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Modern Rheumatology Sep 2021We sought to clarify the safety and tolerability of ultrasound (US)-guided synovial needle biopsy in hand and knee joints in Japanese arthritis patients.
OBJECTIVES
We sought to clarify the safety and tolerability of ultrasound (US)-guided synovial needle biopsy in hand and knee joints in Japanese arthritis patients.
METHODS
A total of nine consecutive arthritis patients were recruited and scheduled for US-guided synovial needle biopsies. Patients completed a safety questionnaire and patient-reported outcomes (PRO) data of joint pain, stiffness, and swelling pre- and postbiopsy. We also recorded patients' characteristics and willingness to undergo a second biopsy by the same technique. All synovial needle biopsy samples were assessed with pathological and microbial examination to verify whether clinical evaluation was possible.
RESULTS
Five and 4 patients underwent US-guided biopsy from hand and knee joints, respectively. PRO data showed no significant differences in pain, swelling, or stiffness levels before and after biopsy, with a mean 11.8 samples collected per procedure. No significant complications, including joint infection, bleeding, or vasovagal signs, were reported. Histologically adequate synovial tissue was identified in 83 (78%) samples. We were able to submit the biopsy samples to pathological and bacterial analysis to exclude septic arthritis.
CONCLUSION
We demonstrated that a minimally invasive US-guided needle biopsy is a safe and well-tolerated procedure and the synovial tissue collected was of adequate quality for pathological analysis.
Topics: Arthritis; Biopsy, Needle; Humans; Image-Guided Biopsy; Japan; Ultrasonography, Interventional
PubMed: 33155872
DOI: 10.1080/14397595.2020.1847754 -
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 -
Climacteric : the Journal of the... Feb 2020Breast lesions with atypia are a spectra of diseases that confer increased risk of breast cancer because of an increased probability of finding concomitant cancer after... (Review)
Review
Breast lesions with atypia are a spectra of diseases that confer increased risk of breast cancer because of an increased probability of finding concomitant cancer after excision, or evolution toward in situ or invasive cancer over the long term. The widespread use of radiologic tools and core needle breast biopsies, in recent years, has led to an increase in the diagnosis of these atypical breast lesions. Concurrent with this has been an improvement in the classification and pathogenesis of these lesions. Current evidence suggests that the recognition and treatment of patients with atypical histology after biopsy and surgical excision requires a multidisciplinary approach to decrease the overdiagnosis and overtreatment risks. This focused review investigates the controversy and current management of atypical ductal hyperplasia, lobular neoplasia, flat epithelial atypia, and intraductal papilloma with atypia along with the risk-reducing strategies.
Topics: Biopsy, Needle; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Precancerous Conditions; Risk Assessment
PubMed: 31566023
DOI: 10.1080/13697137.2019.1660637 -
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 -
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 -
Journal of the American Society of... 2020Emphasis on the use of small specimens for biomarker testing to provide prognostic and predictive information for guiding clinical management for patients with... (Review)
Review
Emphasis on the use of small specimens for biomarker testing to provide prognostic and predictive information for guiding clinical management for patients with advanced-stage cancer has been increasing. These biomarker tests include molecular analysis, cytogenetic tests, and immunohistochemical assays. Owing to the limited nature of the cellular material procured in these small specimens, which are collected using minimally invasive techniques (ie, fine needle aspiration and core needle biopsy), pathologists have been required to triage these samples judiciously and provide the clinically relevant genomic information required for patient care. Awareness of the advantages and limitations of these specimen preparations and the specific preanalytic requirements for the testing methods will help pathologists to develop optimal strategies to maximize the chances of effectively using these samples for comprehensive diagnostic and relevant biomarker testing.
Topics: Biomarkers, Tumor; Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Health Knowledge, Attitudes, Practice; Humans; Molecular Diagnostic Techniques; Mutation; Neoplasm Staging; Neoplasms; Pathologists; Prognosis; Triage
PubMed: 32507626
DOI: 10.1016/j.jasc.2020.05.001 -
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 -
Computers in Biology and Medicine Aug 2022Prevalently considered as the "gold-standard" for diagnosis of hepatic fibrosis and cirrhosis, the clinical liver needle biopsy is known to be subject to inadequate...
