromagnetic needle can be considered to be equivalent to a mean difference between patient related median scores of the specimens of - 0.05 (95 % confidence interval [- 0.46; 0.36]) and a given equivalence limit of 1. The MRI biopsies showed more tissue fragmentation (p = 0.001) but fewer crush artifacts (p = 0.022) while the accessibility did not differ significantly between the two needle types (p = 0.064). There was also no significant difference in the calculated areas of the tissue cores (p = 0.236). According to the different calibers of the biopsy needles, the lengths (p = 0.008) and widths (p = 0.000) of the biopsy specimens differed significantly. CONCLUSIONS: The core biopsy specimens obtained with an MR-compatible 16G titanium alloy biopsy needle are of the same histopathologic quality as specimens obtained with a ferromagnetic 18G stainless steel needle.

Aged↗
PubMed2001

Magnetic resonance imaging-guided core needle biopsy and needle localized excision of occult breast lesions.

BACKGROUND: Breast magnetic resonance imaging (MRI) has been reported to be twice as sensitive and three times more specific in detecting breast cancer. We report a series of MRI-guided stereotactic breast biopsies (SCNBB) and needle localized breast biopsies (NLBB) to evaluate MRI as a localization tool. METHODS: Forty-one breast lesions were identified in 39 patients who subsequently had SCNBB or NLBB. Suspicious areas of enhancement were stereotactically biopsied with 16-G core biopsy needles or localized with 22-G wires for excision under laser guidance. RESULTS: Forty-one breast lesions were identified from 1,292 breast MRIs. SCNBB identified three malignancies and two areas of atypia. Two additional cancers were found after NLBB. In patients having NLBB alone, five cancers and two areas of atypia were identified. CONCLUSIONS: In this initial series, breast MRI-guided SCNBB and NLBB were valuable tools in the management of patients with suspicious abnormalities seen only on MRI.

Adult↗
PubMed2004

MRI-guided breast biopsy: clinical experience with 14-gauge stainless steel core biopsy needle.

OBJECTIVE: Core needle biopsy has proven advantages for wire localization and excision; however, MRI-guided core biopsy has been limited by less satisfactory sampling efficiency and less availability of MRI-compatible biopsy needles. We evaluated the feasibility and diagnostic yield of MRI-guided biopsy using 14-gauge stainless steel core biopsy needles and MRI-compatible coaxial sheaths in a closed 1.5-T scanner. MATERIALS AND METHODS: Thirty-five consecutive breast biopsies performed in 29 women between March 2001 and August 2002 were retrospectively reviewed. For each procedure, an MRI-compatible sheath was placed under MRI guidance using a dedicated breast coil and biopsy guidance system. With the patient out of the magnet, a 14-gauge steel core biopsy needle was used to obtain multiple samples. Lesion characteristics, including size, morphology, and enhancement, were recorded. Histology of all the lesions was obtained; and surgical, imaging, or clinical follow-up was performed. RESULTS: Targeted masses and enhancing foci ranged from 3 to 17 mm. Regional enhancement ranged from 14 to 70 mm. Thirty-four of the 35 biopsies were technically successful. Histology revealed malignancy in eight lesions (23%), atypical ductal hyperplasia in five lesions (14%), and benign entities in 21 lesions (60%). Surgery confirmed all eight core biopsies with malignant findings. Two of five lesions with atypical ductal hyperplasia were upgraded to malignancy after surgery. CONCLUSION: This new method of MRI-guided breast biopsy with a 14-gauge stainless steel core biopsy needle and a closed 1.5-T MRI scanner is feasible, safe, and effective and produces satisfactory diagnostic yield. This method offers an alternative to MRI-guided wire localization and to MRI-guided core biopsy with nonferrous needles.

Adult↗
PubMed1998

Gleason scores from prostate biopsies obtained with 18-gauge biopsy needles poorly predict Gleason scores of radical prostatectomy specimens.

