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Revista Portuguesa de Pneumologia 2005Transbronchial needle aspiration was initially invented in 1949 by Schieppati. After its adaptation to the flexible bronchoscope in 1983 by Wang this technique has gain... (Review)
Review
Transbronchial needle aspiration was initially invented in 1949 by Schieppati. After its adaptation to the flexible bronchoscope in 1983 by Wang this technique has gain firm indications in the diagnosis and staging of lung cancer, in peripheral pulmonary nodules and masses; in the evaluation of endobronchial masses; in the disease of submucosal, in benign diseases, i.e. sarcoidoses and mediastinal cysts and abscesses. The yield of this technique published in the literature makes it more than useful. The material available has different indications and usefulness in different clinical settings. Despite the almost absence of complications this procedure is yet underutilized, in spite of its twenty years of results which may be due to the established routines and the lack of training.
Topics: Biopsy, Needle; Bronchoscopy; Contraindications; Humans; Lung; Lung Diseases; Lung Neoplasms
PubMed: 16027948
DOI: 10.1016/s0873-2159(15)30503-1 -
PloS One 2023Nitrous oxide (N2O) with rapid analgesic effect is often used to relieve pain induced by diagnostic procedures. This review was conducted to evaluate the efficacy and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nitrous oxide (N2O) with rapid analgesic effect is often used to relieve pain induced by diagnostic procedures. This review was conducted to evaluate the efficacy and safety of N2O in patients undergoing puncture biopsy.
METHODS
We systematically searched PubMed, Embase, the Cochrane Library, Web of Science, Scopus and the ClinicalTrials.gov up to March, 2022. Randomized controlled trials (RCTs) were included if they investigated the effect of N2O in adults undergoing puncture biopsy. The primary outcome was pain score. Secondary outcomes included anxiety score, patient satisfaction and side effects.
RESULTS
Twelve RCTs with 1070 patients were included in the qualitative review, of which eleven RCTs were included in the meta-analysis. Pooled analysis suggested that compared with the controls (placebo, lidocaine and midazolam), N2O had better analgesic effect (MD -1.12, 95% CI -2.12 to -0.13, P = 0.03; I2 = 94%). In addition, N2O significantly alleviated patient anxiety (MD = -1.79, 95% CI -2.41 to -1.18, P<0.00001; I2 = 0%) and improved patient satisfaction (MD 1.81, 95% CI 0.11 to 3.50, P = 0.04; I2 = 92%). There was no significant difference regrading the risk of nausea (RR 2.56; 95% CI 0.70 to 9.31, P = 0.15; I2 = 0%), headache (RR 0.62, 95% CI 0.17 to 2.33, P = 0.48; I2 = 46%), dizziness (RR 1.80, 95% CI 0.63 to 5.13, P = 0.27; I2 = 0%) or euphoria (RR 2.67, 95% CI 0.81 to 8.79, P = 0.11; I2 = 8%) between the N2O group and the control group.
CONCLUSION
The present review suggested that N2O might be effective for pain management in patients undergoing puncture biopsy.
Topics: Humans; Adult; Nitrous Oxide; Randomized Controlled Trials as Topic; Pain; Analgesics; Biopsy, Needle
PubMed: 37279243
DOI: 10.1371/journal.pone.0286713 -
World Journal of Gastroenterology Jun 2008Chronic viral hepatitis is a common disease in the general population. During chronic hepatitis, the prognosis and clinical management are highly dependent on the extent... (Review)
Review
Chronic viral hepatitis is a common disease in the general population. During chronic hepatitis, the prognosis and clinical management are highly dependent on the extent of liver fibrosis. The fibrosis evaluation can be performed by FibroTest (using serological markers), by Elastography or FibroScan (a noninvasive percutaneous technique using the elastic properties of the hepatic tissue) and by liver biopsy (LB), considered to be the "gold standard". Currently, there are three techniques for performing LB: percutaneous, transjugular and laparoscopic. The percutaneous LB can be performed blind, ultrasound (US) guided or US assisted. There are two main categories of specialists who perform LB: gastroenterologists (hepatologists) and radiologists, and the specialty of the individual who performs the LB determines if the LB is performed under ultrasound guidance or not. There are two types of biopsy needles used for LB: cutting needles (Tru-Cut, Vim-Silverman) and suction needles (Menghini, Klatzkin, Jamshidi). The rate of major complications after percutaneous LB ranges from 0.09% to 2.3%, but the echo-guided percutaneous liver biopsy is a safe method for the diagnosis of chronic diffuse hepatitis (cost-effective as compared to blind biopsy) and the rate of complications seems to be related to the experience of the physician and the type of the needle used (Menghini type needle seems to be safer). Maybe, in a few years we will use non-invasive markers of fibrosis, but at this time, most authorities in the field consider that the LB is useful and necessary for the evaluation of chronic hepatopathies, despite the fact that it is not a perfect test.