INTRODUCTION
Prevalently considered as the "gold-standard" for diagnosis of hepatic fibrosis and cirrhosis, the clinical liver needle biopsy is known to be subject to inadequate sampling and a high mis-sampling rate. However, quantifying such sampling bias has been difficult as generating a large number of needle biopsies from the same living patient is practically infeasible. We construct a three-dimension (3D) virtual liver tissue volume by spatially registered high resolution Whole Slide Images (WSIs) of serial liver tissue sections with a novel dynamic registration method. We further develop a Virtual Needle Biopsy Sampling (VNBS) method that mimics the needle biopsy sampling process. We apply the VNBS method to the reconstructed digital liver volume at different tissue locations and angles. Additionally, we quantify Collagen Proportionate Area (CPA) in all resulting virtual needle biopsies in 2D and 3D.
RESULTS
The staging score of the center 2D longitudinal image plane from each 3D biopsy is used as the biopsy staging score, and the highest staging score of all sampled needle biopsies is the diagnostic staging score. The Mean Absolute Difference (MAD) in reference to the Scheuer and Ishak diagnostic staging scores are 0.22 and 1.00, respectively. The absolute Scheuer staging score difference in 22.22% of sampled biopsies is 1. By the Ishak staging method, 55.56% and 22.22% of sampled biopsies present score difference 1 and 2, respectively. There are 4 (Scheuer) and 6 (Ishak) out of 18 3D virtual needle biopsies with intra-needle variations. Additionally, we find a positive correlation between CPA and fibrosis stages by Scheuer but not Ishak method. Overall, CPA measures suffer large intra- and inter- needle variations.
CONCLUSIONS
The developed virtual liver needle biopsy sampling pipeline provides a computational avenue for investigating needle biopsy sampling bias with 3D virtual tissue volumes. This method can be applied to other tissue-based disease diagnoses where the needle biopsy sampling bias substantially affects the diagnostic results.
Topics: Biopsy; Biopsy, Needle; Collagen; Humans; Liver; Liver Cirrhosis; Selection Bias
PubMed: 35797891
DOI: 10.1016/j.compbiomed.2022.105764 -
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 -
Acta Radiologica (Stockholm, Sweden :... Feb 2022While the majority of bleeding complications after a percutaneous kidney biopsy (PKB) occur early (≤24 h), delayed onset bleeding complications (>24 h) have been... (Observational Study)
Observational Study
BACKGROUND
While the majority of bleeding complications after a percutaneous kidney biopsy (PKB) occur early (≤24 h), delayed onset bleeding complications (>24 h) have been rarely reported and can be catastrophic for the patient.
PURPOSE
To describe the incidence, risk factors, and outcomes of delayed bleeding complications after PKB.
MATERIAL AND METHODS
We retrospectively studied native and graft kidney biopsies in patients who developed delayed bleeding complications (>24 h) after the biopsy performed in the Department of Nephrology and Renal Transplantation of a tertiary care medical institution in north India between January 2014 to December 2018.
RESULTS
Of the 4912 renal biopsies reviewed, 20 patients (16 men, 4 women; 0.40%) had a delayed biopsy bleeding complication. Of these patients, 95% had major bleeding complications requiring blood transfusions and 85% needed intervention like gelfoam/coil embolization. Despite intervention, one patient (5%) had mortality due to complications of bleeding and sepsis. When compared to a control group of patients with early biopsy bleed, patients with the delayed biopsy bleed had similar demographic and clinical profiles except for higher pre-biopsy hemoglobin and lower systolic and diastolic blood pressure.
CONCLUSION
A post-PKB delayed onset bleed is not uncommon, and the vast majority of these patients had major bleeding complications requiring blood transfusions and/or intervention like embolization. They had a similar demographic and clinical profile presentation as early bleed patients. Meticulous outpatient monitoring and patient education after discharge may be useful to detect this complication promptly and to intervene early to have good patient outcome.
Topics: Biopsy, Needle; Blood Transfusion; Embolization, Therapeutic; Female; Hemorrhage; Humans; Image-Guided Biopsy; Kidney; Male; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
PubMed: 33497275
DOI: 10.1177/0284185120988812