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Medline ® Abstracts for References 11-23

of 'Endoscopic ultrasound-guided trucut biopsy'

11
TI
Diagnosis of soft tissue tumours by Tru-Cut biopsy.
AU
Ball AB, Fisher C, Pittam M, Watkins RM, Westbury G
SO
Br J Surg. 1990;77(7):756.
 
Tru-Cut biopsies were obtained from 52 consecutive patients referred with soft tissue tumours. Forty-five patients had soft tissue sarcomas; seven had benign soft tissue tumours. Of the biopsies 96 per cent provided adequate material for diagnosis. The histological diagnosis made from the Tru-Cut biopsy was compared with that made from the resected specimen. There were no false positive diagnoses of malignancy. The accuracy of Tru-Cut biopsy was 98 per cent for the diagnosis of malignancy and 94 per cent for the diagnosis of sarcoma. Tumour subtype was correctly specified in 85 per cent of sarcomas and tumour grade in 88 per cent. Tru-Cut biopsy should replace open biopsy as the primary means of diagnosis of soft tissue tumours unless a satisfactory tissue sample cannot be obtained.
AD
Academic Surgical Unit, Royal Marsden Hospital, London, UK.
PMID
12
TI
Ultrasound-guided core-needle biopsy is effective in the initial diagnosis of lymphoma patients.
AU
Zinzani PL, Colecchia A, Festi D, Magagnoli M, Larocca A, Ascani S, Bendandi M, Orcioni GF, Gherlinzoni F, Albertini P, Pileri SA, Roda E, Tura S
SO
Haematologica. 1998;83(11):989.
 
BACKGROUND AND OBJECTIVE: With the development and refinement of new guidance methods for percutaneous biopsies, many investigators have reported studies supporting a role for radiologically guided core-needle biopsy in the diagnosis of malignant lymphoma under certain clinical circumstances. The aims of this report are to evaluate the efficacy of findings at ultrasound (US)-guided core-needle biopsy of abdominal lymphoma on patient care and define the key determinants of clinical success.
DESIGN AND METHODS: US-guided core needle biopsies were performed in 55 patients with abdominal lymphoma: 44 non-Hodgkin's lymphoma (NHL) and 11 Hodgkin's disease (HD); 41 had had no prior lymphoma and 14 had previously diagnosed lymphoma. All the biopsies were performed under US control using a 21-gauge modified Menghini needle. Overall, 53/55 (96%) patients were treated on the basis of biopsy findings only, including 14/14 (100%) patients with a history of lymphoma and 39/41 (93%) patients with no such history.
RESULTS: In 46/53 (87%) patients it was possible to assess the specific histotype. No differences between the diagnostic rates of HD and high grade-NHL were recorded. There were no complications related to the biopsies.
INTERPRETATION AND CONCLUSIONS: Our data indicate that abdominal US-guided core-needle biopsy should be considered as an effective and safe procedure in the diagnosis of patients with lymphoma offering the possibility of determining the tumor subtype and the subsequent specific treatment.
AD
Institute of Hematology and Medical Oncology Seràgnoli, Bologna University, Italy.
PMID
13
TI
Diagnostic value of ultrasound-guided fine-needle aspiration biopsy, core-needle biopsy, and evaluation of combined use in the diagnosis of breast lesions.
AU
Hatada T, Ishii H, Ichii S, Okada K, Fujiwara Y, Yamamura T
SO
J Am Coll Surg. 2000;190(3):299.
 
