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Sample records for 14-gauge core biopsy

  1. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    PubMed Central

    Hari, Smriti; Kumari, Swati; Srivastava, Anurag; Thulkar, Sanjay; Mathur, Sandeep; Veedu, Prasad Thotton

    2016-01-01

    Background & objectives: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. Based on retrospective studies, image guided biopsy is considered more accurate than palpation guided breast biopsy; however, these techniques have not been compared prospectively. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. Methods: Over a period of 18 months, 36 patients each with palpable breast masses were randomized into palpation guided and image guided breast biopsy arms. Ultrasound was used for image guidance in 33 patients and mammographic (stereotactic) guidance in three patients. All biopsies were performed using 14 gauge automated core biopsy needles. Inconclusive, suspicious or imaging-histologic discordant biopsies were repeated. Results: Malignancy was found in 30 of 36 women in palpation guided biopsy arm and 27 of 36 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 46.7, 100, 100, 27.3 per cent, respectively, for diagnosing breast cancer. Nineteen of 36 women (52.8%) required repeat biopsy because of inadequate samples (7 of 19), suspicious findings (2 of 19) or imaging-histologic discordance (10 of 19). On repeat biopsy, malignancy was found in all cases of imaging-histologic discordance. Image guided biopsy had 96.3 per cent sensitivity and 100 per cent specificity. There was no case of inadequate sample or imaging-histologic discordance with image guided biopsy. Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates. PMID:27488003

  2. Association of breast cancer with the finding of atypical ductal hyperplasia at core breast biopsy.

    PubMed Central

    Moore, M M; Hargett, C W; Hanks, J B; Fajardo, L L; Harvey, J A; Frierson, H F; Slingluff, C L

    1997-01-01

    OBJECTIVE: The purpose of the study is to evaluate the prevalence of occult breast carcinoma in surgical breast biopsies performed on nonpalpable breast lesions diagnosed initially as atypical ductal hyperplasia (ADH) by core needle biopsy. BACKGROUND: Atypical ductal hyperplasia is a lesion with significant malignant potential. Some authors note that ADH and ductal carcinoma in situ (DCIS) frequently coexist in the same lesion. The criterion for the diagnosis of DCIS requires involvement of at least two ducts; otherwise, a lesion that is qualitatively consistent with DCIS but quantitatively insufficient is described as atypical ductal hyperplasia. Thus, the finding of ADH in a core needle breast biopsy specimen actually may represent a sample of a true in situ carcinoma. METHODS: Between May 3, 1994, and June 12, 1996, image-guided core biopsies of 510 mammographically identified lesions were performed using a 14-gauge automated device with an average of 7.5 cores obtained per lesion. Atypical ductal hyperplasia was found in 23 (4.5%) of 510 lesions, and surgical excision subsequently was performed in 21 of these cases. In these 21 cases, histopathologic results from core needle and surgical biopsies were reviewed and correlated. RESULTS: Histopathologic study of the 21 surgically excised lesions having ADH in their core needle specimens showed seven (33.3%) with DCIS. CONCLUSIONS: In the authors' patient population, one third of patients with ADH at core biopsy have an occult carcinoma. A core needle breast biopsy finding of ADH for nonpalpable lesions therefore warrants a recommendation for excisional biopsy. Images Figure 1. Figure 2. Figure 3. PMID:9230813

  3. Prostate biopsy

    MedlinePlus

    ... prostate biopsy; Fine needle biopsy of the prostate; Core biopsy of the prostate; Targeted prostate biopsy; Prostate biopsy - transrectal ultrasound (TRUS); Stereotactic transperineal prostate biopsy (STPB)

  4. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation. PMID:27236576

  5. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation.

  6. Laryngeal chondrosarcoma diagnosed by core-needle biopsy.

    PubMed

    Miyamaru, Satoru; Haba, Koichi

    2014-01-01

    We report a case of chondrosarcoma of the larynx, diagnosed by a percutaneous core-needle biopsy (CNB). Cartilaginous tumors of the larynx are usually diagnosed by biopsy with direct laryngomicroscopy under general anesthesia. However, patients find it difficult to undergo a biopsy under general anesthesia, for physical, economic, and social reasons. Instead, we can readily detect and sample tumors of the larynx using ultrasound under local anesthesia with reduced stress. Concerning needle-puncture biopsies, including fine-needle aspiration cytology (FNAC) and CNB, some studies have reported needle track dissemination, a possible complication in patients with malignant tumors. Thus, in the head and neck region, we generally use FNAC for biopsies, not CNB. However, it can be difficult to diagnose bone tumors by cytology alone. Regarding primary bone tumors, only one study has reported needle track dissemination by CNB, in osteosarcoma of the femur. Additionally, this complication has not been reported before with chondrosarcoma anywhere in the body. To our knowledge, this is the first report concerning chondrosarcoma of the larynx diagnosed by percutaneous CNB. We recommend CNB as a useful and safe diagnostic technique for primary bone tumors in the head and neck region.

  7. Combination of needle aspiration and core needle biopsy: A new technique of stereotactic biopsy

    PubMed Central

    Wani, Abrar Ahad; Wani, M. Afzal; Ramzan, Altaf U.; Nizami, Furqan A.; Malik, Nayil K.; Shafiq, S.; Ahmad, Rais; Kumar, Ashish; Lone, Iqbal; Makhdoomi, Rumana

    2016-01-01

    Aim: The study aims at describing the results of using a new technique to acquire the tissue sample in stereotactic biopsy of brain lesions. Materials and Methods: The study was performed in 19 patients over a period of 5 years in which we used the new technique, i.e., Abrar and Afzal technique (AT) of obtaining tissue biopsy. It is a combination of core tissue biopsy and needle aspiration techniques. The technique was devised to acquire greater amount of tissue for pathologic study. Results: While we could give pathologic diagnosis in 18 patients out of 19 (94.7%), in one patient, the tissue sample revealed only inflammatory cells and definitive diagnosis could not be reached. There was no significant morbidity or any mortality in the series. Conclusion: Abrar and Afzal technique is a reasonably accurate technique of acquiring larger tissue sample in stereotactic brain biopsy without any additional risks. It can be done with little modification of the conventional equipment available with the stereotactic system. PMID:27057212

  8. Mammographically Occult Asymptomatic Radial Scars/Complex Sclerosing Lesions at Ultrasonography-Guided Core Needle Biopsy: Follow-Up Can Be Recommended.

    PubMed

    Park, Vivian Youngjean; Kim, Eun-Kyung; Kim, Min Jung; Yoon, Jung Hyun; Moon, Hee Jung

    2016-10-01

    An increasing number of radial scars are detected by ultrasound (US), but their management is controversial. This study investigated the upgrade rate in mammographically occult radial scars/complex sclerosing lesions without epithelial atypia at US-guided 14-gauge core needle biopsy in asymptomatic patients. Nineteen mammographically occult benign radial scars/complex sclerosing lesions (median size, 7 mm; range, 3-23 mm) were included. Patients underwent surgical excision (n = 10) or vacuum-assisted excision, with follow-up US at least 6 mo after benign vacuum-assisted excision results (n = 8), or underwent US follow-up for 2 y after core needle biopsy (n = 1). Any cases with change in diagnosis to high-risk lesions or malignancy at excision were considered upgrades. The upgrade rate was 0.0%. Based on US findings, 15.8% (3/19) were Breast Imaging Reporting and Data System (BI-RADS) category 3, 68.4% (13/19) were BI-RADS category 4a and 15.8% (3/19) were BI-RADS category 4b. Follow-up with US can be considered for mammographically occult benign radial scar/complex sclerosing lesions diagnosed by US core needle biopsy in asymptomatic patients. PMID:27444865

  9. Core needle biopsy guidance based on EMOCT imaging (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor V.; Park, Jesung; Maguluri, Gopi

    2016-03-01

    We present a novel method, based on encoder mapping OCT imaging, for real-time guidance of core biopsy procedures. This method provides real-time feedback to the interventional radiologist, such that he/she can reorient the needle during the biopsy and sample the most representative area of the suspicious mass that is being investigated. This aspect is very important for tailoring therapy to the specific cancer based on biomarker analysis, which will become one of the next big advances in our search for the optimal cancer therapy. To enable individualized treatment, the genetic constitution and the DNA repair status in the affected areas is needed for each patient. Thus, representative sampling of the tumor is needed for analyzing various biomarkers, which are used as a tool to personalize cancer therapy. The encoder-based OCT enables samping of large size masses and provides full control on the imaging probe, which is passed through the bore of the biopsy guidance needle. The OCT image is built gradually, based on the feedback of an optical encoder which senses the incremental movement of the needle with a few microns resolution. Tissue mapping is independent of the needle speed, while it is advanced through the tissue. The OCT frame is analyzed in real-time and tissue cellularity is reported in a very simple manner (pie chart). Our preliminary study on a rabbit model of cancer has demonstrated the capability of this technology for accurately differentiating between viable cancer and heterogeneous or necrotic tissue.

  10. Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy

    PubMed Central

    Ishikawa, Toru; Kamimura, Hiroteru; Tsuchiya, Atsunori; Togashi, Tadayuki; Watanabe, Kouji; Seki, Kei-ichi; Ohta, Hironobu; Yoshida, Toshiaki; Ishihara, Noriko; Kamimura, Tomoteru

    2006-01-01

    AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods’ specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick-Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any patient. CONCLUSION: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick-Core biopsy needle. Using the new biopsy needle device, the

  11. Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy

    PubMed Central

    Kim, Tae Sun; Ko, Kwang Jin; Shin, Seung Jea; Ryoo, Hyun Soo; Song, Wan; Sung, Hyun Hwan; Han, Deok Hyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Kyu Sung; Lee, Sung Won; Lee, Hyun Moo; Choi, Han Yong

    2015-01-01

    Purpose To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy. Materials and Methods We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). We compared the cancer detection rate and Gleason scores on second biopsy and the unfavorable disease rate after radical prostatectomy among the three groups. Results A total of 214 patients (16.2%) were diagnosed with prostate cancer on a second biopsy. The rate of cancer detection was 14.6% in the benign diagnosis group, 22.1% in the HGPIN group, and 32.1% in the ASAP group, respectively (p<0.001). When patients were divided into subgroups according to the number of positive cores, the rate of cancer detection was 16.7%, 30.5%, 31.0%, and 36.4% in patients with a single core of HGPIN, more than one core of HGPIN, a single core of ASAP, and more than one core of ASAP, respectively. There were no significant differences in Gleason scores on second biopsy (p=0.324) or in the unfavorable disease rate after radical prostatectomy among the three groups (benign diagnosis vs. HGPIN, p=0.857, and benign diagnosis vs. ASAP, p=0.957, respectively). Conclusions Patients with multiple cores of HGPIN or any core number of ASAP on a first biopsy had a significantly higher cancer detection rate on a second biopsy. Repeat biopsy should be considered and not be delayed in those patients. PMID:26682019

  12. Atypical apocrine adenosis diagnosed on breast core biopsy: implications for management.

    PubMed

    Calhoun, Benjamin C; Booth, Christine N

    2014-10-01

    Apocrine adenosis (AA) and atypical apocrine adenosis (AAA) are uncommon findings in breast biopsies that may be misinterpreted as carcinoma. The data from long-term follow up studies of open biopsies suggest that AAA is not a high-risk or precursor lesion. The clinical significance and risk implications of AAA diagnosed on core biopsy are not well established. The goal of this study was to determine the frequency of carcinoma in excision specimens after a core biopsy diagnosis of AA or AAA. We identified 34 core biopsies of AA (22) and AAA (12) performed between 1996 and 2014. The mean age at diagnosis was 60 years. The most common indications for core biopsy were calcifications (11), a mass or density (18), and a mass or density with calcifications (3). Two cases were detected on magnetic resonance imaging (MRI) studies. Available pathology reports and slides were reviewed, and surgical excision findings were correlated with core biopsy diagnoses. Of the core biopsies with AA or AAA, 7 also contained atypical ductal or lobular hyperplasia (AH) and 4 contained ductal carcinoma in situ or invasive carcinoma. In the absence of coexisting AH or carcinoma in the initial core biopsy specimen, none of the surgical excision specimens after a diagnosis of AA (2) or AAA (7) contained ductal carcinoma in situ or invasive carcinoma. AAA by itself is an uncommon core biopsy diagnosis that may not require surgical excision.