OBJECTIVES: Prostate cancer is the most frequent cancer among men in the US. Histological grading is an important part of the diagnostic evaluation aside from clinical staging and serum PSA. The most commonly used grading system is the one described by Gleason. From a prognostic point of view, it is of considerable interest to know how accurate the needle biopsy Gleason score is in predicting the final score of the radical prostatectomy specimen. From an outcome research point of view, it is important to recognize that a stratification of patients by Gleason score may prove correct in patients undergoing radical prostatectomy, while in patients undergoing radiation or conservative management some of the well-differentiated cancers could actually be moderately and poorly differentiated, and some of the moderately differentiated might be poorly differentiated, thus favoring radical prostatectomy in a direct comparison of treatment efficacy. We aimed to determine (1) whether such undergrading exists, (2) what the magnitude of the bias is, and (3) whether it is common and similar in different institutions. MATERIALS AND METHODS: We retrospectively reviewed the records of 415 patients who underwent radical prostatectomy in three Dallas area hospitals, excluding patients who received neoadjuvant therapy prior to surgery. Data of Gleason grades and score were collected from the needle biopsy and the radical prostatectomy specimen. Analysis was done using three categorization schemes for mild, moderate and poor differentiation for the three individual hospitals and the entire group. RESULTS: The most common Gleason score by needle biopsy and prostatectomy was five. 37.2% of all patients had no change in score assignment, while 12.7% were 'overgraded' and 50.1% 'undergraded' by needle biopsy. The most common undergrading was by 1 or 2 score points. Only 23.7% of the category 'well' cancers remained so after surgery. Between 65.0 and 88.4% of the category 'moderate' cancers remained so after surgery. To determine the degree of agreement between needle biopsy and surgery category, kappa statistics were employed. The kappa value ranged from 0.148 to 0.328 for all categories and classification schemes indicating poor reproducibility. Serum prostate-specific antigen was not helpful in predicting Gleason score upgrading. CONCLUSIONS: Independent of the setting, about 50% of all Gleason score assignments made on needle biopsy specimen are revised in the direction of a worse score/category. It is important for clinicians to realize this phenomenon when consulting with patients regarding treatment choices if the grade is taken into consideration. For outcome research purposes, it is important to realize that this introduces a bias into direct comparisons between surgical and nonsurgical (radiation and watchful waiting) series favoring the outcomes of surgical series as the nonsurgical series suffer from a less favorable patient mix.

Biopsy↗
PubMed1991

[Study on usefulness of an aspirating biopsy needle (Vacu-Cut) and an automatic biopsy needle (Biopty-Cut) for renal biopsy--comparison with a Tru-Cut biopsy needle].

Our medical team conducted the percutaneous renal biopsy, using an aspirating biopsy needle (Vacu-Cut) in 101 cases, and an automatic biopsy needle (Biopty-Cut) in 82 cases. Thereafter, we examined the usefulness of the two types of needles in comparison with that of Tru-Cut used in 101 cases. The test confirmed that in the cases of Vacu-Cut, 7.6 glomeruli (p less than 0.01), on the average, existed in LM specimen; 9.0 glomeruli (ns), Biopty-Cut, and 10.7 glomeruli, Tru-Cut, respectively. However the incidence of cases containing more than 5 glomeruli was not significant statistically between Vacu-Cut/Biopty-Cut and Tru-Cut. The incidence that each type of needles obtained more than one glomerulus in IF specimen was as follows: 73.3%, Vacu-Cut (p less than 0.05), 81.7%, Biopty-Cut (ns), 87.1%, Tru-Cut, respectively. As for in EM specimen, 61.4%, Vacu-Cut (ns), 67.1%, Biopty-Cut (ns), and 70.3%, Tru-Cut, respectively. As for complications, in the cases of Vacu-Cut and Biopty-Cut, gross hematuria and post-biopsy pain occurred in 6.9 to 9.8% (p less than 0.01- p less than 0.05), whereas in Tru-Cut, they occurred in 20.7 to 24.8%. As for blood pressure lowering (less than 90 mmHg) and anemia (the cases in which blood transfusion was required), 0%, Vacu-Cut and Biopty-Cut, 2 to 3%, Tru-Cut, respectively. As for fever, Vacu-Cut 0%, Vacu-Cut (p less than 0.01), 3.7%, Biopty-Cut (ns), and 7.9%, Tru-Cut, respectively. The above findings lead to conclusion that both Vacu-Cut and Biopty-Cut are useful instruments for renal biopsy.