BACKGROUND: To investigate whether ultrasound-guided core-needle biopsy (US-CNB) has more diagnostic value for breast tumors than ultrasound-guided fine-needle aspiration biopsy (US-FNAB) and to evaluate their combined use in patients with breast tumors.
STUDY DESIGN: US-FNAB was carried out in 233 patients with breast tumors (254 lesions); both US-FNAB and US-CNB (combined biopsy) were performed in 81 of these patients (82 lesions). The diagnosis obtained by US-FNAB and US-CNB was compared with the surgical findings and the diagnostic value of US-CNB and combined biopsy were retrospectively evaluated.
RESULTS: The sensitivity of US-FNAB was 86.9%, the specificity was 78.6%, and the accuracy was 84%. In contrast, the sensitivity of US-CNB was 86.2%, the specificity was 95.8%, and the accuracy was 89%. The specificity of US-CNB was significantly higher than that of US-FNAB and the inadequate biopsy rate of US-CNB was significantly lower than that of US-FNAB. For combined biopsy, the sensitivity, specificity, and accuracy were all 100%. The sensitivity, specificity, and accuracy of combined biopsy were significantly higher than those of US-FNAB.
CONCLUSIONS: These findings suggest that US-CNB is more useful than US-FNAB, and that a combination of US-CNB and US-FNAB can markedly improve the preoperative diagnosis of breast cancer.
AD
The Second Department of Surgery, Hyogo College of Medicine, Japan.
PMID
14
TI
Transrectal Tru-cut biopsy of the prostate using a protective sheath.
AU
Radhakrishnan V
SO
Br J Urol. 1994;73(4):454.
 
AD
Department of Urology, Sunderland Royal Infirmary, UK.
PMID
15
TI
Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature.
AU
Rodríguez LV, Terris MK
SO
J Urol. 1998;160(6 Pt 1):2115.
 
PURPOSE: Transrectal ultrasound guided needle biopsy of the prostate is routinely performed to diagnose and stage prostate cancer. We prospectively evaluated the true incidence of complications and identified risk factors of needle biopsy.
MATERIALS AND METHODS: We prospectively studied 128 patients who underwent transrectal ultrasound guided needle biopsy. A pre-biopsy questionnaire provided demographic information. Immediate complications were recorded by the surgical team at the procedure. Information on delayed complications was obtained by telephone interview. Univariate and multivariate analyses were performed.
RESULTS: There was 1 major and 135 minor complications in 77 patients with at least 1 complication in 63.6%. Most patients tolerated the procedure with minimal discomfort regardless of the number and location of biopsies but younger patients had significantly more discomfort than older men (R = -0.26, p = 0.005). The most common complication was persistent hematuria in 47.1% of cases. None of the hemorrhagic complications was related to previous aspirin or nonsteroidal anti-inflammatory drug use, or the total number of biopsies performed. Infectious complications were rare with only a 1.7% incidence of fever. This rate was associated with the choice of antibiotic combination used (R = 0.25, p = 0.006).
CONCLUSIONS: Transrectal ultrasound guided needle biopsy is safe for diagnosing prostate cancer with few major but frequent minor complications. Patients are likely to have persistent hematuria for up to 3 to 7 days after the procedure. Recent use of aspirin or nonsteroidal anti-inflammatory drugs is not an absolute contraindication for this procedure. Additional analgesics are not required in patients who undergo anterior or multiple biopsies but they may be useful in younger patients.
AD
Department of Urology, Stanford University Medical Center, California, USA.
PMID
16
TI
Laparoscopic four-way ultrasound probe with histologic biopsy facility using a flexible tru-cut needle.
AU
Durup Scheel-Hincke J, Mortensen MB, Pless T, Hovendal CP
SO
Surg Endosc. 2000;14(9):867.
 
Laparoscopic ultrasound (LUS) is widely used in the staging of upper gastrointestinal malignancies. However, accurate N-staging and pathological confirmation of metastases have proved difficult. A new four-way laparoscopic ultrasound probe has been developed. The probe has a biopsy attachment with a needle guide for a flexible tru-cut needle or an aspiration needle. It is now possible to take real-time laparoscopic ultrasound guided biopsies. Furthermore, there is a possibility for interventionel LUS with tumor destruction, celiac plexus neurolysis, and cyst aspiration. In this short technical note, the equipment and the technique are described.
AD
Department of Gastroenterolgy, A. Odense University Hospital, Sdr. Boulevard 29 5000, Odense, Denmark.
PMID
17
TI
Trans anal full thickness tru-cut needle biopsies in anal canal tumors after conservative treatment.
AU
Indinnimeo M, Cicchini C, Stazi A, Mingazzini P, Ghini C, Pavone P
SO
Oncol Rep. 1998;5(2):325.
 
