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Abdominal Radiology (New York) Aug 2022Image-guided percutaneous needle biopsy (PNB) is an important and increasingly utilized method of minimally invasive tissue sampling for a broad variety of disease... (Review)
Review
Image-guided percutaneous needle biopsy (PNB) is an important and increasingly utilized method of minimally invasive tissue sampling for a broad variety of disease processes. While infrequent, major bleeding is a potential complication of PNB and can be life-threatening, especially when unrecognized. On the other hand, prompt recognition and treatment of major bleeding in this setting can prevent significant morbidity or mortality. It is therefore crucial for anyone performing PNB to be familiar with the diagnosis and management of bleeding complications. This article reviews the risk factors for major bleeding in the setting of PNB, the presentation and imaging findings of a spectrum of bleeding complications encountered during and following PNB, and the management of those findings based on experience at a single, high volume, biopsy center.
Topics: Biopsy, Needle; Hemorrhage; Humans; Image-Guided Biopsy; Needles; Retrospective Studies; Ultrasonography, Interventional
PubMed: 34882270
DOI: 10.1007/s00261-021-03357-5 -
Computers in Biology and Medicine Aug 2019Planning and practice of surgical procedures can be improved through the use of modelling. This study provides an insight into the biopsy needle (i.e. hollow cannula)...
Planning and practice of surgical procedures can be improved through the use of modelling. This study provides an insight into the biopsy needle (i.e. hollow cannula) and needle-tissue interactions using a modelling approach, thus enabling the optimization of needle-tip designs not only for training but also for the planning of surgical procedures. Simulations of needle insertion into agar gel were performed using a Coupled Eulerian-Lagrangian (CEL) based finite element (FE) analysis, adapted for large deformation and tissue fracture. The experimental work covers needle insertion into 3% agar gel using a needle with a beveled tip of various angles, to assess the validity of the simulation. The simulated needle deflection and insertion force for two needles (i.e. Needle 1 with 18° bevel angle and Needle 2 with 27° bevel angle) were compared with corresponding experimental results. The contact stress (i.e. contact pressure) on the needles from the agar gel during the insertion of the needles were also studied. Observations indicate that varying the needle bevel angle from 27° to 18° results in a decrease of the peak force (i.e. puncture force) and an increase in needle deflection. Quantitatively, the percentage errors between the experimental data and the FE model for the total insertion force along the z-direction (i.e. Z Force) for Needle 1 and 2 were 4% and 4.8% (p > 0.05), respectively. Similarly, needle deflection percentage errors along the x-z plane were 5.7% and 10% respectively. Therefore, the forces and needle deflection values predicted by the simulation are a close approximation of the experimental model, validating the Coupled Eulerian-Lagrangian based FE model. Thus, providing an experimentally validated model for biopsy and cytology needle design in silico that has the potential to replace the current build and break approach of needle design used by manufacturers.
Topics: Biopsy, Needle; Equipment Design; Finite Element Analysis; Gels; Humans; Models, Biological; Needles; Phantoms, Imaging; Reproducibility of Results
PubMed: 31279981
DOI: 10.1016/j.compbiomed.2019.103337 -
World Journal of Surgery Jun 2022Core biopsy has replaced fine needle aspiration cytology in the assessment of breast lumps to diagnose malignancy and is now standard of care in developed countries....
BACKGROUND
Core biopsy has replaced fine needle aspiration cytology in the assessment of breast lumps to diagnose malignancy and is now standard of care in developed countries. Unfortunately, cost of core biopsy system is a major limitation in low-and middle-income countries (LMICs). This prompted us to devise and appraise a low-cost technique of core biopsy using negative pressure.
METHODS
We devised and prospectively evaluated a simple model of core biopsy (vacuum assisted core needle biopsy-VACNB) using a 50 ml syringe, a 10 ml syringe and a 14G needle.
RESULTS
57 consecutive women (median age 42.66 years) with breast lumps (median diameter 5.2 cm) underwent VACNB. The sensitivity for diagnosing malignancy was 92%, specificity was 100%, and diagnostic accuracy was 92.98%. The positive predictive value of this technique was 100%, and negative predictive value was 63.64%. The cost (~ 5.5 USD) of the system was significantly less than the cost of core biopsy needle (~ 41.00 USD) and vacuum assisted breast biopsy needle (~ 341.00 USD) in India.