  13. Does length of prostate biopsy cores have an impact on diagnosis of prostate cancer?

    PubMed Central

    Ergün, Müslüm; İslamoğlu, Ekrem; Yalçınkaya, Soner; Tokgöz, Hüsnü; Savaş, Murat

    2016-01-01

    Objective To investigate whether core length is a significant biopsy parameter in the detection of prostate cancer. Material and methods We retrospectively analyzed pathology reports of the specimens of 188 patients diagnosed with prostate cancer who had undergone initial transrectal ultrasound (TRUS) guided prostate biopsy, and compared biopsy core lengths of the patients with, and without prostate cancer. The biopsy specimens of prostate cancer patients were divided into 3 groups according to core length, and the data obtained were compared (Group 1; total core length <10 mm, Group 2; total core length 10 mm–19 mm, and Group 3; total core length >20 mm). Biopsy core lengths of the patients diagnosed as prostate cancer, and benign prostatic hyperplasia were compared, and a certain cut-off value for core length with optimal diagnostic sensitivity and specificity for prostate cancer was calculated. Results Mean age, PSA and total length of cores were 65.08±7.41 years, 9.82±6.34 ng/mL and 11.2±0.2 mm, respectively. Assessment of biopsy core lengths showed that cores with cancer (n=993, median length 12.5 mm) were significantly longer than benign cores (n=1185, median length=11.3 mm) (p<0.001). Core length analysis yielded 12 mm cores have an optimal sensitivity (41.9%) and specificity (62%) for detection of cancer (odds ratio: 1.08). Conclusion Biopsy core length is one of the most important parameter that determines the quality of biopsy and detection of prostate cancer. A median sample length of 12 mm is ideal lower limit for cancer detection, and biopsy procedures which yield shorter biopsy cores should be repeated. PMID:27635285

  14. Transfemoral liver biopsy using a Quick-Core biopsy needle system in living donor liver transplantation recipients.

    PubMed

    Li, Fen Qiang; Ko, Gi-Young; Sung, Kyu-Bo; Gwon, Dong-Il; Ko, Heung Kyu; Kim, Jong Woo; Yu, Eunsil

    2014-10-01

    The purpose of this study was to evaluate the efficacy and safety of transfemoral liver biopsy with a Quick-Core biopsy needle in select living donor liver transplantation (LDLT) recipients. Eight LDLT recipients underwent 9 transfemoral liver biopsy sessions. Six patients had undergone modified right lobe (mRL) LDLT, and 2 patients had undergone dual-left lobe LDLT. The indications for transfemoral liver biopsy were a hepatic vein (HV) at an acute angle to the inferior vena cava (IVC) on the coronal plane and a thin (<10-mm) liver parenchyma surrounding the HV to be biopsied on enhanced computed tomography. Under fluoroscopic guidance, the right inferior HV in the mRL or the left HV in the right-sided left lobe with a cranial orientation was negotiated with a 5-Fr catheter via the common femoral vein. Then, a stiffening cannula was introduced into the HV over a stiff guide wire. Needle passage was then performed with an 18- or 19-gauge Quick-Core biopsy needle. Technical success was achieved in all sessions without major complications. The median number of needle passages was 4 (range = 2-6). The median total length of obtained liver specimens in each session was 44 mm (range = 24-75 mm). The median number of portal tracts was 18 (range = 10-29), and the obtained liver specimens were adequate for histological diagnosis in all sessions. In conclusion, transfemoral liver biopsy with a Quick-Core biopsy needle is an effective and safe alternative for obtaining a liver specimen when standard transjugular liver biopsy is not feasible because of an unfavorable HV angle with respect to the IVC and/or a thin liver parenchyma surrounding the HV. PMID:24916429

  15. Are We Overtreating Papillomas Diagnosed on Core Needle Biopsy?

    PubMed Central

    Cyr, Amy E.; Novack, Deborah; Trinkaus, Kathryn; Margenthaler, Julie A.; Gillanders, William E.; Eberlein, Timothy J.; Ritter, Jon; Aft, Rebecca L.

    2014-01-01

    Background Breast papillomas often are diagnosed with core needle biopsy (CNB). Most studies support excision for atypical papillomas, because as many as one half will be upgraded to malignancy on final pathology. The literature is less clear on the management of papillomas without atypia on CNB. Our goal was to determine factors associated with pathology upgrade on excision. Methods Our pathology database was searched for breast papillomas diagnosed by CNB during the past 10 years. We identified 277 charts and excluded lesions associated with atypia or malignancy on CNB. Two groups were identified: papillomas that were surgically excised (group 1) and those that were not (group 2). Charts were reviewed for the subsequent diagnosis of cancer or high-risk lesions. Appropriate statistical tests were used to analyze the data. Results A total of 193 papillomas were identified. Eighty-two lesions were excised (42%). Caucasian women were more likely to undergo excision (p = 0.03). Twelve percent of excised lesions were upgraded to malignancy. Increasing age was a predictor of upgrading, but this was not significant. Clinical presentation, lesion location, biopsy technique, and breast cancer history were not associated with pathology upgrade. Two lesions in group 2 ultimately required excision due to enlargement, and both were upgraded to malignancy. Conclusions Twenty-four percent of papillomas diagnosed on CNB have upgraded pathology on excision—half to malignancy. All of the cancers diagnosed were stage 0 or I. For patients in whom excision was not performed, 2 of 111 papillomas were later excised and upgraded to malignancy. PMID:21046266

  16. Biopsy

    MedlinePlus

    Tissue sampling ... biopsy is called a percutaneous biopsy. It removes tissue using a needle attached to a hollow tube ... The needle is passed several times through the tissue being examined. The doctor uses the needle to ...

  17. A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

    PubMed Central

    Osborn, G; Wilton, F; Stevens, G; Vaughan-Williams, E; Gower-Thomas, K

    2010-01-01

    INTRODUCTION Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagnosed radial scars from the Welsh breast screening programme, Breast Test Wales (BTW), and investigated the outcome of radial scars based on histology from surgical excision in order to evaluate the appropriateness of the current management of these lesions in Wales. PATIENTS AND METHODS All needle core biopsy diagnosed radial scars were identified from the BTW screening database from the start of screening in 1989 until the end of 2007. RESULTS A total of 118 patients were diagnosed with radial scars on needle core biopsy; two patients had bilateral radial scars. Median patient age was 54 years (range, 49-68 years). Ninety-five lesions (79%) were thought to be pure radial scars on needle core biopsy; however, only 81 pure radial scars were identified on excision biopsy histology. Carcinoma was present in seven patients and ductal carcinoma in situ in nine patients at excision biopsy. In two patients, the cancers occurred in lesions reported as pure radial scars on needle core biopsy. Twenty-two lesions showed atypical ductal or lobular hyperplasia (ADH/ALH) or both on excision biopsy; 14 of these lesions were classed as pure radial scars by needle core biopsy. CONCLUSIONS All core biopsy diagnosed radial scars, presenting as screen detected abnormalities, should be excised due to their association with premalignant and malignant conditions. PMID:21073820

  18. Efficacy of Core Needle Biopsy Technique for Jawbone Diseases.

    PubMed

    Stolbizer, Federico; Cabrini, Romulo L; Keszler, Alicia

    2015-12-01

    Core needle biopsy (CNB) has been proven useful for diagnosing bone lesions, although it is not often used for jawbone lesions. The aim of this study was to evaluate the efficacy of the CNB method in a series of cases of intramaxillary lesions. CNB was performed on 85 patients with intraosseous lesions which were grouped according to radiographic appearance as: radiopaque lesions (RO, n=13), radiolucent lesions (RL, n=39) and mixed lesions with both radiolucent and radiopaque areas (RL-RO, n=33). The technique enabled us to obtain several tissue cylinders from each lesion (average 2.5 cylinders), which were processed following routine histopathological technique and H&E stain, plus special techniques when necessary. The histopathological analysis together with clinical data enabled accurate diagnosis (AD) in 81% of the cases and descriptive diagnosis (DD) in 14%. The material obtained in 5% of the cases was not appropriate for study (ND). The difference between successful (AD) and unsuccessful (DD+ND) CNB cases is statistically significant. The highest percentage of successful CBNs was for RO and RLRO lesions (85% and 100% respectively). RL lesions were more difficult because most of them were cystic lesions with fluid content.

  19. What Is the Ideal Core Number for Ultrasound-Guided Prostate Biopsy?

    PubMed Central

    Tsuji, Fábio Hissachi; de Oliveira Lima, Flávio; Yamamoto, Hamilto Akihissa; de Jesus, Carlos Márcio Nóbrega

    2014-01-01

    Purpose We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detecting prostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA) levels, prostate volumes, Gleason scores, and detection rates of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP). Materials and Methods A prospective controlled study was conducted in 354 consecutive patients with various indications for prostate biopsy. Sixteen-core biopsy specimens were obtained from 351 patients. The first 10-core biopsy specimens were obtained bilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateral to the base, middle third, and apex regions, yielding a total of 16-core biopsy specimens. The detection rate of carcinoma in the initial 10-core specimens was compared with that in the 12- and 16-core specimens. Results No significant differences in the cancer detection rate were found between the three biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol, in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) using the 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were compared with stratified PSA levels, stratified prostate volumes, Gleason scores, and detection rates of HGPIN and ASAP; no significant differences were found. Conclusions Cancer positivity with the 10-core protocol was not significantly different from that with the 12- and 16-core protocols, which indicates that the 10-core protocol is acceptable for performing a first biopsy. PMID:25405014

  20. The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.

    PubMed

    Tang, Jing-Hua; An, Xin; Lin, Xi; Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-10-20

    Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120 patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders.

  1. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

    SciTech Connect

    Cunningham, Jane D. McCusker, Mark W.; Power, Sarah; PearlyTi, Joanna; Thornton, John; Brennan, Paul; Lee, Michael J.; O’Hare, Alan; Looby, Seamus

    2015-04-15

    PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

  2. Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy.

    PubMed

    Hou, Yanjun; Chaudhary, Shweta; Gao, Faye F; Li, Zaibo

    2016-10-01

    Apocrine adenosis (AA) and atypical apocrine adenosis (AAA) are uncommon findings in breast biopsies that may be misinterpreted as carcinoma. The clinical significance and risk implications of AAA diagnosed on core biopsy are not well established. This study aimed to determine the frequency of carcinoma on follow-up excision in patients with a diagnosis of AA or AAA on core biopsy. Forty-one breast core biopsies of AA (n=29) and AAA (n=12) were identified during a study period of 12 years. Of the 41 core biopsies with AA or AAA, 10 biopsies showed coexisting/concurrent atypical hyperplasia or carcinoma. In the absence of coexisting/concurrent atypical hyperplasia or carcinoma in core biopsy, none of the follow-up excision specimens after a diagnosis of AA or AAA showed ductal carcinoma in situ or invasive carcinoma. In conclusion, AA or AAA by itself is an uncommon core biopsy diagnosis that may not require surgical excision.

  3. Surgical follow-up results for apocrine adenosis and atypical apocrine adenosis diagnosed on breast core biopsy.

    PubMed

    Hou, Yanjun; Chaudhary, Shweta; Gao, Faye F; Li, Zaibo

    2016-10-01

    Apocrine adenosis (AA) and atypical apocrine adenosis (AAA) are uncommon findings in breast biopsies that may be misinterpreted as carcinoma. The clinical significance and risk implications of AAA diagnosed on core biopsy are not well established. This study aimed to determine the frequency of carcinoma on follow-up excision in patients with a diagnosis of AA or AAA on core biopsy. Forty-one breast core biopsies of AA (n=29) and AAA (n=12) were identified during a study period of 12 years. Of the 41 core biopsies with AA or AAA, 10 biopsies showed coexisting/concurrent atypical hyperplasia or carcinoma. In the absence of coexisting/concurrent atypical hyperplasia or carcinoma in core biopsy, none of the follow-up excision specimens after a diagnosis of AA or AAA showed ductal carcinoma in situ or invasive carcinoma. In conclusion, AA or AAA by itself is an uncommon core biopsy diagnosis that may not require surgical excision. PMID:27649945

  4. 49 CFR 178.337-14 - Gauging devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices. 178.337-14 Section 178.337-14... Specifications for Containers for Motor Vehicle Transportation § 178.337-14 Gauging devices. (a) Liquid level gauging devices. See § 173.315(h) of this subchapter. (b) Pressure gauges. (1) See § 173.315(h) of...

  5. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices. 178.338-14 Section 178.338-14... Specifications for Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices. (1) Unless a cargo tank is intended to be filled by weight, it must be equipped with...

  6. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  7. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  8. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... Containers for Motor Vehicle Transportation § 178.338-14 Gauging devices. (a) Liquid level gauging devices... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure,...

  9. Core needle biopsy versus fine needle aspiration biopsy in breast--a historical perspective and opportunities in the modern era.

    PubMed

    Nassar, Aziza

    2011-05-01

    Breast fine-needle aspiration biopsy (FNAB) by palpation is on the decline, due to its limitations in diagnostic accuracy, decreased sensitivity, and its replacement with core needle biopsy (CNB). Despite its decreasing utility, superficial fine-needle aspiration (FNA) in breast is still the main modality for evaluating metastatic lesions, recurrence, and axillary lymph node metastasis. New modalities including proteomic pattern expression and methylation profiling of breast lesions are other promising techniques that can be used as ancillary tests for refining the diagnosis of breast lesions using FNAB. Image-guided breast FNA proves to be a successful alternative with high sensitivity and specificity. In this review, the advantages, disadvantages, and inherent limitations of breast FNA and CNB, and new advanced techniques are discussed.