After conservative treatment anal mucosal biopsies enable exclusion of neoplastic cells only on the endoluminal surface. We used transanal full thickness tru-cut needle biopsies in the follow-up of 11 anal tumors. Full thickness tru-cut needle biopsies showed malignant cells in the fibrous tissue in 3 patients and few cells with atypical nuclear features in another 2. All diagnostic exams resulted negative. Therefore, needle biopsies were helpful to diagnose neoplastic remainder. Multiple samples are necessary to reduce the false negative number. This method is simple, relatively inexpensive, easily repeatable and not burdened with complications.
AD
I Clinica Chirurgica Policlinico, Universita di Roma, via del Policlinico 155, Rome, 00161, Italy.
PMID
18
TI
Transjugular liver biopsy: a comparison of aspiration and trucut techniques.
AU
Sada PN, Ramakrishna B, Thomas CP, Govil S, Koshi T, Chandy G
SO
Liver. 1997;17(5):257.
 
The results of 67 transjugular liver biopsies are described. Two failures were encountered due to inability to pass the needle into acutely angulated hepatic veins. Thirty-four patients underwent a liver aspiration biopsy using a Colapinto needle, while the remainder were biopsied using a trucut needle. The success rate with the Colapinto needle was 68% and with the trucut model, 97%. Capsular perforation occurred in three cases, but without significant morbidity or mortality. It is concluded that the trucut needle biopsy is more reliable than aspiration biopsy, when the transjugular approach is mandated, in obtaining optimal liver tissue for histopathological diagnosis.
AD
Department of Radiology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
PMID
19
TI
Transjugular liver biopsy with an automated trucut-type needle: comparative study with percutaneous liver biopsy.
AU
Chau TN, Tong SW, Li TM, To HT, Lee KC, Lai JY, Lai ST, Yuen H
SO
Eur J Gastroenterol Hepatol. 2002;14(1):19.
 
OBJECTIVE: Transjugular liver biopsy using the suction method usually produces small specimens with excessive fragmentation, hence the diagnosis adequacy of specimens and the clinical impact of performing the biopsy have been questioned. An alternative biopsy needle, the Quick-Core needle system, which uses an automated trucut-type mechanism, has been shown to produce non-fragmented tissue specimens. The aim of the present study was to evaluate the safety, adequacy and clinical impact of the transjugular liver biopsy by comparing it with the standard percutaneous liver biopsy.
DESIGN: We recruited all patients who underwent liver biopsies by percutaneous or transjugular routes in the Department of Medicine, Princess Margaret Hospital, Hong Kong between January 1998 and December 1999.
METHOD: We recorded demographics and clinical features of patients, indications and complications, and the clinical impact of the liver biopsy procedure. All liver biopsy specimens were reviewed by the histopathologist, who was blinded to the approach of taking the biopsy. All variables between patients undergoing transjugularand percutaneous liver biopsies were compared.
RESULTS: During the study period, 50 percutaneous and 18 transjugular liver biopsies were performed. All transjugular liver biopsies were performed successfully with adequate tissue for diagnosis. Although specimens obtained by the transjugular technique tended to be shorter (10 mm v. 18 mm by the percutaneous approach, P<0.001), the presence of fragmentation was similar to that in biopsies obtained by the percutaneous approach. Respectively, 100% and 98% of specimens obtained by the transjugular and percutaneous approaches were considered to be adequate for histological assessment. The clinical impact of transjugular and percutaneous liver procedures was comparable (89% v. 76%, P = 0.25).
CONCLUSION: Specimens obtained by a transjugular automated trucut needle are sufficient for histological assessment, and carry clinical impact in patient management.
AD
Department of Medicine, Princess Margaret Hospital, Hong Kong SAR, China.
PMID
20
TI
Peroperative transduodenal biopsy of the pancreas.
AU
Tweedle DE
SO
Gut. 1979;20(11):992.
 
Peroperative transduodenal biopsy of the pancreas was performed in 65 patients with the disposable Trucut needle. The technique described is simple, effective, and may reveal unsuspected malignancy. A histological diagnosis of malignancy is reliable but false negative diagnosis may arise because of failure to obtain representative samples.
AD
PMID
21
TI
Cystic pancreatic tumors: CT and sonographic assessment.
AU
Johnson CD, Stephens DH, Charboneau JW, Carpenter HA, Welch TJ
SO
AJR Am J Roentgenol. 1988;151(6):1133.
 