Topics: Biomarkers; Biopsy, Needle; Chronic Disease; Clinical Competence; Elasticity; Equipment Design; Hepatitis, Viral, Human; Humans; Laparoscopy; Liver; Liver Cirrhosis; Needles; Patient Selection; Severity of Illness Index; Ultrasonography, Interventional
PubMed: 18528937
DOI: 10.3748/wjg.14.3396 -
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 -
The British Journal of Radiology Dec 2018Needle biopsy has replaced excisional biopsy as a definitive diagnostic technique for breast tumours, although excisional biopsy is still used for complete tumour... (Review)
Review
Needle biopsy has replaced excisional biopsy as a definitive diagnostic technique for breast tumours, although excisional biopsy is still used for complete tumour removal for therapeutic and/or diagnostic purposes. Many vacuum-assisted breast biopsy (VAB) systems have been made available by several manufacturers since the release of the Mammotome (MMT) by Johnson & Johnson in 1995. Several recent discussions have been conducted to identify whether core needle biopsy (CNB) or VAB, is more appropriate. However, currently available VAB systems differ from the conventional system (i.e. articulate arm type 11-gauge(G) MMT), and the characteristics of both CNB and VAB have been improved. In CNB, a 14-G needle is frequently used to obtain a larger sample. By contrast, VAB is considered easier to perform because it uses a thinner needle and a lighter, non-tethered system. When differentiating CNB from VAB, the type of VAB should also be defined. In this review, we discuss the characteristics of ultrasonography-guided VAB and CNB with a focus on practical issues such as the number of samples and volume of tissue obtained during ultrasonography-guided needle biopsy.
Topics: Biopsy, Large-Core Needle; Biopsy, Needle; Breast Neoplasms; Female; Humans; Image-Guided Biopsy; Ultrasonography; Vacuum
PubMed: 29975150
DOI: 10.1259/bjr.20180250 -
Journal of Orthopaedic Surgery and... Mar 2021This study was aimed to explore the application value of modified closed biopsy technique in puncture biopsy of rabbit VX2 transplanted bone tumor model.
BACKGROUND
This study was aimed to explore the application value of modified closed biopsy technique in puncture biopsy of rabbit VX2 transplanted bone tumor model.
METHODS
VX2 tumor was transplanted into the bilateral tibia of 30 rabbits through the tibial plateau to make the model of VX2 transplanted bone tumor. Seven days after modeling, the proximal tibia biopsy was performed under the guidance of X-ray, and the biopsy specimen was examined pathologically. The left leg was biopsied with modified closed biopsy technique (experimental group), and the right leg was biopsied with hollow needle (control group). After 14 days of modeling, all rabbits were killed after X-ray examination around the puncture hole, and the soft tissue around the puncture hole was taken for pathological examination, and the expression levels of PCNA and CD34 in the tissue extract were detected by enzyme-linked immunosorbent assay (ELISA).
RESULTS
By the end of the experiment, a total of 3 rabbits died, and finally, 27 rabbits were included in the study. Tumor cells were detected in all the intramedullary specimens obtained by puncture biopsy. On the 14th day after modeling, X-ray showed that the occurrence rate of periosteal reaction and extraosseous high-density shadow around the puncture hole was 14.81% (4/27) in the experimental group and 40.74% (11/27) in the control group. The difference was statistically significant (P<0.05). The pathological results of soft tissue around the puncture hole showed that the tumor cell metastasis rate was 29.63% (8/27) in the experimental group and 100% (27/27) in the control group, and the difference was statistically significant (P<0.05). The expression levels of PCNA and CD34 in the experimental group were lower than those in the control group (P < 0.05).
CONCLUSION
Both the modified closed biopsy technique and needle aspiration biopsy can provide sufficient biopsy tissue for the diagnosis of VX2-transplanted bone tumor in rabbits. At the same time, the improved closed biopsy technique has a certain application value in preventing local metastasis of tumor cells along the puncture channel.