  10. Efficiency of Core Biopsy for BI-RADS-5 Breast Lesions.

    PubMed

    Wolf, Ronald; Quan, Glenda; Calhoun, Kris; Soot, Laurel; Skokan, Laurie

    2008-01-01

    Stereotactic biopsy has proven more cost effective for biopsy of lesions associated with moderately suspicious mammograms. Data regarding selection of stereotactic biopsy (CORE) instead of excisional biopsy (EB) as the first diagnostic procedure in patients with nonpalpable breast lesions and highest suspicion breast imaging-reporting and data system (BI-RADS)-5 mammograms are sparse. Records from a regional health system radiology database were screened for mammograms associated with image-guided biopsy. A total of 182 nonpalpable BI-RADS-5 lesions were sampled in 178 patients over 5 years, using CORE or EB. Initial surgical margins, number of surgeries, time from initial procedure to last related surgical procedure, and hospital and professional charges for related admissions were compared using chi-squared, t-test, and Wilcoxon Mann-Whitney tests. A total of 108 CORE and 74 EB were performed as the first diagnostic procedure. Invasive or in situ carcinoma was diagnosed in 156 (86%) of all biopsies, 95 in CORE and 61 in EB groups. Negative margins of the first surgical procedure were more frequent in CORE (n = 70, 74%) versus EB (n = 17, 28%), p < 0.05. Use of CORE was associated with fewer total surgical procedures per lesion (1.29 +/- 0.05 versus 1.8 +/- 0.05, p < 0.05). Time of initial diagnostic procedure to final treatment did not vary significantly according to group (27 +/- 2 days versus 22 +/- 2 days, CORE versus EB). Mean charges including the diagnostic procedure and all subsequent surgeries were not different between CORE and EB groups ($10,500 +/- 300 versus $11,500 +/- 500, p = 0.08). Use of CORE as the first procedure in patients with highly suspicious mammograms is associated with improved pathologic margins and need for fewer surgical procedures than EB, and should be considered the preferred initial diagnostic approach. PMID:18821933

  11. Transjugular Core Liver Biopsy with a 19-Gauge Spring-Loaded Cutting Needle

    SciTech Connect

    Choh, Jeffery; Dolmatch, Bart; Safadi, Rami; Long, Phil; Geisinger, Michael; Lammert, Gary; Dempsey, James

    1998-01-15

    One hundred and five sequential transjugular core liver biopsies (TJLBx) were performed in 101 patients with coagulopathy and/or ascites using the 19-gauge Quick-Core Biopsy (QCB) needle. Two-hundred and seventy-three cores were obtained in 295 passes (92.5%). One-hundred and two of the 105 procedures (97.1%) led to a histopathologic diagnosis. One of the three nondiagnostic biopsies was done because of severe autolysis of the liver. There was one subcapsular hematoma, one hepatic arteriovenous fistula, and one liver capsular puncture. Two minor neck hematomas occurred. One death was reported (unrelated to the procedure). QCB needle TJLBx is an effective and relatively safe way to obtain core liver samples.

  12. Surgical excision of pure flat epithelial atypia identified on core needle breast biopsy.

    PubMed

    Prowler, Vanessa L; Joh, Jennifer E; Acs, Geza; Kiluk, John V; Laronga, Christine; Khakpour, Nazanin; Lee, M Catherine

    2014-08-01

    The biology of flat epithelial atypia (FEA) is still being investigated as its presence becomes more frequent on biopsy specimens. FEA is more commonly associated with malignancy when found in association with ADH, ALH or LCIS. Pure FEA is only upgraded to cancer in 3.2% of patients. Surgical excision of pure FEA found on core needle biopsy results in overtreatment in the vast majority of breast patients and may not be necessary.

  13. Probability modeling of the number of positive cores in a prostate cancer biopsy session, with applications.

    PubMed

    Serfling, Robert; Ogola, Gerald

    2016-02-10

    Among men, prostate cancer (CaP) is the most common newly diagnosed cancer and the second leading cause of death from cancer. A major issue of very large scale is avoiding both over-treatment and under-treatment of CaP cases. The central challenge is deciding clinical significance or insignificance when the CaP biopsy results are positive but only marginally so. A related concern is deciding how to increase the number of biopsy cores for larger prostates. As a foundation for improved choice of number of cores and improved interpretation of biopsy results, we develop a probability model for the number of positive cores found in a biopsy, given the total number of cores, the volumes of the tumor nodules, and - very importantly - the prostate volume. Also, three applications are carried out: guidelines for the number of cores as a function of prostate volume, decision rules for insignificant versus significant CaP using number of positive cores, and, using prior distributions on total tumor size, Bayesian posterior probabilities for insignificant CaP and posterior median CaP. The model-based results have generality of application, take prostate volume into account, and provide attractive tradeoffs of specificity versus sensitivity. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Ten-core versus 16-core transrectal ultrasonography guided prostate biopsy for detection of prostatic carcinoma: a prospective comparative study in Indian population

    PubMed Central

    Prakash, V. Surya; Mohan, G. Chandra; Krishnaiah, S. Venkata; Vijaykumar, V.; Babu, G. Ramesh; Reddy, G. Vijaya Bhaskar; Mahaboob, V. S.

    2013-01-01

    Purpose: To compare the cancer detection rate in patients with raised serum prostate-specific antigen (PSA) or abnormal digital rectal examination (DRE) results between the 10-core and the 16-core biopsy techniques in an Indian population. Methods: Between November 2010 and November 2012, 95 men aged >50 years who presented to the Urology Department with lower urinary tract symptoms, elevated serum PSA, and/or abnormal DRE findings underwent transrectal ultrasonography (TRUS)-guided prostate biopsy. A total of 53 patients underwent 10-core biopsy and 42 patients underwent 16-core biopsy. Results: Of the 53 men in the 10-core group, 8 had cancer, whereas in the 16-core biopsy group, 23 of 42 men had cancer. Detection of prostate cancer was significantly higher in patients who underwent 16-core biopsy than in those who underwent 10-core biopsy (P<0.001). Among the 95 men, 44 men had abnormal DRE findings (46.3%), of whom 23 showed cancer (52.27%). Of 51 men with normal DRE findings and elevated PSA, 8 men had malignancy with a cancer detection rate of 15.68%. Among 20 men with PSA between 4.1 and 10 ng/mL, 2 (10%) had cancer. In 31 men with PSA between 10.1 and 20 ng/mL, 3 cancers (9.67%) were detected, and in 44 men with PSA >20 ng/mL, 26 cancers were detected (59.09%). Conclusions: The cancer detection rate with 16-core TRUS-guided biopsy is significantly higher than that with 10-core biopsy (54.76% vs. 15.09%, P<0.001). In patients with both normal and abnormal DRE findings, 16-core biopsy has a better detection rate than the 10-core biopsy protocol. With increasing PSA, there is a high rate of detection of prostate cancer in both 10-core and 16-core biopsy patients. PMID:24392441

  15. Raman spectroscopy: a real-time tool for identifying microcalcifications during stereotactic breast core needle biopsies

    PubMed Central

    Saha, A.; Barman, I.; Dingari, N. C.; McGee, S.; Volynskaya, Z.; Galindo, L. H.; Liu, W.; Plecha, D.; Klein, N.; Dasari, R. R.; Fitzmaurice, M.

    2011-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We present here a Raman spectroscopic tool for detecting microcalcifications in breast tissue based on their chemical composition. We collected ex vivo Raman spectra from 159 tissue sites in fresh stereotactic breast needle biopsies from 33 patients, including 54 normal sites, 75 lesions with microcalcifications and 30 lesions without microcalcifications. Application of our Raman technique resulted in a positive predictive value of 97% for detecting microcalcifications. This study shows that Raman spectroscopy has the potential to detect microcalcifications during stereotactic breast core biopsies and provide real-time feedback to radiologists, thus reducing non-diagnostic and false negative biopsies. PMID:22025985

  16. IMAGING GUIDED PERCUTANEAL CORE BIOPSY OF PULMONARY AND PLEURAL MASSES - TECHNIQUE AND COMPLICATIONS.

    PubMed

    Azrumelashvili, T; Mizandari, M; Dundua, T

    2016-01-01

    Paper presents the ultrasound (US) and computed tomography (CT) guided percutaneous lung core biopsy technique and procedure associated complications. 148 percutaneous biopsies of lung and peural lesions were performed in 143 patients ( in 5 (3.4%) cases the repeated procedure was needed). Procedure was guided by US in 42 cases, by CT - in 106 cases. Post-biopsy CT scan was performed and patients observed for any complications. No complications were detected after US guided procedures; No major complications were detected after CT guided biopsy procedures; minor complications (pneumothorax, hemothorax and hemophtysis) were detected in 24 (22.6%) cases. In 18 (17.0%) cases pneumothorax, in 1 (0/9%) cases - hemothorax and in 5 (4.7%) cases hemophtisis was detected on CT guided procedures. All hemothorax and hemophtisis and 13(12.3%) pneumothorax cases happened to be self-limited; in 3(2.8%) pneumothorax cases aspiration and in 2(1.9%) cases - pleural drainage was needed. Ultrasound is the most efficient for biopsy guidance if the "target" can be adequately imaged by this technique. If US guidance is impossible biopsy should be performed under CT guidance. Pneumothorax and hemothoraxs was associated with multiple needle passes, lesion diameter <2 cm and larger diameter needle use. Hemoptysis was not associated with multiple needle passes, lesioan size and larger diameter needle. No air embolism was detected on our study. The safety and biopsy procedure success high rate proves the use of imaging guided percutaneal core biopsy of pulmonary and pleural masses as a first choice procedure when the lung or pleural mass morphology is needed. PMID:26870971

  17. Core Needle Biopsy of Breast Cancer Tumors Increases Distant Metastases in a Mouse Model12

    PubMed Central

    Mathenge, Edward Gitau; Dean, Cheryl Ann; Clements, Derek; Vaghar-Kashani, Ahmad; Photopoulos, Steffany; Coyle, Krysta Mila; Giacomantonio, Michael; Malueth, Benjamin; Nunokawa, Anna; Jordan, Julie; Lewis, John D.; Gujar, Shashi Ashok; Marcato, Paola; Lee, Patrick W.K.; Giacomantonio, Carman Anthony

    2014-01-01

    INTRODUCTION: Incisional biopsies, including the diagnostic core needle biopsy (CNB), routinely performed before surgical excision of breast cancer tumors are hypothesized to increase the risk of metastatic disease. In this study, we experimentally determined whether CNB of breast cancer tumors results in increased distant metastases and examine important resultant changes in the primary tumor and tumor microenvironment associated with this outcome. METHOD: To evaluate the effect of CNB on metastasis development, we implanted murine mammary 4T1 tumor cells in BALB/c mice and performed CNB on palpable tumors in half the mice. Subsequently, emulating the human scenario, all mice underwent complete tumor excision and were allowed to recover, with attendant metastasis development. Tumor growth, lung metastasis, circulating tumor cell (CTC) levels, variation in gene expression, composition of the tumor microenvironment, and changes in immunologic markers were compared in biopsied and non-biopsied mice. RESULTS: Mice with biopsied tumors developed significantly more lung metastases compared to non-biopsied mice. Tumors from biopsied mice contained a higher frequency of myeloid-derived suppressor cells (MDSCs) accompanied by reduced CD4 + T cells, CD8 + T cells, and macrophages, suggesting biopsy-mediated development of an increasingly immunosuppressive tumor microenvironment. We also observed a CNB-dependent up-regulation in the expression of SOX4, Ezh2, and other key epithelial-mesenchymal transition (EMT) genes, as well as increased CTC levels among the biopsy group. CONCLUSION: CNB creates an immunosuppressive tumor microenvironment, increases EMT, and facilitates release of CTCs, all of which likely contribute to the observed increase in development of distant metastases. PMID:25425969

  18. Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin

    PubMed Central

    Vasudeva, Pawan; Kumar, Niraj; Kumar, Anup; Singh, Harbinder; Kumar, Gaurav

    2015-01-01

    ABSTRACT Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA), prostate volume, hemoglobin (Hb %), number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding. Results: Of 681 eligible patients, Group A and B had 191 and 490 patients respectively. The mean age, prostate volume, serum PSA and pre-biopsy hemoglobin were similar in both Groups with no significant differences noted between them. None of the post-biopsy complications, including number of hematuria episodes (p=0.83), number of patients reporting hematuria (p=0.55), number of patients reporting hematospermia (p=0.36) and number of patients reporting rectal bleeding (p=0.65), were significantly different between Groups A and B respectively. None of the hemorrhagic complication in either group required intervention and were self limiting. Conclusion: Continuing low dose aspirin during TRUS guided prostate biopsy neither alters the minor bleeding episodes nor causes major bleeding complication. So, discontinuation of low dose aspirin prior to TRUS guided prostate biopsy is not required. PMID:26742966

