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Gastroenterologia Y Hepatologia Sep 2014Pancreatic cancer (PC) still typically has a poor prognosis. In addition to smoking, obesity and new-onset diabetes mellitus are considered to be significant risk... (Review)
Review
Pancreatic cancer (PC) still typically has a poor prognosis. In addition to smoking, obesity and new-onset diabetes mellitus are considered to be significant risk factors. An endoscopic ultrasound (EUS) remains the mainstay for diagnosis and on which the majority of advances are based. In this sense, needle-based confocal laser endomicroscopy (nCLE) is gaining importance in the differential diagnosis of solid pancreatic lesions and studies comparing different needle types (cytology vs. histology) for EUS-guided puncture. Intravenous contrast (IC-EUS) and elastography are additional tools associated with EUS that can assist in diagnosing PC. Regarding prognostic factors, the importance of the role of mesenteric-portal vein resection was emphasized, given the limited advances in treatment, as in previous years. Regarding cystic tumors, work focuses on validating the new international guidelines from Fukuoka 2012 (revised Sendai criteria) and on determining predictors of cystic lesion malignancy, mainly of intraductal papillary mucinous neoplasm (IPMN). From a therapeutic point of view, there are theories regarding the usefulness of alcohol and the gemcitabine-paclitaxel combination in the ablation of small mucinous cystic lesions through EUS-injection.
Topics: Biopsy, Needle; Endoscopy; Endosonography; Equipment Design; Humans; Image-Guided Biopsy; Pancreatic Neoplasms; Prognosis; Risk Factors
PubMed: 25294272
DOI: 10.1016/S0210-5705(14)70089-5 -
Gastrointestinal Endoscopy Dec 2019
Topics: Biopsy, Large-Core Needle; Digestive System Abnormalities; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Needles; Network Meta-Analysis
PubMed: 31759416
DOI: 10.1016/j.gie.2019.08.017 -
Medicine Nov 2022This study aims to investigate the effect of ultrasound (US)-guided coaxial puncture needle in puncture biopsy of peripheral pulmonary masses. In this retrospective...
This study aims to investigate the effect of ultrasound (US)-guided coaxial puncture needle in puncture biopsy of peripheral pulmonary masses. In this retrospective analysis, 157 patients who underwent US-guided percutaneous lung biopsy in our hospital were divided into a coaxial biopsy group and a conventional biopsy group (the control group) according to the puncture tools involved, with 73 and 84 patients, respectively. The average puncture time, number of sampling, sampling satisfaction rate, puncture success rate and complication rate between the 2 groups were compared and discussed in detail. One hundred fifty-seven patients underwent puncture biopsy, and 145 patients finally obtained definitive pathological results. The overall puncture success rate was 92.4% ([145/157]; with a puncture success rate of 97.3% [71/73] from the coaxial biopsy group and a puncture success rate of 88.1% [74/84] from the conventional biopsy group (P < .05). For peripheral pulmonary masses ≤3 cm, the average puncture time in the coaxial biopsy group was shorter than that in the conventional biopsy group, and the number of sampling, sampling satisfaction rate and puncture success rate were significantly higher than those in the conventional biopsy group (P < .05). There was no significant difference in the complication rate between the 2 groups (P > .05). For peripheral pulmonary masses >3 cm, the average puncture time in the coaxial biopsy group was still shorter than that in the conventional biopsy group (P < .05). The differences between the 2 groups in the number of sampling, satisfaction rate of the sampling, the success rate of puncture and the incidence of complications were not significant (P > .05). US guided coaxial puncture biopsy could save puncture time, increase the number of sampling, and improve the satisfaction rate of sampling and the success rate of puncture (especially for small lesions) by establishing a biopsy channel on the basis of the coaxial needle sheath. It provided reliable information for the diagnosis, differential diagnosis and individualized accurate treatment of lesions as well.