CONCLUSION
Frugal innovations are needed to overcome cost constraints in LMICs. Our low-cost VACNB technique is easy to use and accurate.
Topics: Adult; Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Breast; Breast Neoplasms; Female; Humans; Image-Guided Biopsy; Sensitivity and Specificity; Vacuum
PubMed: 35166879
DOI: 10.1007/s00268-022-06475-3 -
Muscle biopsy technical safety and quality using a self-contained, vacuum-assisted biopsy technique.Neuromuscular Disorders : NMD May 2018Muscle sampling via percutaneous biopsy has been shown to be safe and effective using a Bergström needle; however, the use of a single-operator, self-contained,...
Muscle sampling via percutaneous biopsy has been shown to be safe and effective using a Bergström needle; however, the use of a single-operator, self-contained, vacuum-assisted biopsy technique has not been explored. We performed a retrospective chart review of muscle biopsy samples obtained using the Vacora® self-contained vacuum-assisted biopsy system between 2013 and 2016, at the Toronto General Hospital. During this period, 102 single-operator muscle biopsies were performed using the Vacora® system. 54/102 showed normal or non-specific findings, while 39/102 were suggestive or diagnostic of a neuromuscular condition. 8 samples did not provide sufficient muscle tissue for diagnosis, and complications (intramuscular hematoma) occurred in 3/102 cases. Mean sample weight was 0.19 grams, which exceeded reported mean sample weights using the suction-modified Bergström technique (0.125 grams). We therefore conclude that the Vacora® vacuum-assisted biopsy system provides a safe and effective method to obtain diagnostic muscle biopsy samples; although complication rates are slightly higher than reported using the Bergström technique, possibly related to more vigorous suction or a sharp needle tip.
Topics: Biopsy, Needle; Humans; Muscle, Skeletal; Muscular Diseases; Retrospective Studies
PubMed: 29631953
DOI: 10.1016/j.nmd.2018.02.006 -
Cytopathology : Official Journal of the... Jul 2024Although surgical biopsy remains the gold standard for the diagnosis of lymphoma, small-volume biopsies including fine-needle aspiration and core needle biopsy are... (Review)
Review
Although surgical biopsy remains the gold standard for the diagnosis of lymphoma, small-volume biopsies including fine-needle aspiration and core needle biopsy are increasingly being used as a first line diagnostic tool. Small-volume biopsies are safe, rapid and cost effective; however, diagnostic utility varies by lymphoma subtype. It is important for pathologists and clinicians to recognize both the strengths and limitations of such biopsies.
Topics: Humans; Lymphoma; Biopsy, Fine-Needle; Biopsy, Large-Core Needle
PubMed: 38462899
DOI: 10.1111/cyt.13372 -
Journal of the Mechanical Behavior of... Apr 2020This study investigates the effect of needle tip geometry on the needle deflection and tissue sampling length in biopsy. Advances in medical imaging have allowed the...
This study investigates the effect of needle tip geometry on the needle deflection and tissue sampling length in biopsy. Advances in medical imaging have allowed the identification of suspicious cancerous lesions which then require needle biopsy for tissue sampling and subsequent confirmatory pathological analysis. Precise needle insertion and adequate tissue sampling are essential for accurate cancer diagnosis and individualized treatment decisions. However, the single-bevel needles in current hand-held biopsy devices often deflect significantly during needle insertion, causing variance in the targeted and actual locations of the sampled tissue. This variance can lead to inaccurate sampling and false-negative results. There is also a limited understanding of factors affecting the tissue sampling length which is a critical component of accurate cancer diagnosis. This study compares the needle deflection and tissue sampling length between the existing single-bevel and exploratory multi-bevel needle tip geometries. A coupled Eulerian-Lagrangian finite element analysis was applied to understand the needle-tissue interaction during needle insertion. The needle deflection and tissue sampling length were experimentally studied using tissue-mimicking phantoms and ex-vivo tissue, respectively. This study reveals that the tissue separation location at the needle tip affects both needle deflection and tissue sampling length. By varying the tissue separation location and creating a multi-bevel needle tip geometry, the bending moments induced by the insertion forces can be altered to reduce the needle deflection. However, the tissue separation location also affects the tissue contact inside the needle groove, potentially reducing the tissue sampling length. A multi-bevel needle tip geometry with the tissue separation point below the needle groove face may reduce the needle deflection while maintaining a long tissue sampling length. Results from this study can guide needle tip design to enable the precise needle deployment and adequate tissue sampling for the needle biopsy procedures.