  19. Pathologic findings in patients with targeted magnetic resonance imaging-guided prostate needle core biopsies

    PubMed Central

    Geller, Rachel L; Nour, Sherif G; Osunkoya, Adeboye O

    2015-01-01

    In contrast to the routine (non-targeted) sampling approach of transrectal ultrasound guided biopsies (TRUS-GB), targeted magnetic resonance imaging-guided biopsies (TMRI-GB) target regions of the prostate suspicious for prostate cancer (PCa), based on findings on multiparametric MRI. We sought to examine the pathologic findings identified on TMRI-GB, due to the fact that there are limited studies on this in the Pathology literature. A search was made through our Urologic Pathology files for prostate needle core biopsies that were obtained via TMRI-GB. Forty-six patients were identified. Mean patient (PT) age was 62 years (range: 50-78 years). Twenty one of 46 PTs (46%) had a history of PCa, 10/46 PTs (22%) had a history of negative TRUS-GB and rising PSA, and the remaining 15/46 PTs (32%) had never undergone biopsy. Cancer detection rate on TMRI-GB was 57% for PTs with a prior diagnosis of PCa, 50% for PTs with a history of benign biopsy, and 67% who were biopsy naïve. An average of 3.16 cores were sampled from malignant lesions and an average of 2.74 were sampled from benign lesions (P=0.02). TMRI-GB has a higher cancer detection rate than TRUS-GB. TMRI-GB may have a critical role as a tool for active surveillance, tumor mapping, and primary detection of PCa, which will likely evolve as the ability to identify malignant lesions improve. The roles of pathologists and radiologists in the validation of this procedure will continue to be even more vital in the future. PMID:26617689

  20. Inflammation and focal atrophy in prostate needle biopsy cores and association to prostatic adenocarcinoma.

    PubMed

    Benedetti, Ines; Bettin, Alfonso; Reyes, Niradiz

    2016-10-01

    The possible origin of proliferative inflammatory atrophy in the regenerative proliferation of prostate epithelial cells in response to injury caused by inflammation, and their relation to prostate adenocarcinoma have not been defined. Inflammation and focal atrophy are common pathological findings in prostate biopsies, currently not routinely included in surgical pathology reports. The objective of the study was to determine the correlation between inflammation and focal atrophy with prostate adenocarcinoma. Prostate needle biopsies from 203 patients with clinical parameters suspicious for malignancy were evaluated for the presence and extent of chronic inflammation, type and grade of focal atrophy, high-grade intraepithelial neoplasia, and adenocarcinoma. Relations among them and with age were also analyzed. χ(2) tests and binary logistic regression were used to estimate associations. Chronic inflammation was observed in 77.3% of the biopsies, significantly associated to adenocarcinoma (P = .031). Moderate/severe inflammation in at least 1 biopsy core increased the risk of prostate adenocarcinoma (odds ratio, 2.94; 95% confidence interval, 1.27-6.8), whereas glandular localization of inflammation decreased the risk. Focal atrophy was present in 72.9% of the biopsies, proliferative inflammatory atrophy was the most common type, and its grade was significantly associated to inflammation (P < .0001) and inflammation intensity (P = .003). An association between prostate adenocarcinoma and inflammation was found, with higher odds in presence of moderate/severe inflammation in at least 1 biopsy core. Increasing grades of proliferative inflammatory atrophy were associated to high levels of inflammation, supporting its previously proposed inflammatory nature. PMID:27649956

  1. The effect of excisional biopsy on the accuracy of sentinel lymph node mapping in early stage breast cancer: comparison with core needle biopsy.

    PubMed

    Forghani, Mohammad Naser; Memar, Bahram; Jangjoo, Ali; Zakavi, Rasoul; Mehrabibahar, Mostafa; Kakhki, Vahid Reza Dabbagh; Kashani, Ida; Hashemian, Farnaz; Sadeghi, Ramin

    2010-11-01

    Despite the successful application of sentinel node mapping in breast cancer patients, its use in patients with a history of previous excisional biopsy of the breast tumors is a matter of controversy. In the present study we evaluated the accuracy of sentinel node biopsy in this group of patients and compared the results with those in whom the diagnosis of breast cancer was established by core needle biopsy. Eighty patients with early stage breast carcinoma were included into our study. Forty patients had a history of previous excisional biopsy and the remainder 40 had undergone core needle biopsy. Intradermal injections of 99mTc-antimony sulfide colloid as well as patent blue were both used for sentinel node mapping. Sentinel nodes were harvested during surgery with the aid of surgical gamma probe. All patients underwent standard axillary lymph node dissection subsequently. Detection rate was 97.5 per cent for both groups of the study. Number of detected sentinel node during surgery was not significantly different between groups. False negative rate was 0 per cent for both groups of the study. In conclusion sentinel node biopsy is reliable in patients with previous history of excisional biopsy of the breast tumors and has a low false negative rate.

  2. Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis

    PubMed Central

    Tyng, Chiang J; Almeida, Maria Fernanda A; Barbosa, Paula NV; Bitencourt, Almir GV; Berg, José Augusto AG; Maciel, Macello S; Coimbra, Felipe JF; Schiavon, Luiz Henrique O; Begnami, Maria Dirlei; Guimarães, Marcos D; Zurstrassen, Charles E; Chojniak, Rubens

    2015-01-01

    AIM: To evaluate the techniques, results, and complications related to computed tomography (CT)-guided percutaneous core needle biopsies of solid pancreatic lesions. METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle (10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect (transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year (range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm (range: 15-195 mm). Most (75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2% (23/103) of cases and indirect transhepatic or transgastric access was used in 4.8% (5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1% (101/103) of cases, confirming 3.9% (4/103) of tumors were benign and 94.2% (97/103) were malignant; results were atypical in 1.9% (2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients (8.7%), and they were more commonly associated with biopsies of lesions located in the head/uncinate process (n = 8), than of those located in the body/tail (n = 1) of the pancreas, but this difference was not significant. CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally

  3. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.

    PubMed

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-06-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled on the basis of the breast tissue components, and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma, and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity, and specificity of 100%, 95.6%, 62.5%, and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, fibroadenoma, or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study shows the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing nondiagnostic and false-negative biopsies. PMID:23729641

  4. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy

    PubMed Central

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled based on the breast tissue components and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma (FA) and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity and specificity of 100%, 95.6%, 62.5% and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, FA or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study demonstrates the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing non-diagnostic and false negative biopsies. PMID:23729641

  5. Feasibility of near-infrared diffuse optical spectroscopy on patients undergoing image-guided core-needle biopsy

    PubMed Central

    Yu, Bing; Burnside, Elizabeth S.; Sisney, Gale A.; Harter, Josephine M.; Zhu, Changfang; Dhalla, Al-Hafeez; Ramanujam, Nirmala

    2009-01-01

    We describe a side-firing fiber optic sensor based on near-infrared spectroscopy for guiding core needle biopsy diagnosis of breast cancer. The sensor is composed of three side firing optical fibers (two source fibers and one detection fiber), providing two source-detector separations. The entire assembly is inserted into a core biopsy needle, allowing for sampling to occur at the biopsy site. A multi-wavelength frequency-domain near-infrared instrument is used to collect diffuse reflectance in the breast tissue through an aperture on the biopsy needle before the tissue is removed for histology. Preliminary in vivo measurements performed on 10 normal or benign breast tissues from 5 women undergoing stereo- or ultrasound-guided core needle biopsy show the ability of the system to determine tissue optical properties and constituent concentrations, which are correlated with breast tissue composition derived from histopathology. PMID:19547057

  6. Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer

    PubMed Central

    Ganott, Marie A.; Zuley, Margarita L.; Abrams, Gordon S.; Lu, Amy H.; Kelly, Amy E.; Chivukula, Mamatha; Carter, Gloria; Austin, R. Marshall; Bandos, Andriy I.

    2014-01-01

    Rationale and Objectives. To compare the sensitivities of ultrasound guided core biopsy and fine needle aspiration (FNA) for detection of axillary lymph node metastases in patients with a current diagnosis of ipsilateral breast cancer. Materials and Methods. From December 2008 to December 2010, 105 patients with breast cancer and abnormal appearing lymph nodes in the ipsilateral axilla consented to undergo FNA of an axillary node immediately followed by core biopsy of the same node, both with ultrasound guidance. Experienced pathologists evaluated the aspirate cytology without knowledge of the core histology. Cytology and core biopsy results were compared to sentinel node excision or axillary dissection pathology. Sensitivities were compared using McNemar's test. Results. Of 70 patients with axillary node metastases, FNA was positive in 55/70 (78.6%) and core was positive in 61/70 (87.1%) (P = 0.18). The FNA and core results were discordant in 14/70 (20%) patients. Ten cases were FNA negative/core positive. Four cases were FNA positive/core negative. Conclusion. Core biopsy detected six (8.6%) more cases of metastatic lymphadenopathy than FNA but the difference in sensitivities was not statistically significant. Core biopsy should be considered if the node is clearly imaged and readily accessible. FNA is a good alternative when a smaller needle is desired due to node location or other patient factors. This trial is registered with NCT01920139. PMID:24649373

  7. Greater Biopsy Core Number Is Associated With Improved Biochemical Control in Patients Treated With Permanent Prostate Brachytherapy

    SciTech Connect

    Bittner, Nathan; Wallner, Kent E.

    2010-11-15

    Purpose: Standard prostate biopsy schemes underestimate Gleason score in a significant percentage of cases. Extended biopsy improves diagnostic accuracy and provides more reliable prognostic information. In this study, we tested the hypothesis that greater biopsy core number should result in improved treatment outcome through better tailoring of therapy. Methods and Materials: From April 1995 to May 2006, 1,613 prostate cancer patients were treated with permanent brachytherapy. Patients were divided into five groups stratified by the number of prostate biopsy cores ({<=}6, 7-9, 10-12, 13-20, and >20 cores). Biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS) were evaluated as a function of core number. Results: The median patient age was 66 years, and the median preimplant prostate-specific antigen was 6.5 ng/mL. The overall 10-year bPFS, CSS, and OS were 95.6%, 98.3%, and 78.6%, respectively. When bPFS was analyzed as a function of core number, the 10-year bPFS for patients with >20, 13-20, 10-12, 7-9 and {<=}6 cores was 100%, 100%, 98.3%, 95.8%, and 93.0% (p < 0.001), respectively. When evaluated by treatment era (1995-2000 vs. 2001-2006), the number of biopsy cores remained a statistically significant predictor of bPFS. On multivariate analysis, the number of biopsy cores was predictive of bPFS but did not predict for CSS or OS. Conclusion: Greater biopsy core number was associated with a statistically significant improvement in bPFS. Comprehensive regional sampling of the prostate may enhance diagnostic accuracy compared to a standard biopsy scheme, resulting in better tailoring of therapy.