Thirty-five CT scans and 23 sonograms of 45 pathologically proved pancreatic cystic neoplasms (16 microcystic adenomas, 17 mucinous [macrocystic]cystadenomas, and 12 mucinous [macrocystic]cystadenocarcinomas) in 43 patients were retrospectively and blindly reviewed. Radiologic findings and their usefulness in differentiating microcystic from mucinous subtypes were assessed. The number of cysts within the tumors (more than six in microcystic adenomas and six or fewer in mucinous cystadenomas and cystadenocarcinomas) and the diameter of the majority of cysts within the tumor (less than or equal to 2 cm in microcystic adenomas and greater than 2 cm in mucinous tumors) were the most helpful radiologic findings in differentiating tumor types. Calcification was present in 38% of microcystic adenomas, 18% of mucinous cystadenomas, and 8% of mucinous cystadenocarcinomas by CT. Calcification was not definitely identified on any of the sonograms. A central scar was identified in only two (13%) of 16 microcystic adenomas. Blind retrospective review was often able to correctly classify tumors as either microcystic (CT, 93%; sonography, 78%) or mucinous (CT, 95%; sonography, 93%). All tumors with a typical appearance on either CT or sonography were categorized correctly. Cystic pancreatic tumors may be difficult to prospectively separate from other types of pancreatic cysts. Assuming a cystic neoplasm is present, it often can be classified correctly asmicrocystic or mucinous (macrocystic) by using the above criteria.
AD
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
PMID
22
TI
Yield and complications in ultrasound-guided biopsy of abdominal lesions. Comparison of fine-needle aspiration biopsy and 1.2-mm needle core biopsy using an automated biopsy gun.
AU
Nyman RS, Cappelen-Smith J, Brismar J, von Sinner W, Kagevi I
SO
Acta Radiol. 1995;36(5):485.
 
A series of 458 consecutive ultrasound-guided biopsies in 347 patients-171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs)-was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%)-3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p<0.001), while the complication rate remains the same.
AD
Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
PMID
23
TI
Cytologic versus histologic evaluation of needle biopsy of the lung, hilum and mediastinum. Sensitivity, specificity and typing accuracy.
AU
Böcking A, Klose KC, Kyll HJ, Hauptmann S
SO
Acta Cytol. 1995;39(3):463.
 
Fine needle aspiration biopsy (FNAB) and punch biopsy (PB) are reliable methods of establishing a morphologic diagnosis in thoracic lesions. However, some reservations exist concerning the diagnostic accuracy of and indications for both methods. Therefore, we evaluated the sensitivity, specificity, typing accuracy and complication rates of both methods. We present a six-year experience with 501 thoracic FNABs and PBs in 482 patients. To examine site-specific differences, we evaluated three different compartments: lung, mediastinum and hilum. In 457 cases the final outcome was known for evaluating the accuracy of the cytologic or histologic diagnoses. FNAB was used most often in lung (81.8%) and hilar lesions (87.3%), whereas PB was used mostly in mediastinal (67.9%) and pleural lesions or if a mesenchymal lesion was suggested radiologically but never in foci below 20 mm in diameter. Our complication rate was 21.3% for FNAB and 4.6% for PB. The most frequent complications were pneumothorax, one hematothorax and intercostal neuralgia. The overall sensitivities of the biopsy methods were equal (FNAB, 98.4%; PB, 98%), but the typing accuracy was better for PB than FNAB (87.2% vs. 83.5%). In the hilum the sensitivities of FNAB and PB were 94.6% and 85.7%, respectively, and for the lungs, 99% and 98.2%. In the mediastinum the sensitivity was 100% for both methods. There were false-positive diagnoses in 5% with FNAB of the lung due to misinterpretation of regenerating epithelium and hamartochondroma and a 0.1% rate of false-negative diagnoses as a result of misplacement of the cannula, leading to inflammation, infarction or scarring. Our data indicate that FNAB is the method of choice in pulmonary and hilar lesions because of the similar diagnostic accuracy. Mediastinal and pleural lesions and presumed mesenchymal tumors should be sampled with PB because the typing accuracy of FNAB is insufficient in these cases.
AD
Institute of Cytopathology, University of Düsseldorf, Germany.
PMID