Topics: Humans; Retrospective Studies; Image-Guided Biopsy; Biopsy, Needle; Punctures; Ultrasonography, Interventional
PubMed: 36397368
DOI: 10.1097/MD.0000000000031070 -
The Laryngoscope Dec 2018
Review
Topics: Biopsy, Large-Core Needle; Head and Neck Neoplasms; Humans; Neoplasm Staging; Ultrasonography, Interventional
PubMed: 29521423
DOI: 10.1002/lary.27149 -
The American Journal of Nursing Sep 2019: Background: At our institution, RNs have performed bone marrow aspiration and biopsy procedures for more than 10 years. A recent review of our institutional policies... (Review)
Review
UNLABELLED
: Background: At our institution, RNs have performed bone marrow aspiration and biopsy procedures for more than 10 years. A recent review of our institutional policies and practices regarding RN-performed bone marrow procedures was intended to ensure that we were using a safe and evidence-based approach and prompted this program evaluation.
METHODS
We conducted a literature search and review of our institutional policies and practices regarding RN-performed bone marrow procedures. All elements of our clinical practice were reviewed and evaluated, including outcomes.
RESULTS
Between 2010 and 2017, the RN team completed a total of 10,867 bone marrow procedures in our hospital-based ambulatory infusion center. The team included 15 nurses who completed up to eight patient procedures each weekday. Patient satisfaction rates were consistently high and complication rates were very low: less than 1% of all patients experienced postprocedure bleeding, and less than 2% required urgent medical care within 24 hours of the procedure. In an analysis of bone marrow procedures performed between 2016 and 2017, the quality of bone marrow samples obtained by the RN team remained high, consistently meeting or exceeding our 95% clinical adequacy goal.
CONCLUSIONS
There is limited evidence in the literature supporting the practice of RN-performed bone marrow procedures. Our review revealed a robust program with excellent clinical and diagnostic outcomes that can be emulated by other institutions interested in pursuing RN-performed bone marrow procedures.
Topics: Biopsy, Needle; Bone Marrow; Humans; Nurse's Role
PubMed: 31449123
DOI: 10.1097/01.NAJ.0000580260.18537.ca -
Expert Review of Medical Devices Feb 2018Endoscopic ultrasound (EUS)-guided tissue acquisition by-fine needle biopsy (EUS-FNB) developed over the last two decades as an attempt to overcome the limitations of... (Comparative Study)
Comparative Study Review
INTRODUCTION
Endoscopic ultrasound (EUS)-guided tissue acquisition by-fine needle biopsy (EUS-FNB) developed over the last two decades as an attempt to overcome the limitations of fine needle aspiration (FNA). There are now three commercially available second-generation FNB needles with different tip designs.
AREAS COVERED
In this review the roles of EUS-FNA and FNB, the history and evolution of the EUS core biopsy needle are addressed followed by a presentation of currently available needles. Literature search was conducted using MEDLINE, Controlled Trials Register, US Patent Registry, Google Scholar, and Conference Abstracts.
EXPERT COMMENTARY
While FNA remains the reference standard, it is limited by the inability to retain stroma and associated cellular architecture in biopsy samples. Histologic architecture is of paramount importance in providing a molecular diagnosis and for accurate tumor staging. FNB offers a superior diagnostic yield to FNA and initial experiences with the three commercially available second-generation FNB needles show highly promising results.
Topics: Biopsy, Large-Core Needle; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Image-Guided Biopsy; Needles; Ultrasonography, Interventional
PubMed: 29334842
DOI: 10.1080/17434440.2018.1425137 -
Journal of Surgical Oncology Apr 2015There is overlap in the clinical presentation of benign soft tissue tumors and soft tissue sarcomas. A preoperative sarcoma diagnosis would allow for consideration for... (Review)
Review
There is overlap in the clinical presentation of benign soft tissue tumors and soft tissue sarcomas. A preoperative sarcoma diagnosis would allow for consideration for neoadjuvant therapy, including preoperative radiation, as well as optimal surgical treatment planning, and patient counseling. Image guided core needle biopsy is a low morbidity, cost-effective, highly accurate approach for obtaining a definitive pathologic diagnosis. Any biopsy approach should minimize the potential for tumor seeding of otherwise uninvolved anatomic structures.