  8. Chronic Inflammation in Prostate Biopsy Cores is an Independent Factor that Lowers the Risk of Prostate Cancer Detection and is Inversely Associated with the Number of Positive Cores in Patients Elected to a First Biopsy

    PubMed Central

    Porcaro, Antonio B.; Novella, Giovanni; Mattevi, Daniele; Bizzotto, Leonardo; Cacciamani, Giovanni; Luyk, Nicolò De; Tamanini, Irene; Cerruto, Maria A.; Brunelli, Matteo; Artibani, Walter

    2016-01-01

    Objectives To investigate associations of chronic inflammatory infiltrate (CII) with prostate cancer (PCa) risk and the number of positive cores in patients elected to a first set of biopsies. Materials and Methods Excluding criteria were as follows: active surveillance, prostate specific antigen (PSA) ≥ 30 ng/l, re-biopsies, incidental PCa, less than 14 cores, metastases, or 5-alpha reductase inhibitors. The cohort study was classified as negative (control group) and positive cores between 1 and 2 or > 2. Results The cohort included 421 cases who did not meet the exclusion criteria. PCa was detected in 192 cases (45.6%) of which the number of positive cores was between 1 and 2 in 77 (40.1%) cases. The median PSA was 6.05 ng/ml (range 0.3-29 ng/ml). Linear regression models showed that CII was an independent predictor inversely associated with the risk of PCa. Multinomial logistic regression models showed that CII was an independent factor that was inversely associated with PCa risk in cases with positive cores between 1 and 2 (OR = 0.338; p = 0.004) or more than 2 (OR = 0.076; p < 0.0001) when compared to the control group. Conclusion In a cohort of men undergoing the first biopsy set after prostate assessment, the presence of CII in the biopsy core was an independent factor inversely associated with PCa risk as well as with the number of positive biopsy cores (tumor extension). Clinically, the detection of CII in negative biopsy cores might reduce the risk of PCa in repeat biopsies as well as the probability of detecting multiple positive cores. PMID:27390581

  9. Diffuse optical spectroscopy measurements of healing in breast tissue after core biopsy: case study

    PubMed Central

    Tanamai, Wendy; Chen, Cynthia; Siavoshi, Sara; Cerussi, Albert; Hsiang, David; Butler, John; Tromberg, Bruce

    2010-01-01

    Diffuse optical spectroscopy (DOS) has been used to monitor and predict the effects of neoadjuvant (i.e., presurgical) chemotherapy in breast cancer patients in several pilot studies. Because patients with suspected breast cancers undergo biopsy prior to treatment, it is important to understand how biopsy trauma influences DOS measurements in the breast. The goal of this study was to measure the effects of a standard core breast biopsy on DOS measurements of tissue deoxyhemoglobin, hemoglobin, water, and bulk lipid concentrations. We serially monitored postbiopsy effects in the breast tissue in a single subject (31-year-old premenopausal female) with a 37×18×20 mm fibroadenoma. A baseline measurement and eight weekly postbiopsy measurements were taken with a handheld DOS imaging instrument. Our instrument used frequency domain photon migration combined with broadband steady-state spectroscopy to characterize tissues via quantitative measurements of tissue absorption and reduced scattering coefficients from 650 to 1000 nm. The concentrations of significant near-infrared (NIR) absorbers were mapped within a 50 cm2 area over the biopsied region. A 2-D image of a contrast function called the tissue optical index (TOI=deoxyhemoglobin×water/bulk lipid) was generated and revealed that a minimum of 14 days postbiopsy was required to return TOI levels in the biopsied area to their prebiopsy levels. Changes in the TOI images of the fibroadenoma also reflected the progression of the patient’s menstrual cycle. DOS could therefore be useful in evaluating both wound-healing response and the effects of hormone and hormonal therapies in vivo. PMID:19256712

  10. Real-time three-dimensional optical coherence tomography image-guided core-needle biopsy system

    PubMed Central

    Kuo, Wei-Cheng; Kim, Jongsik; Shemonski, Nathan D.; Chaney, Eric J.; Spillman, Darold R.; Boppart, Stephen A.

    2012-01-01

    Advances in optical imaging modalities, such as optical coherence tomography (OCT), enable us to observe tissue microstructure at high resolution and in real time. Currently, core-needle biopsies are guided by external imaging modalities such as ultrasound imaging and x-ray computed tomography (CT) for breast and lung masses, respectively. These image-guided procedures are frequently limited by spatial resolution when using ultrasound imaging, or by temporal resolution (rapid real-time feedback capabilities) when using x-ray CT. One feasible approach is to perform OCT within small gauge needles to optically image tissue microstructure. However, to date, no system or core-needle device has been developed that incorporates both three-dimensional OCT imaging and tissue biopsy within the same needle for true OCT-guided core-needle biopsy. We have developed and demonstrate an integrated core-needle biopsy system that utilizes catheter-based 3-D OCT for real-time image-guidance for target tissue localization, imaging of tissue immediately prior to physical biopsy, and subsequent OCT imaging of the biopsied specimen for immediate assessment at the point-of-care. OCT images of biopsied ex vivo tumor specimens acquired during core-needle placement are correlated with corresponding histology, and computational visualization of arbitrary planes within the 3-D OCT volumes enables feedback on specimen tissue type and biopsy quality. These results demonstrate the potential for using real-time 3-D OCT for needle biopsy guidance by imaging within the needle and tissue during biopsy procedures. PMID:22741064

  11. Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRI-targeted prostate biopsy (32 cores).

    PubMed

    Pepe, P; Pennisi, M

    2016-01-01

    Erectile dysfunction (ED) following transperineal prostate biopsy (TPB) was prospectively evaluated. From January 2011 to January 2014, 1050 patients were submitted to TPB: 18 core (extended TPB) in 610 cases, 28 core (saturation TPB) in 360 cases and 32 core (saturation plus magnetic resonance imaging (MRI) targeted TPB) in 210 cases. The indications for biopsy were increasing prostate-specific antigen (PSA) or PSA>10 ng ml(-1). All patients were prospectively evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) at time zero and at 1, 3 and 6 months from TPB. Prostate cancer was diagnosed in 385/1050 (36.6%) patients; 560 men (350 vs 110 vs 100) having benign histology and normal sexual activity also completed the study. Overall, IEEF-5 score at time zero and at 1, 3 and 6 months did not significantly worsen (P>0.05); in detail, at 1 month from biopsy 15 extended TPB (4.2%) vs 7 saturation TPB (6.4%) vs 7 saturation plus MRI targeted TPB (7%) men referred mild ED that disappeared after 3 months. Irrespective of method (18 vs 28 vs 32 core) TPB did not significantly worsen erectile function at 3-6 months from the procedure. PMID:26289906

  12. Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRI-targeted prostate biopsy (32 cores).

    PubMed

    Pepe, P; Pennisi, M

    2016-01-01

    Erectile dysfunction (ED) following transperineal prostate biopsy (TPB) was prospectively evaluated. From January 2011 to January 2014, 1050 patients were submitted to TPB: 18 core (extended TPB) in 610 cases, 28 core (saturation TPB) in 360 cases and 32 core (saturation plus magnetic resonance imaging (MRI) targeted TPB) in 210 cases. The indications for biopsy were increasing prostate-specific antigen (PSA) or PSA>10 ng ml(-1). All patients were prospectively evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) at time zero and at 1, 3 and 6 months from TPB. Prostate cancer was diagnosed in 385/1050 (36.6%) patients; 560 men (350 vs 110 vs 100) having benign histology and normal sexual activity also completed the study. Overall, IEEF-5 score at time zero and at 1, 3 and 6 months did not significantly worsen (P>0.05); in detail, at 1 month from biopsy 15 extended TPB (4.2%) vs 7 saturation TPB (6.4%) vs 7 saturation plus MRI targeted TPB (7%) men referred mild ED that disappeared after 3 months. Irrespective of method (18 vs 28 vs 32 core) TPB did not significantly worsen erectile function at 3-6 months from the procedure.

  13. Intramuscular Hemangioma in the Anterior Scalene Muscle Diagnosed by Core Needle Biopsy

    PubMed Central

    Cho, Jae-Keun; Sung, Myung-Whun

    2015-01-01

    Intramuscular hemangioma (IMH) is a rare, benign vascular lesion that frequently develops within skeletal muscles. Preoperatively, accurate diagnosis of IMH is often extremely difficult because of nonspecific clinical findings and the inaccuracy of fine-needle aspiration cytology. IMH is suspected in only 8% of preoperative diagnoses before surgical exploration. Here, we report a case of a 44-year-old man with a huge IMH in the anterior scalene muscle that was preoperatively diagnosed using ultrasonography-guided core needle biopsy, and was successfully treated based on preoperative clinical information. PMID:26330928

  14. Construction of tissue microarrays from core needle biopsies - a systematic literature review.

    PubMed

    Albanghali, Mohammad; Green, Andrew; Rakha, Emad; Aleskandarany, Mohamed; Nolan, Chris; Ellis, Ian; Cheung, Kwok-Leung

    2016-02-01

    In some clinical circumstances, core needle biopsy (CNB) may be the only source of material from cancer tissue for diagnostic use. The volume of tissue available in a CNB is low, and opportunities for research use can therefore be limited. The tissue microarray (TMA) principle, if applied to the use of CNBs, could facilitate research studies in circumstances where CNB specimens are available. However, various challenges are expected in applying such a technique in CNBs, which has limited their use in research. We therefore conducted a systematic review of the literature on this subject. A systematic search was carried out with CINAHL, EMBASE, the Cochrane library, and MEDLINE, to identify studies that have primarily developed methods for constructing TMAs from CNBs. Eight studies were found to meet the inclusion criteria; six of these employed the vertical rearrangement technique, and two used multiple layers of biopsy tissue. Representation of the CNB was significantly influenced by the quantity of tumour cells present in the original biopsy and the degree of heterogeneity of biomarker expression. This review shows that technologies have been developed to enable construction of TMAs from CNBs. However, challenges remain to improve amplification and representation.

  15. Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses.

    PubMed

    Pfeiffer, J; Ridder, G J

    2012-04-01

    The salivary glands are unique in the diversity and complexity of their pathologies. Because fine needle aspiration cytology and frozen section are associated with major diagnostic difficulties, the authors analyzed the use of core needle biopsy (CNB) for the histologic assessment of salivary gland lesions. A systematic observational clinicopathologic quality assessment study was performed over 81 months including 161 CNB procedures in 76 patients with salivary gland pathologies. Adequate samples containing the target tissue were obtained in 73 patients. These samples revealed malignant disease in 45 (62%) patients, benign disease in 26 (36%) patients, and were inconclusive in 2 (3%) patients. Follow-up uncovered no false-positive or false-negative results. On the basis of secondary histologic and clinical follow-up, the statistical parameters were calculated as follows: sensitivity 94%; specificity 100%; accuracy 96%; positive predictive value 100%; negative predictive value 90%. The advantages and potential limitations of CNB in patients with salivary gland masses are discussed. CNB is a reliable biopsy technique for the assessment of salivary gland pathologies, although limitations remain for the subclassification of some neoplastic lesions. The authors recommend CNB as the biopsy technique of choice for a selection of indications.

  16. Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection

    PubMed Central

    Kato, Tomonori; Komiya, Akira; Morii, Akihiro; Iida, Hiroaki; Ito, Takatoshi; Fuse, Hideki

    2016-01-01

    Saturation prostate biopsy protocols have been developed to improve the prostate cancer (PCa) detection rate, particularly in the setting of repeat biopsies. The present study attempted to clarify the association between PCa detection and various risk factors in repeat saturation biopsies. A retrospective analysis was conducted on 78 Japanese patients for whom findings had caused suspicion of PCa despite previous negative prostate biopsies, and who consecutively underwent a 24-core transperineal repeat biopsy at Toyama University Hospital (Toyama, Japan). PCa was confirmed histologically in 16 of the 78 patients (20.5%). A univariate analysis revealed that the prostate-specific antigen (PSA) level at repeat biopsy was higher (P<0.01), the fPSA/tPSA ratio was lower (P=0.04), the total prostate volume was smaller (P=0.01) and the PSA density was higher (P<0.01) in PCa patients than in patients with benign prostatic disease (BPD). Histological inflammation was more frequently observed in BPD patients than in PCa patients (P<0.01). A multivariate analysis revealed that histological inflammation was the only independent predictor of the presence of a malignant lesion on repeat biopsy (odds ratio, 0.027; P=0.01). It must be considered that inflammation may cause a PSA increase in some patients with a negative initial biopsy, leading to unnecessary repeat biopsy. PMID:27446407

  17. Percutaneous CT-Guided Core Needle Biopsy Versus Fine Needle Aspiration in Diagnosing Pneumonia and Mimics of Pneumonia

    SciTech Connect

    Thanos, Loukas; Galani, Panagiota Mylona, Sophia; Pomoni, Maria; Mpatakis, Nikolaos

    2004-08-15

    The purpose of this study was to determine the diagnostic value of percutaneous core needle biopsy (CNB) relative to fine needle aspiration (FNA) in patients with pneumonia and pneumonia mimics. In this prospective study we present our experience with 48 thoracic FNAs and CNBs carried out on 48 patients with pneumonia and pneumonia mimics. Samples were obtained from all patients using both CNB (with an automated 18-G core biopsy needle and a gun) and FNA (with a 22-G needle). A specific diagnosis was made in 10/48 cases (20.83%) by FNA and in 42/48 (87.5%) by CNB. The main complications encountered were pneumothorax (n = 4) and hemoptysis (n = 2), yielding a total complication rate of 12.5%. We concluded that CNB using an automated biopsy gun results in a higher diagnostic accuracy for pneumonia and pneumonia mimic biopsies than FNA. Complications should be considered and proper patient observation should follow the procedure.

  18. Percentage of Positive Biopsy Cores: A Better Risk Stratification Model for Prostate Cancer?

    SciTech Connect

    Huang Jiayi; Vicini, Frank A.; Williams, Scott G.; Ye Hong; McGrath, Samuel; Ghilezan, Mihai; Krauss, Daniel; Martinez, Alvaro A.; Kestin, Larry L.