Adolescent↗
PubMed1988

Jamshidi needle biopsy for diagnosis of bone lesions in small animals.

Sixty-two bone lesions in 59 small animals were biopsied using a Jamshidi-type biopsy needle. In all instances, the Jamshidi needle biopsy diagnosis was confirmed or disputed by results of histologic examination of specimens obtained by surgical resection or by amputation or at necropsy. In 57 of 62 bone lesions, biopsy resulted in an accurate diagnosis of tumor vs nontumor, yielding an accuracy rate of 91.9%. The specific tumor type or lesion type was identified accurately by Jamshidi needle biopsy in 51 of 62 lesions, yielding an accuracy of 82.3%. Of the 62 bone lesions, 48 were intramedullary osteosarcoma and 62.5% of these were subclassified correctly by Jamshidi needle biopsy results as osteoblastic, chondroblastic, fibroblastic, osteoclastic, or poorly differentiated osteosarcoma. Jamshidi needle biopsy was easy, quick, and safe, and its high accuracy rate of diagnosis indicated that it should be a valuable aid for diagnosis of bone lesions in small animals.

Animals↗
PubMed1999

EUS-guided fine needle biopsy: minimally invasive access to metastatic or recurrent cancer.

OBJECTIVE: Endoscopic ultrasound (EUS) is a sensitive technique for preoperative staging of gastrointestinal tumors. However, the value of this technique in the diagnosis of metastatic or recurrent disease is limited by the inability to differentiate malignant and benign lesions. We have prospectively investigated the role of EUS-guided biopsy in the evaluation of peri-intestinal tumors. METHODS: EUS-guided biopsy was performed in 167 patients with thoracic, intra-abdominal or pelvic lesions. The upper gastrointestinal tract was examined with a flexible echoendoscope equipped with a 7.5 MHz curved array transducer. For transrectal EUS a rigid endoprobe with a bifocal multiplane transducer (10 MHz) was used. Both instruments allowed to observe the biopsy procedure exactly in the longitudinal scan plane. RESULTS: Real time ultrasonography guidance of the biopsy needle enabled precise tissue sampling even of small lesions with a diameter of 1 cm. Overall EUS-guided fine needle biopsy yielded tissue samples for histopathologic or cytologic analysis in of 151 of 167 patients. Histology demonstrated benign lesions in 71 of 74 patients and malignant tumors in 68 of 93 patients. EUS-guided fine needle biopsy failed to provide the correct diagnosis in 28 cases. The overall sensitivity and specificity of EUS-guided biopsy in the diagnosis of malignancy were 73 and 96%, respectively. The histopathological results changed the clinical and endosonographic diagnosis in 49 patients. No complications were observed related to the biopsy. CONCLUSIONS: EUS-guided needle biopsy is a safe and efficient method for tissue sampling of peri-intestinal lesions. This minimally invasive technique provides adequate biopsies and improves the diagnostic value of endoscopic ultrasonography considerably.

Biopsy, Needle↗
PubMed1997

Endosonography-guided fine-needle biopsy of indurated pancreatic lesions using an automated biopsy device.