Topics: Animals; Antigens, CD34; Biomarkers, Tumor; Biopsy, Needle; Bone Neoplasms; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Gene Expression; Neoplasm Metastasis; Neoplasm Transplantation; Proliferating Cell Nuclear Antigen; Rabbits; Radiography; Tibia
PubMed: 33743772
DOI: 10.1186/s13018-021-02333-5 -
Acta Ophthalmologica Sep 2009Ocular oncologists require a strong indication for intraocular biopsy before the procedure can be performed because it carries a risk for serious eye complications and... (Review)
Review
Ocular oncologists require a strong indication for intraocular biopsy before the procedure can be performed because it carries a risk for serious eye complications and the dissemination of malignant cells. The purpose of this review is to evaluate the extent to which this restricted practice is supported by evidence from previous reports and to outline our main indications and contraindications. The different intraocular biopsy techniques in the anterior and posterior segment are discussed with a focus on our preferred method, fine-needle aspiration biopsy (FNAB). In the literature, complications are typically under-reported, which reduces the possibilities of evaluating the risks correctly and of making fair comparisons with other biopsy methods. In FNAB, the exact placement of the needle is critical, as is an accurate assessment of the size of the lesion. Fine-needle aspiration biopsy is usually not a reliable diagnostic tool in lesions < 2 mm in thickness. It is very advantageous to have a cytopathologist present in the operating theatre or close by. This ensures adequate sampling and encourages repeated biopsy attempts if necessary. This approach reduces false negative results to < 3%. Adjunct immunocytochemistry is documented to increase specificity and is essential for diagnosis and management in about 10% of cases. In some rare pathological processes the diagnosis depends ultimately on the identification of specific cell markers. An accurate diagnosis may have a decisive influence on prognosis. The cytogenetic prognostications made possible after FNAB are reliable. Biopsy by FNA has a low complication rate. The calculated risk for retinal detachment is < 4%. Intraocular haemorrhage is frequently observed, but clears spontaneously in nearly all cases. Only a single case of epibulbar seeding of malignant cells at the scleral pars plana puncture site of transvitreal FNAB has been documented. Endophthalmitis has been reported and adequate standard preoperative preparation is obligatory. An open biopsy is still an option in the anterior segment, but has been abandoned in the posterior segment. Although vitrectomy-based procedures are becoming increasingly popular, we recommend using FNAB as part of a stepwise approach. A vitrectomy-assisted biopsy should be considered in cases where FNAB fails. In any adult patient with suspected intraocular malignancy in which enucleation is not the obvious treatment, the clinician should strive for a diagnosis based on biopsy. When the lesion is too small for biopsy or the risks related to the procedure are too great, it is reasonable to be reluctant to biopsy. The standards applied in the treatment of intraocular malignant diseases should be equivalent to those in other fields of oncology. Our view is controversial and contrary to opinion that supports current standards of care for this group of patients.
Topics: Biopsy; Biopsy, Needle; Contraindications; Cytogenetic Analysis; Endophthalmitis; Eye; Eye Hemorrhage; Eye Neoplasms; Humans; Immunohistochemistry; Neoplasm Seeding; Prognosis; Retinal Detachment; Risk Assessment; Sensitivity and Specificity; Specimen Handling; Vitrectomy
PubMed: 19719804
DOI: 10.1111/j.1755-3768.2009.01637.x -
BMC Medical Imaging Nov 2023The purpose of this study was to investigate the utility of contrast-enhanced ultrasound (CEUS) in percutaneous renal space-occupying lesion puncture biopsy.
OBJECTIVE
The purpose of this study was to investigate the utility of contrast-enhanced ultrasound (CEUS) in percutaneous renal space-occupying lesion puncture biopsy.
METHODS
Ultrasound (US)-guided percutaneous needle biopsies were performed on 55 patients with renal space-occupying lesions, and the results were analyzed retrospectively. The US group included 36 patients receiving conventional US, and the contrast-enhanced ultrasound (CEUS) group included 22 patients, including 19 patients receiving CEUS directly and 3 patients receiving additional enhanced ultrasound due to the first conventional ultrasound puncture failure. The relevant data were subjected to statistical analysis.
RESULTS
The results of this study showed that the successful rate of obtaining effective tissue (100% vs. 75%) and the puncture accuracy (100% vs. 88.89%) in CEUS group were significantly higher than those in US group (P < 0.05). CEUS-guided puncture biopsy of renal mass, especially in the case of urothelial carcinoma of the renal pelvis, outperforms conventional ultrasound, and the difference was statistically significant (P < 0.05).
CONCLUSION
Percutaneous renal space-occupying lesion puncture biopsies aided by CEUS yield more effective tissue and improved puncture accuracy.
Topics: Humans; Retrospective Studies; Carcinoma, Transitional Cell; Contrast Media; Urinary Bladder Neoplasms; Biopsy, Needle; Ultrasonography; Punctures; Biopsy
PubMed: 37940851
DOI: 10.1186/s12880-023-01137-9 -
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