    2012-07-15

    Purpose: To assess the prognostic value of the percentage of positive biopsy cores (PPC) and perineural invasion in predicting the clinical outcomes after radiotherapy (RT) for prostate cancer and to explore the possibilities to improve on existing risk-stratification models. Methods and Materials: Between 1993 and 2004, 1,056 patients with clinical Stage T1c-T3N0M0 prostate cancer, who had four or more biopsy cores sampled and complete biopsy core data available, were treated with external beam RT, with or without a high-dose-rate brachytherapy boost at William Beaumont Hospital. The median follow-up was 7.6 years. Multivariate Cox regression analysis was performed with PPC, Gleason score, pretreatment prostate-specific antigen, T stage, PNI, radiation dose, androgen deprivation, age, prostate-specific antigen frequency, and follow-up duration. A new risk stratification (PPC classification) was empirically devised to incorporate PPC and replace the T stage. Results: On multivariate Cox regression analysis, the PPC was an independent predictor of distant metastasis, cause-specific survival, and overall survival (all p < .05). A PPC >50% was associated with significantly greater distant metastasis (hazard ratio, 4.01; 95% confidence interval, 1.86-8.61), and its independent predictive value remained significant with or without androgen deprivation therapy (all p < .05). In contrast, PNI and T stage were only predictive for locoregional recurrence. Combining the PPC ({<=}50% vs. >50%) with National Comprehensive Cancer Network risk stratification demonstrated added prognostic value of distant metastasis for the intermediate-risk (hazard ratio, 5.44; 95% confidence interval, 1.78-16.6) and high-risk (hazard ratio, 4.39; 95% confidence interval, 1.70-11.3) groups, regardless of the use of androgen deprivation and high-dose RT (all p < .05). The proposed PPC classification appears to provide improved stratification of the clinical outcomes relative to the National

  19. Positron Emission Mammography Imaging with Low Activity Fluorodeoxyglucose and Novel Utilization in Core-needle Biopsy Sampling

    PubMed Central

    Choudhery, Sadia; Seiler, Stephen

    2015-01-01

    Positron emission mammography (PEM), a relatively novel breast imaging modality, provides certain advantages over magnetic resonance imaging, including the ability to image biopsy samples. However, the radiation activity associated with PEM has remained a concern in clinical practice. We present a case of an invasive ductal carcinoma that was adequately imaged with a much lower than the standard 185 to 370 MBq activity of 18F-fluorodeoxyglucose. In addition, we demonstrate ultrasound-guided core-needle biopsy sample imaging with PEM to assess adequacy of sampling, a strategy that has previously only been documented with vacuum-assisted biopsy samples. PMID:25709550

  20. Fluorescence Spectroscopy: An Adjunct Diagnostic Tool to Image-Guided Core Needle Biopsy of the Breast

    PubMed Central

    Zhu, Changfang; Burnside, Elizabeth S.; Sisney, Gale A.; Salkowski, Lonie R.; Harter, Josephine M.; Yu, Bing

    2009-01-01

    We explored the use of a fiber-optic probe for in vivo fluorescence spectroscopy of breast tissues during percutaneous image-guided breast biopsy. A total of 121 biopsy samples with accompanying histological diagnosis were obtained clinically and investigated in this study. The tissue spectra were analyzed using partial least-squares analysis and represented using a set of principal components (PCs) with dramatically reduced data dimension. For nonmalignant tissue samples, a set of PCs that account for the largest amount of variance in the spectra displayed correlation with the percent tissue composition. For all tissue samples, a set of PCs was identified using a Wilcoxon rank-sum test as showing statistically significant differences between: 1) malignant and fibrous/benign; 2) malignant and adipose; and 3) malignant and nonmalignant breast samples. These PCs were used to distinguish malignant from other nonmalignant tissue types using a binary classification scheme based on both linear and nonlinear support vector machine (SVM) and logistic regression (LR). For the sample set investigated in this study, the SVM classifier provided a cross-validated sensitivity and specificity of up to 81% and 87%, respectively, for discrimination between malignant and fibrous/benign samples, and up to 81% and 81%, respectively, for discriminating between malignant and adipose samples. Classification based on LR was used to generate receiver operator curves with an area under the curve (AUC) of 0.87 for discriminating malignant versus fibrous/benign tissues, and an AUC of 0.84 for discriminating malignant from adipose tissue samples. This study demonstrates the feasibility of performing fluorescence spectroscopy during clinical core needle breast biopsy, and the potential of this technique for identifying breast malignancy in vivo. PMID:19272976

  1. Can problematic fibroepithelial lesions be accurately classified on core needle biopsies?

    PubMed

    Bandyopadhyay, Sudeshna; Barak, Stephanie; Hayek, Kinda; Thomas, Sumi; Saeed, Haleema; Beydoun, Rafic; Shi, Dongping; Arabi, Haitham; Ruterbusch, Julie; Cote, Michele; Ali-Fehmi, Rouba

    2016-01-01

    Fibroepithelial lesions (FEL) of the breast are notoriously difficult to classify on core needle biopsies. The goal of this study was to evaluate interobserver variability and accuracy of subclassifying difficult FELs into fibroadenoma (FA) and phyllodes tumors (PTs). We identified 50 breast core needle biopsies, initially diagnosed generically as FEL, with subsequent excision and final diagnosis of either FA or benign PT. Five surgical pathologists from one institution independently reviewed these in 3 rounds. The pathologists were blinded to the final excisional diagnosis. Two diagnostic categories were allowed: FA and PT. A set of histologic criteria was provided including the presence of subepithelial condensation, stromal heterogeneity, overgrowth, pleomorphism, fragmentation, cellularity, adipose tissue entrapment, and mitotic count and asked to review the slides for the second round. A third round of interpretations was conducted after each criterion was defined. Interobserver agreement for the diagnosis and each criterion was evaluated using the κ level of agreement. Accuracy of ratings to final diagnosis was calculated using Wilcoxon signed-rank test. κ Values for interobserver agreement were fair for the first and second rounds varying from 0.20 to 0.22, respectively. This increased to 0.27 in round 3. When considering each category, the κ value varied from 0.26 to 0.29 for FA and 0.28 to 0.14 for PT. Overall, there was fair agreement between the pathologists in all categories. The rate of correctly diagnosed cases ranged from 40% in the first round, to 48% in the second round, to 67% in round 3. Overall the pathologists performed better in identifying FA than PT. The accuracy of interpretations was significantly different between the first (40%), second (48%), and third rounds (67%). PMID:26521710

  2. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study

    PubMed Central

    DiMaio, Christopher J.; Kolb, Jennifer M.; Benias, Petros C.; Shah, Hiral; Shah, Shashin; Haluszka, Oleh; Maranki, Jennifer; Sharzehi, Kaveh; Lam, Eric; Gordon, Stuart R.; Hyder, Sarah M.; Kaimakliotis, Pavlos Z.; Allaparthi, Satya B.; Gress, Frank G.; Sethi, Amrita; Shah, Ashish R.; Nieto, Jose; Kaul, Vivek; Kothari, Shivangi; Kothari, Truptesh H.; Ho, Sammy; Izzy, Manhal J.; Sharma, Neil R.; Watson, Rabindra R.; Muthusamy, V. Raman; Pleskow, Douglas K.; Berzin, Tyler M.; Sawhney, Mandeep; Aljahdi, Emad; Ryou, Marvin; Wong, Clarence K.; Gupta, Parantap; Yang, Dennis; Gonzalez, Susana; Adler, Douglas G.

    2016-01-01

    Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland). Data regarding patient demographics, lesion type/location, technical parameters, and diagnostic yield was obtained. Results: A total of 250 lesions were biopsied in 226 patients (Median age 66 years; 113 (50 %) male). Median size of all lesions (mm): 26 (2 – 150). Overall, a cytologic diagnosis was rendered in 81 % specimens with a median number of 3 passes. When rapid onsite cytologic evaluation (ROSE) was used, cytologic diagnostic yield was 126/149 (85 %) with a median number of 3 passes; without ROSE, cytologic diagnostic yield was 31/45 (69 %, P = 0.03) with a median number of 3 passes. Overall, a pathologic diagnosis was rendered in 130/147 (88 %) specimens with a median number of 2 passes. Pathologic diagnostic yield for specific lesion types: pancreas 70/81 (86 %), subepithelial lesion 13/15 (87 %), lymph node 26/28 (93 %). Ten patients (10/226, 4 %) experienced adverse events: 4 acute pancreatitis, 5 pain, 1 fever/cholangitis. Conclusions: Initial experience with a novel EUS core biopsy needle demonstrates excellent pathologic diagnostic yield with a minimum number of passes.

  3. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study

    PubMed Central

    DiMaio, Christopher J.; Kolb, Jennifer M.; Benias, Petros C.; Shah, Hiral; Shah, Shashin; Haluszka, Oleh; Maranki, Jennifer; Sharzehi, Kaveh; Lam, Eric; Gordon, Stuart R.; Hyder, Sarah M.; Kaimakliotis, Pavlos Z.; Allaparthi, Satya B.; Gress, Frank G.; Sethi, Amrita; Shah, Ashish R.; Nieto, Jose; Kaul, Vivek; Kothari, Shivangi; Kothari, Truptesh H.; Ho, Sammy; Izzy, Manhal J.; Sharma, Neil R.; Watson, Rabindra R.; Muthusamy, V. Raman; Pleskow, Douglas K.; Berzin, Tyler M.; Sawhney, Mandeep; Aljahdi, Emad; Ryou, Marvin; Wong, Clarence K.; Gupta, Parantap; Yang, Dennis; Gonzalez, Susana; Adler, Douglas G.

    2016-01-01

    Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-guided fine-needle biopsies obtained using a novel biopsy needle (SharkCore FNB needle, Medtronic, Dublin, Ireland). Data regarding patient demographics, lesion type/location, technical parameters, and diagnostic yield was obtained. Results: A total of 250 lesions were biopsied in 226 patients (Median age 66 years; 113 (50 %) male). Median size of all lesions (mm): 26 (2 – 150). Overall, a cytologic diagnosis was rendered in 81 % specimens with a median number of 3 passes. When rapid onsite cytologic evaluation (ROSE) was used, cytologic diagnostic yield was 126/149 (85 %) with a median number of 3 passes; without ROSE, cytologic diagnostic yield was 31/45 (69 %, P = 0.03) with a median number of 3 passes. Overall, a pathologic diagnosis was rendered in 130/147 (88 %) specimens with a median number of 2 passes. Pathologic diagnostic yield for specific lesion types: pancreas 70/81 (86 %), subepithelial lesion 13/15 (87 %), lymph node 26/28 (93 %). Ten patients (10/226, 4 %) experienced adverse events: 4 acute pancreatitis, 5 pain, 1 fever/cholangitis. Conclusions: Initial experience with a novel EUS core biopsy needle demonstrates excellent pathologic diagnostic yield with a minimum number of passes. PMID:27652304

  4. High-Throughput Prostate Cancer Gland Detection, Segmentation, and Classification from Digitized Needle Core Biopsies

    NASA Astrophysics Data System (ADS)

    Xu, Jun; Sparks, Rachel; Janowczyk, Andrew; Tomaszewski, John E.; Feldman, Michael D.; Madabhushi, Anant

    We present a high-throughput computer-aided system for the segmentation and classification of glands in high resolution digitized images of needle core biopsy samples of the prostate. It will allow for rapid and accurate identification of suspicious regions on these samples. The system includes the following three modules: 1) a hierarchical frequency weighted mean shift normalized cut (HNCut) for initial detection of glands; 2) a geodesic active contour (GAC) model for gland segmentation; and 3) a diffeomorphic based similarity (DBS) feature extraction for classification of glands as benign or cancerous. HNCut is a minimally supervised color based detection scheme that combines the frequency weighted mean shift and normalized cuts algorithms to detect the lumen region of candidate glands. A GAC model, initialized using the results of HNCut, uses a color gradient based edge detection function for accurate gland segmentation. Lastly, DBS features are a set of morphometric features derived from the nonlinear dimensionality reduction of a dissimilarity metric between shape models. The system integrates these modules to enable the rapid detection, segmentation, and classification of glands on prostate biopsy images. Across 23 H & E stained prostate studies of whole-slides, 105 regions of interests (ROIs) were selected for the evaluation of segmentation and classification. The segmentation results were evaluated on 10 ROIs and compared to manual segmentation in terms of mean distance (2.6 ±0.2 pixels), overlap (62±0.07%), sensitivity (85±0.01%), specificity (94±0.003%) and positive predictive value (68±0.08%). Over 105 ROIs, the classification accuracy for glands automatically segmented was (82.5 ±9.10%) while the accuracy for glands manually segmented was (82.89 ±3.97%); no statistically significant differences were identified between the classification results.

  5. Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study

    PubMed Central

    Cirla, A.; Rondena, M.; Bertolini, G.

    2016-01-01

    The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single centre. A complete ophthalmic examination was always followed by orbital ultrasound and computed tomography (CT) examination of the head. All masses were sampled with the patient still on the CT table using ultrasound (US) guided automatic tru-cut device. The most suitable sampling approach to the orbit was chosen each time based on the CT image analysis. One of the following different approaches was used: trans-orbital, trans-conjunctival or trans-masseteric. In all cases, the imaging-guided biopsy provided a sufficient amount of tissue for the histopathological diagnosis, which concurred with the biopsies obtained using the excisional technique. CT examination was essential for morphological diagnosis and provided detailed topographic information that allowed us to choose the safest orbital approach for the biopsy. US guided automatic tru-cut biopsy based on CT images, performed with patient still on the CT table, resulted in a minimally invasive, relatively easy, and accurate diagnostic procedure in dogs with orbital masses. PMID:27540512

  6. Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision.