Topics: Biopsy; Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Humans; Intestinal Neoplasms; Sarcoma
PubMed: 25663366
DOI: 10.1002/jso.23870 -
Head & Neck Jun 2021The diagnostic role of fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) has not been comprehensively assessed in head and neck sarcomas. A systematic... (Review)
Review
The diagnostic role of fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) has not been comprehensively assessed in head and neck sarcomas. A systematic review of published cases (1990-2020) was conducted. Diagnostic performance of both FNAC/CNB to determine tumor dignity and histopathological diagnosis was calculated. One hundred and sixty-eight cases were included for which FNAC (n = 156), CNB (n = 8), or both (n = 4) were used. Predominant histologies were skeletal muscle, chondrogenic and vascular sarcomas. FNAC correctly assessed dignity in 76.3% and histology in 45% of cases. Dignity was significantly better for vascular tumors, metastatic and recurrent specimens, and worse for chondrogenic sarcomas. CNB showed a 92% accuracy to identify dignity and 83% for histopathology. FNAC and CNB are useful methods for the diagnosis of head and neck sarcomas, particularly well-suited in the context of recurrent or metastatic disease. The role of CNB remains largely unexplored for this indication.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Head and Neck Neoplasms; Humans; Sarcoma; Sensitivity and Specificity; Soft Tissue Neoplasms
PubMed: 33687108
DOI: 10.1002/hed.26670 -
In Vivo (Athens, Greece) 2023This is a retrospective evaluation of whether percutaneous direct puncture biopsy of lung lesions contacting to the pleura is justified.
BACKGROUND/AIM
This is a retrospective evaluation of whether percutaneous direct puncture biopsy of lung lesions contacting to the pleura is justified.
PATIENTS AND METHODS
Between August 2016 and July 2021, 163 consecutive patients (100 males, 63 females with a median age of 73 years) who had malignant lung tumors measuring 0.6-12.4 cm (median, 2.9 cm) that contacted to the pleura and underwent percutaneous lung biopsy under computed tomography fluoroscopic guidance using an 18-gauge end-cut needle were examined. The trajectory was direct puncture in 80 patients (49.1%, 80/163), and trans-lung in 83 patients (50.9%, 83/163). Diagnostic yield and major adverse event rates of direct and trans-lung puncture biopsies were compared.
RESULTS
No difference was found in diagnostic yield between direct puncture and trans-lung biopsies (93.8% vs. 98.8%, p=0.11). Major adverse events were major pneumothorax (n=13/163, 8.0%), pleural dissemination (n=18/163, 11.0%), and hemothorax requiring arterial embolization (n=1/163, 1.0%). Direct puncture caused major pneumothorax significantly less than trans-lung puncture did (0%, 0/80 vs. 15.7%, 13/83, p<0.001). No significant difference was found between the two biopsy methods regarding the incidence of pleural dissemination (11.0%, 11/80 vs. 8.4%, 7/83, p=0.32).
CONCLUSION
Direct puncture biopsy of malignant lung tumors contacting to the pleura is justified.
Topics: Male; Female; Humans; Aged; Pleura; Pneumothorax; Retrospective Studies; Lung Neoplasms; Biopsy, Needle; Lung
PubMed: 37652495
DOI: 10.21873/invivo.13325 -
Journal of Medical Ultrasonics (2001) Apr 2024Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the first-choice procedure for obtaining pathological tissue samples from gastrointestinal (GI)... (Review)
Review
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the first-choice procedure for obtaining pathological tissue samples from gastrointestinal (GI) subepithelial lesions (SELs). However, its diagnostic accuracy is lower than that for pancreatic masses owing to puncture difficulty and the need for immunostaining for definitive diagnosis. The advent of fine-needle biopsy needles, which have become well known in recent years, improves the diagnostic accuracy of EUS-FNA for GI SELs. The forward-viewing echoendoscope and rapid on-site evaluation (ROSE) have also helped to improve diagnostic accuracy. Furthermore, in facilities where ROSE is not available, endosonographers perform a macroscopic on-site evaluation. With these procedural innovations, EUS-FNA is now performed aggressively even for SELs smaller than 20 mm. The incidence of procedure-related adverse events such as bleeding and infection is low, and thus, EUS-FNA can be safely performed to diagnose SELs.
Topics: Humans; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Gastrointestinal Neoplasms; Gastrointestinal Tract; Gastrointestinal Diseases
PubMed: 37490244
DOI: 10.1007/s10396-023-01342-7