Topics: Biopsy, Needle; Equipment Design; Finite Element Analysis; Needles; Phantoms, Imaging
PubMed: 32174391
DOI: 10.1016/j.jmbbm.2020.103632 -
Cancer Cytopathology Dec 2016Fine-needle aspiration (FNA) and core needle biopsy (CNB) represent 2 of the most common minimally invasive tissue sampling modalities. Although similar in many ways,... (Comparative Study)
Comparative Study Review
Fine-needle aspiration (FNA) and core needle biopsy (CNB) represent 2 of the most common minimally invasive tissue sampling modalities. Although similar in many ways, there are significant differences in the collection, processing, interpretation, and suitability for ancillary testing that exist between FNA and CNB. This review provides a brief overview of the strengths and weaknesses of FNA compared with CNB, as well as an update regarding the landscape of recently published studies that investigate the organ-specific comparative performance metrics of FNA and CNB. A current understanding of the benefits and limitations of FNA and CNB will help the cytopathologist and the clinician alike to select the right procedure for the right patient at the right time. Cancer Cytopathol 2016;124:862-870. © 2016 American Cancer Society.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Female; Humans; Minimally Invasive Surgical Procedures; Neoplasms; Organ Specificity
PubMed: 27182895
DOI: 10.1002/cncy.21742 -
Cancer Cytopathology Mar 2024The risks of malignancy for cytologic categories in renal biopsy specimens differ from the risks in most other sites. There are obvious areas in which cytopathologists... (Review)
Review
The risks of malignancy for cytologic categories in renal biopsy specimens differ from the risks in most other sites. There are obvious areas in which cytopathologists can do better at classifying these cases, and the routine use of immunohistochemistry and core-needle biopsy may improve the accuracy of the classification of these specimens.
Topics: Humans; Neoplasms; Biopsy, Large-Core Needle; Nephrectomy
PubMed: 37747428
DOI: 10.1002/cncy.22759 -
Endoscopy Jan 2020
Topics: Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography
PubMed: 31853926
DOI: 10.1055/a-1039-1327 -
Journal of the American Society of... 2020Fine-needle aspiration (FNA) has long been considered the first and an important diagnostic tool in the evaluation of thyroid nodules. The advantages of FNA include... (Comparative Study)
Comparative Study Review
Fine-needle aspiration (FNA) has long been considered the first and an important diagnostic tool in the evaluation of thyroid nodules. The advantages of FNA include simplicity, safety, cost-effectiveness, high diagnostic accuracy, and low complication rate. Nevertheless, limitations associated with FNA include a substantial rate of inconclusive results and indeterminate interpretations. Therefore, core needle biopsy (CNB) of the thyroid gland has been proposed as a complementary or even alternate diagnostic method to evaluate thyroid nodules. Although controversial, a growing number of researchers have reported CNB to be an effective and safe sampling method for thyroid nodules, especially for cases with inadequate or indeterminate FNA yields. Skeptics highlight local pain and bleeding risk. Supporters highlight the potential likelihood of overcoming FNA limitations by obtaining a larger amount of tissue and using architecture and cellular details to guide possible ancillary testing. This review evaluates the indications, advantages, and disadvantages of CNB as compared with FNA of the thyroid gland.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Cost-Benefit Analysis; Data Accuracy; Hemorrhage; Humans; Image-Guided Biopsy; Pain, Postoperative; Thyroid Gland; Thyroid Nodule
PubMed: 32665216
DOI: 10.1016/j.jasc.2020.06.003