    PubMed

    Lavoué, Vincent; Roger, Claire Marie; Poilblanc, Mathieu; Proust, Nicolas; Monghal-Verge, Camille; Sagan, Christine; Tas, Patrick; Mesbah, Habiba; Porée, Philippe; Gay, Catherine; Body, Gilles; Levêque, Jean

    2011-01-01

    Flat epithelial atypia (FEA) is recognized as a precursor of breast cancer and its management (surgical excision or intensive follow-up) remains unclear after diagnosis on core needle biopsy (CNB). The aim of this study was to determine the underestimation rate of pure FEA on CNB and clinical, radiological, and pathological factors of underestimation. 4,062 CNBs from 5 breast cancer centers, performed over a 5-year period, were evaluated. A CNB diagnosis of pure FEA was made in 60 cases (1.5%) (the presence of atypical ductal hyperplasia, lobular neoplasia, radial scars, phyllodes tumor, papillary lesions, ductal carcinoma in situ or invasive carcinoma at CNB were exclusion criteria), and subsequent surgical excision was systematically performed. The histological diagnosis was retrospectively reviewed using standardized criteria and the precise terminology of the World Health Organization by two pathologist physicians. At surgical excision, 6 (10%) ductal carcinoma in situ and 2 (3%) invasive carcinoma were diagnosed. The total underestimation rate was 13%. FEA was associated with atypical ductal hyperplasia in 10 (17%) cases and with lobular neoplasia in 2 (3%) at final pathology. Residual FEA was found in 14 (23%) cases. No clinical, radiological or pathological factors were significantly associated with underestimation. Our data highlight the importance of recognizing and diagnosing FEA in core needle biopsies. Thus, the presence of FEA on CNB, even in isolation, warrants follow-up excision.

  7. Predicting malignancy from mammography findings and image-guided core biopsies

    PubMed Central

    Ferreira, Pedro; Fonseca, Nuno A.; Dutra, Inês; Woods, Ryan; Burnside, Elizabeth

    2016-01-01

    The main goal of this work is to produce machine learning models that predict the outcome of a mammography from a reduced set of annotated mammography findings. In the study we used a dataset consisting of 348 consecutive breast masses that underwent image guided core biopsy performed between October 2005 and December 2007 on 328 female subjects. We applied various algorithms with parameter variation to learn from the data. The tasks were to predict mass density and to predict malignancy. The best classifier that predicts mass density is based on a support vector machine and has accuracy of 81.3%. The expert correctly annotated 70% of the mass densities. The best classifier that predicts malignancy is also based on a support vector machine and has accuracy of 85.6%, with a positive predictive value of 85%. One important contribution of this work is that our model can predict malignancy in the absence of the mass density attribute, since we can fill up this attribute using our mass density predictor. PMID:26333262

  8. Malignant-looking thyroid nodules with size reduction: core needle biopsy results

    PubMed Central

    Shong, Young Kee

    2016-01-01

    Purpose The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. Methods From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. Results All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. Conclusion In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery. PMID:27184652

  9. Efficacy of ultrasound-guided core-needle biopsy in the diagnosis of hepatic alveolar echinococcosis: a retrospective analysis

    PubMed Central

    Bulakci, Mesut; Ilhan, Mehmet; Bademler, Suleyman; Yilmaz, Erdem; Gulluoglu, Mine; Bayraktar, Adem; Asik, Murat; Guloglu, Recep

    2016-01-01

    Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis. PMID:27101838

  10. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    SciTech Connect

    Fukuda, Hozumi Ibukuro, Kenji; Tsukiyama, Toshitaka; Ishii, Rei

    2004-09-15

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis.

  11. Underestimation of cancer in case of diagnosis of atypical ductal hyperplasia (ADH) by vacuum assisted core needle biopsy

    PubMed Central

    Polom, Karol; Murawa, Dawid; Kurzawa, Paweł; Michalak, Michał; Murawa, Paweł

    2012-01-01

    Background With the introduction of mammography screening, we are more often dealing with the diagnosis of precancerous and preinvasive breast lesions. An increasing number of patients are observed to show a premalignant change of ADH (atypical ductal hyperplasia). It also involves a wider use of the vacuum assisted core biopsy as a tool for verifying nonpalpable changes identified by mammography. Aim This paper describes our experience of 134 cases of ADH diagnosed at Mammotome® vacuum core needle biopsy. Material and methods Of 4326 mammotomic biopsies performed at our institution in 2000–2006, ADH was diagnosed in 134 patients (3.1%). Patients underwent surgery to remove the suspected lesion. All histopathological blocks were again reviewed by one pathologist. Clinical, radiological and pathological data were collected for statistical evaluation. Results Underestimation of invasive changes occurred in 12 patients (9%). The only clinicopathologic feature of statistical significance radiologically and pathologically was the presence of radial scar in the mammography. Conclusions More frequent diagnosis of precancerous changes in the mammotomic breast biopsy forces us to establish a clear clinical practice. The problem is the underestimation of invasive changes. The occurrence of radial scar on mammography for diagnosis of the presence of ADH increases the risk of invasive changes. PMID:24377013

  12. Photoacoustic Imaging of Breast Microcalcifications: A Preliminary Study with 8-Gauge Core-Biopsied Breast Specimens

    PubMed Central

    Kim, Ga Ram; Kang, Jeeun; Kwak, Jin Young; Chang, Jin Ho; Kim, Seung Il; Youk, Ji Hyun; Moon, Hee Jung; Kim, Min Jung; Kim, Eun-Kyung

    2014-01-01

    Background We presented the photoacoustic imaging (PAI) tool and to evaluate whether microcalcifications in breast tissue can be detected on photoacoustic (PA) images. Methods We collected 21 cores containing microcalcifications (n = 11, microcalcification group) and none (n = 10, control group) in stereotactic or ultrasound (US) guided 8-gauge vacuum-assisted biopsies. Photoacoustic (PA) images were acquired through ex vivo experiments by transmitting laser pulses with two different wavelengths (700 nm and 800 nm). The presence of microcalcifications in PA images were blindly assessed by two radiologists and compared with specimen mammography. A ratio of the signal amplitude occurring at 700 nm to that occurring at 800 nm was calculated for each PA focus and was called the PAI ratio. Results Based on the change of PA signal amplitude between 700 nm and 800 nm, 10 out of 11 specimens containing microcalcifications and 8 out of 10 specimens without calcifications were correctly identified on blind review; the sensitivity, specificity, accuracy, positive predictive and negative predictive values of our blind review were 90.91%, 80.0%, 85.71%, 83.33% and 88.89%. The PAI ratio in the microcalcification group was significantly higher than that in the control group (the median PAI ratio, 2.46 versus 1.11, respectively, P = .001). On subgroup analysis in the microcalcification group, neither malignant diagnosis nor the number or size of calcification-foci was proven to contribute to PAI ratios. Conclusion Breast microcalcifications generated distinguishable PA signals unlike breast tissue without calcifications. So, PAI, a non-ionizing and non-invasive hybrid imaging technique, can be an alternative in overcoming the limitations of conventional US imaging. PMID:25153128

  13. Imaging and pathology findings after an initial negative MRI-US fusion-guided and 12-core extended sextant prostate biopsy session

    PubMed Central

    Hong, Cheng William; Walton-Diaz, Annerleim; Rais-Bahrami, Soroush; Hoang, Anthony N.; Türkbey, Barış; Stamatakis, Lambros; Xu, Sheng; Amalou, Hayet; Minhaj Siddiqui, M.; Nix, Jeffrey W.; Vourganti, Srinivas; Merino, Maria J.; Choyke, Peter L.; Wood, Bradford J.; Pinto, Peter A.

    2014-01-01

    PURPOSE A magnetic resonance imaging-ultrasonography (MRI-US) fusion-guided prostate biopsy increases detection rates compared to an extended sextant biopsy. The imaging characteristics and pathology outcomes of subsequent biopsies in patients with initially negative MRI-US fusion biopsies are described in this study. MATERIALS AND METHODS We reviewed 855 biopsy sessions of 751 patients (June 2007 to March 2013). The fusion biopsy consisted of two cores per lesion identified on multiparametric MRI (mpMRI) and a 12-core extended sextant transrectal US (TRUS) biopsy. Inclusion criteria were at least two fusion biopsy sessions, with a negative first biopsy and mpMRI before each. RESULTS The detection rate on the initial fusion biopsy was 55.3%; 336 patients had negative findings. Forty-one patients had follow-up fusion biopsies, but only 34 of these were preceded by a repeat mpMRI. The median interval between biopsies was 15 months. Fourteen patients (41%) were positive for cancer on the repeat MRI-US fusion biopsy. Age, prostate-specific antigen (PSA), prostate volume, PSA density, digital rectal exam findings, lesion diameter, and changes on imaging were comparable between patients with negative and positive rebiopsies. Of the patients with positive rebiopsies, 79% had a positive TRUS biopsy before referral (P = 0.004). Ten patients had Gleason 3+3 disease, three had 3+4 disease, and one had 4+4 disease. CONCLUSION In patients with a negative MRI-US fusion prostate biopsy and indications for repeat biopsy, the detection rate of the follow-up sessions was lower than the initial detection rate. Of the prostate cancers subsequently found, 93% were low grade (≤3+4). In this low risk group of patients, increasing the follow-up time interval should be considered in the appropriate clinical setting. PMID:24509182

  14. Feasibility and Diagnostic Yield of Endoscopic Ultrasonography-Guided Fine Needle Biopsy With a New Core Biopsy Needle Device in Patients With Gastric Subepithelial Tumors

    PubMed Central

    Lee, Minju; Min, Byung-Hoon; Lee, Hyuk; Ahn, Sangjeong; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Jae J.; Sohn, Tae Sung; Kim, Sung; Kim, Kyoung-Mee

    2015-01-01

    Abstract As treatment decisions for patients with gastric subepithelial tumors (SETs) largely depend on the histopathologic diagnosis, noninvasive and effective tissue acquisition methods are definitely required for proper management of gastric SETs. Recently, a new endoscopic ultrasonography-guided fine needle biopsy (EUS-FNB) device with ProCore reverse bevel technology was developed. We aimed to elucidate the feasibility and diagnostic yield of EUS-FNB with this new core biopsy needle device in patients with gastric SETs. A prospectively maintained database was retrospectively reviewed to identify consecutive patients who underwent EUS-FNB with a 22-gauge ProCore needle for gastric SETs 2 cm or larger. The main outcome measurement was the diagnostic yield of EUS-FNB. Procedure results were categorized into diagnostic, suggestive, or nondiagnostic. Of the 43 patients, needle punctures were successful in all cases irrespective of tumor location. EUS-FNB procedure results were diagnostic in 86.0%, suggestive in 4.7%, and nondiagnostic in 9.3% of cases, respectively. The diagnostic yield was the highest in fundus (100.0%), followed by body (89.5%), cardia (83.3%), and antrum (50.0%). All 18 patients with cardiac SET were finally diagnosed to have leiomyoma, and 16 patients with diagnostic or suggestive results avoided surgery. A heterogeneous echo pattern on EUS was found in 33.3% of cases with nondiagnostic or suggestive results and in 5.4% with diagnostic results. In multivariate analysis, no independent predictor of unsuccessful EUS-FNB with nondiagnostic or suggestive results was identified. Agreement between EUS-FNB and surgical pathology was 100% with respect to the diagnosis of gastrointestinal stromal tumor. However, there was a significant discrepancy in mitotic counts observed between the EUS-FNB and surgical specimens in patients with gastrointestinal stromal tumor. There were no significant procedure-related adverse events during and after the

  15. Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer

    PubMed Central

    Pagni, Paola; Spunticchia, Flaminia; Barberi, Simona; Caprio, Giuliana; Paglicci, Carlo

    2014-01-01

    Background and Aims In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB), using Mammotome (vacuum-assisted breast biopsy) and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy. Material and Methods Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC). Results The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up. Conclusions CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions. PMID:25120471

  16. A subset of malignant phyllodes tumors express p63 and p40: a diagnostic pitfall in breast core needle biopsies.

    PubMed

    Cimino-Mathews, Ashley; Sharma, Rajni; Illei, Peter B; Vang, Russell; Argani, Pedram

    2014-12-01

    Breast phyllodes tumors are rare fibroepithelial neoplasms of variable grade, and one key differential of malignant phyllodes on core biopsy is sarcomatoid carcinoma. p63 is reported to be sensitive and specific for sarcomatoid carcinoma, with rare expression in phyllodes in limited series. The p63 deltaNp63 isoform, p40, is postulated to be more specific for squamous differentiation but has not previously been evaluated in breast phyllodes or sarcomatoid carcinoma. Tissue microarrays containing 34 unambiguous phyllodes tumors (10 benign, 10 borderline, 14 malignant), 13 sarcomatoid carcinomas, and 10 fibroadenomas were labeled by immunohistochemistry for p63, p40, CD34, and cytokeratins AE1/AE3, 34betaE12, and CK8/18. No borderline phyllodes tumor, benign phyllodes tumor, or fibroadenoma labeled with p63, p40, or cytokeratin. However, p63 labeled 57% malignant phyllodes tumors and 62% sarcomatoid carcinomas, and p40 labeled 29% malignant phyllodes (focal) and 46% sarcomatoid carcinomas. Among established markers, cytokeratins labeled 21% malignant phyllodes tumors (focal) and 100% sarcomatoid carcinomas. CD34 labeled 57% malignant phyllodes tumors and no sarcomatoid carcinomas. Focal p63, p40, and cytokeratin labeling can be seen in malignant phyllodes tumors but not in lower-grade fibroepithelial lesions, and immunoreactivity with these markers alone is not diagnostic of sarcomatoid carcinoma on core needle biopsy. In the differential diagnosis of malignant phyllodes, p40 is a more specific but less sensitive marker of sarcomatoid carcinoma than p63. These results are consistent with the sarcoma literature in which p63 labeling has been increasingly reported and suggest caution in classifying malignant spindle cell tumors of the breast on core biopsy.