BACKGROUND AND STUDY AIMS: We have designed and evaluated a prototype automated spring-loaded biopsy needle for endoscopic ultrasonography (EUS)-guided tissue sampling of indurated lesions in which sampling using conventional aspiration needles has failed. PATIENTS AND METHODS: EUS-guided fine-needle biopsy using the new device was performed in four patients (two men, two women, mean age 65 years) with indurated pancreatic lesions that could not be penetrated with a conventional manually operated aspiration needle. The lesions were located in the head of the pancreas in two patients, in the genu in one, and in the body in one. RESULTS: The automatic biopsy needle allowed penetration of the pancreatic lesions in all cases. The biopsy route was transduodenal in two patients, and transgastric in the other two. The biopsies provided a core specimen for histological and cytological diagnosis in all cases. No complications occurred. CONCLUSION: The spring-loaded biopsy needle allows tissue sampling of indurated pancreatic lesions that cannot be penetrated with conventional aspiration needles. Further studies are warranted to determine whether this device can improve the results of EUS-guided fine-needle aspiration biopsy.

Adenocarcinoma↗
PubMed1980

Sensitivity and specificity of needle biopsy in lung malignancy.

Ninety-five patients with pulmonary parenchymal lesions suggestive of malignancy underwent 103 combined puncture-aspiration biopsies using an 18-gauge Rotex biopsy needle. The over-all sensitivity of the procedure was 90%, and the specificity was 95%, as determined by pathologic and clinical outcome. Needle biopsy was diagnostic in 69 of 77 patients (90%) with malignancy. In 3 patients with a false-negative biopsy result, a second needle biopsy was diagnostic, increasing the yield to 94%. One false-negative biopsy result occurred in a patient with actinomycosis. In the 17 patients in whom no malignancy was found on percutaneous biopsy, subsequent surgical biopsy, culture of aspirate, or stability or disappearance of the lesion within a year or more confirmed the initial diagnosis of nonmalignant disease. Pneumothorax was the only significant complication, requiring tube drainage after 6 biopsies (5.8%). Our study confirms that needle puncture-aspiration is an extremely reliable technique in diagnosing lung malignancy and is adaptable to use in a community teaching hospital.

Adenocarcinoma↗
PubMed1976

[The optimal diagnosis of recurrence and metastases in female genital cancer by needle biopsy (author's transl)].

The "true-cut" disposable biopsy needle was used for 95 needle biopsies in 42 patients who were suspected to have a recurrence or metastases of low lying gynaecological cancer. Up to 3 biopsies per patient were obtained. In 21 patients the clinical suspicion of malignant was verified by microscopic examination. The needle biopsies were done as often by the vaginal as by the rectal route. Because of the low incidence of complications the needle biopsy was recommended for the definite diagnosis and follow-up examination of suspicious low lying gynaecological tumors.

Biopsy, Needle↗
PubMed2001

Large-needle biopsy versus thin-needle biopsy in diagnostic pathology of liver diseases.

BACKGROUND/AIMS: A study was carried out to determine whether thin-needle biopsy (TNB) yields enough material to study diffuse liver diseases. METHODS: Using TNB (20G and 21G) and a conventional Menghini-type large-needle biopsy (LNB; 17G), the amounts of tissue obtained and the histopathological diagnoses were compared. The biopsies were obtained by surgeons with a several-stroke method (17GS) and by physicians with a single-strike method (17GP, 20GP, 21GP). A total of 343 biopsy specimens from 258 patients were included in the study. RESULTS: A comparison of the mean values for the length of the core biopsy, as well as the mean numbers of portal tracts and terminal hepatic veins among the four groups showed significant differences (p<0.001): the mean number of portal tracts obtained with 17GS was 13.8+/-6.5, with 17GP it was 9.7+/-5.9, with 20GP it was 6.7+/-4.4, and with 21GP it was 4.0+/-3.1. A comparison of the histopathological diagnoses showed no major differences between 17GP and 20GP; the diversity and frequencies of the diagnoses were similar. CONCLUSION: We suggest that the use of TNB, particularly 20G-size needles, could be extended to the investigation of diffuse liver diseases in which LNB carries a high risk of complications or is contraindicated, and when the diagnosis is the primary reason for the biopsy rather than grading or staging of a known diffuse disease.

Adolescent↗