  17. Development and Evaluation of a Prediction Model for Underestimated Invasive Breast Cancer in Women with Ductal Carcinoma In Situ at Stereotactic Large Core Needle Biopsy

    PubMed Central

    Diepstraten, Suzanne C. E.; van de Ven, Stephanie M. W. Y.; Pijnappel, Ruud M.; Peeters, Petra H. M.; van den Bosch, Maurice A. A. J.; Verkooijen, Helena M.; Elias, Sjoerd G.

    2013-01-01

    Background We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. Methods From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization) and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. Results 348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7%) patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28), number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01), presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77), and microinvasion (OR 3.75, 95% CI 1.42-9.87). The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke’s R2), mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73), and fairly good calibration. Conclusion The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery. PMID:24147085

  18. Identification of isolated and early prostatic adenocarcinoma in radical prostatectomy specimens with correlation to biopsy cores: clinical and pathogenetic significance.

    PubMed

    Mai, Kien T; Landry, Denise C; Yazdi, Hossein M; Stinson, William A; Perkins, D Garth; Morash, Christopher

    2002-01-01

    Prostatic adenocarcinoma (PAC) is a multifocal disease. In this study, we identified isolated and small foci of PAC (ISPAC) in radical prostatectomy specimens, described the histopathologic features, investigated their zonal distribution in the prostate and their relationship with large tumor nodules, and correlated the findings with those of preceding biopsy cores. One hundred and thirty radical prostatectomy specimens performed for PAC or for urothelial carcinoma of the urinary bladder with incidental PAC were reviewed for identification of ISPAC. Prostates were serially sectioned in the horizontal plane and submitted in toto for microscopic examination. ISPAC were defined as foci of PAC measuring less than 3 mm in maximum diameter. There were 461 ISPAC identified in 114 cases. They were distributed in the transitional zone (TZ) (18 foci), the apex (73 foci), the anterior horn of the non-TZ (NTZ) (118 foci), the base (8 foci), and the remaining NTZ (244 foci). ISPAC usually consisted of groups of small acini with a GS ranging from 2 to 7 (3 + 4). GSs of ISPAC consisted of single grade or two consecutive grades equal to or lower than those of the main PAC. ISPAC were more often located in close proximity to large tumor nodules. The number of ISPAC increased with the tumor volume up to 3 cm3, then decreased as the PAC became more extensive (p value = 0.02, statistically significant). Prostates with NTZ PAC <1.5 cm3 and TZ PAC or prostates containing 4 or more than 4 ISPAC tended to be frequently associated with small foci of PAC in biopsy cores In this study, we identified ISPAC that likely represent foci of PAC in early development and account for the multicentricity and heterogeneity of PAC. ISPAC in the NTZ were common and may account for small foci of PAC or atypia in biopsy cores. Although these small foci of PAC or atypia in biopsy cores without accompanying higher GS PAC were often associated with significant PAC, they may also occasionally represent

  19. Changing attitudes toward needle biopsies of breast cancer in Shanghai: experience and current status over the past 8 years

    PubMed Central

    Hao, Shuang; Liu, Zhe-Bin; Ling, Hong; Chen, Jia-Jian; Shen, Ju-Ping; Yang, Wen-Tao; Shao, Zhi-Min

    2015-01-01

    Diagnostic patterns in breast cancer have greatly changed over the past few decades, and core needle biopsy (CNB) has become a reliable procedure for detecting breast cancer without invasive surgery. To estimate the changing diagnostic patterns of breast cancer in urban Shanghai, 11,947 women with breast lesions detected by preoperative needle biopsy between January 1995 and December 2012 were selected from the Shanghai Cancer Data base, which integrates information from approximately 50% of breast cancer patients in Shanghai. The CNB procedure uses an automated prone unit, biopsy gun, and 14-gauge needles under freehand or ultrasound guidance and was performed by experienced radiologists and surgeons specializing in needle biopsies. Diagnosis and classification for each patient were independently evaluated by pathologists. Over the indicated 8-year period, biopsy type consisted of 11,947 ultrasound-guided core needle biopsies (UCNBs), 2,015 ultrasound-guided vacuum-assisted biopsies (UVABs), and 654 stereotactic X-ray-guided vacuum-assisted biopsies (XVABs). For all the 11,947 women included in this study, image-guided needle biopsy was the initial diagnostic procedure. Approximately 81.0% of biopsied samples were histopathologically determined to be malignant lesions, 5.5% were determined to be high-risk lesions, and 13.5% were determined to be benign lesions. The number of patients choosing UCNB increased at the greatest rate, and UCNB has become a standard procedure for histodiagnosis because it is inexpensive, convenient, and accurate. The overall false-negative rate of CNB was 1.7%, and the specific false-negative rates for UCNB, UVAB, and XVAB, were 1.7%, 0%, and 0%, respectively. This study suggests that the use of preoperative needle biopsy as the initial breast cancer diagnostic procedure is acceptable in urban Shanghai. Preoperative needle biopsy is now a standard procedure in the Shanghai Cancer Center because it may reduce the number of surgeries

  20. Optically clearing tissue as an initial step for 3D imaging of core biopsies to diagnose pancreatic cancer

    NASA Astrophysics Data System (ADS)

    Das, Ronnie; Agrawal, Aishwarya; Upton, Melissa P.; Seibel, Eric J.

    2014-02-01

    The pancreas is a deeply seated organ requiring endoscopically, or radiologically guided biopsies for tissue diagnosis. Current approaches include either fine needle aspiration biopsy (FNA) for cytologic evaluation, or core needle biopsies (CBs), which comprise of tissue cores (L = 1-2 cm, D = 0.4-2.0 mm) for examination by brightfield microscopy. Between procurement and visualization, biospecimens must be processed, sectioned and mounted on glass slides for 2D visualization. Optical information about the native tissue state can be lost with each procedural step and a pathologist cannot appreciate 3D organization from 2D observations of tissue sections 1-8 μm in thickness. Therefore, how might histological disease assessment improve if entire, intact CBs could be imaged in both brightfield and 3D? CBs are mechanically delicate; therefore, a simple device was made to cut intact, simulated CBs (L = 1-2 cm, D = 0.2-0.8 mm) from porcine pancreas. After CBs were laid flat in a chamber, z-stack images at 20x and 40x were acquired through the sample with and without the application of an optical clearing agent (FocusClear®). Intensity of transmitted light increased by 5-15x and islet structures unique to pancreas were clearly visualized 250-300 μm beneath the tissue surface. CBs were then placed in index matching square capillary tubes filled with FocusClear® and a standard optical clearing agent. Brightfield z-stack images were then acquired to present 3D visualization of the CB to the pathologist.

  1. Collagen, type XI, alpha 1: an accurate marker for differential diagnosis of breast carcinoma invasiveness in core needle biopsies.

    PubMed

    Freire, Javier; Domínguez-Hormaetxe, Saioa; Pereda, Saray; De Juan, Ana; Vega, Alfonso; Simón, Laureano; Gómez-Román, Javier

    2014-12-01

    Accurate diagnosis of invasive breast lesions, when analyzed by Core Needle Biopsy, may suppose a major challenge for the pathologist. Various markers of invasiveness such as laminin, S-100 protein, P63 or calponin have been described; however, none of them is completely reliable. The use of a specific marker of the infiltrating tumor microenvironment seems vital to support the diagnosis of invasive against in situ lesions. At this point, Collagen, type XI, alpha 1 (COL11A1), might be helpful since it has been described to be associated to cancer associated fibroblasts in other tumors such as lung, pancreas or colorectal. This paper aims to analyze the role of COL11A1 as a marker of invasiveness in breast tumor lesions. Two hundred and one breast Core Needle Biopsy samples were analyzed by immunohistochemistry against pro-COL11A1. The results show a significant difference (p < 0.0001) when comparing the expression in infiltrative tumors (93%) versus immunostaining of non-invasive lesions (4%). Forty cases of underestimated DCIS were also stained for COL11A1, presenting a sensitivity of 90% when compared with p63 and calponin which not tagged invasion. In conclusion, pro-COL11A1 expression is a promising marker of invasive breast lesions, and may be included in immunohistochemical panels aiming at identifying infiltration in problematic breast lesions.

  2. MRI-guided core needle biopsy of the prostate: acceptance and side effects

    PubMed Central

    Egbers, Nina; Schwenke, Carsten; Maxeiner, Andreas; Teichgräber, Ulf; Franiel, Tobias

    2015-01-01

    PURPOSE We aimed to study side effects, complications, and patient acceptance of magnetic resonance imaging-guided real-time biopsy (MRI-GB) of the prostate. METHODS Fifty-four men (49–78 years) with elevated prostate-specific antigen after at least one negative systematic transrectal ultrasound-guided biopsy (TRUS-GB) were included in a prospective clinical study. Suspicious areas on images were selectively sampled by obtaining a median of four specimens (range, 1–9 specimens) using MRI-GB. In TRUS-GB, a median of 10 specimens (range, 6–14 specimens) were obtained. Telephone interviews were conducted one week after outpatient MRI-GB, asking patients about pain and side effects (hematuria, hemospermia, rectal bleeding, fever, and chills) of the two biopsy procedures and which of the two procedures they preferred. Multinomial regression analysis and Fisher’s exact test was used to test for differences. RESULTS MRI-GB was preferred by 65% (35/54), and 82% (44/54) would undergo MRI-GB again. Pain intensity (P = 0.005) and bleeding duration (P = 0.004) were significantly lower for MRI-GB compared with TRUS-GB. Hematuria was less common after MRI-GB compared with TRUS-GB (P = 0.006). A high correlation was given between bleeding intensity and bleeding duration for TRUS-GB (r=0.77) and pain intensity and pain duration for MRI-GB (r=0.65). Although hemospermia, rectal hemorrhage, fever, and chills were less common in MRI, they showed no statistically significant difference. CONCLUSION MRI-GB of the prostate seems to have fewer side effects and less pain intensity than TRUS-GB and was preferred by the majority of patients. PMID:25858525

  3. Accuracy of fine needle aspiration and core lung biopsies to predict histology in patients with non-small cell lung cancer.

    PubMed

    Robertson, William Whitney; Steliga, Matthew A; Siegel, Eric R; Arnaoutakis, Konstantinos

    2014-06-01

    Management of advanced non-small cell lung cancer patients is dependent on the histologic diagnosis for both testing and treatment. This study was designed to determine the ability of fine needle aspiration and core biopsies to correctly determine histologic diagnosis in non-small cell lung cancer. Our institutional cardiothoracic surgery database was reviewed for cases of non-small cell lung cancer treated with lobectomy after a preoperative biopsy by CT guidance or bronchoscopy over a 10-year period from 2002 to 2011. The histologic diagnosis of the final lobectomy specimen was compared to the histologic diagnosis from the preoperative biopsy, and the concordance rate was calculated. 119 biopsy specimens from 117 patients were reviewed. Eighty of the 119 biopsies had the same histologic diagnosis as the lobectomy specimen, yielding an overall concordance rate of 67.2 %. Patients with poorly differentiated tumors were at the highest risk of an incorrect histologic diagnosis on preoperative biopsy. Reliance on fine needle aspiration and core biopsies to determine histologic diagnosis in non-small cell lung cancer may put some patients at risk for suboptimal treatment.

  4. Development and validation of a microRNA based diagnostic assay for primary tumor site classification of liver core biopsies.

    PubMed

    Perell, Katharina; Vincent, Martin; Vainer, Ben; Petersen, Bodil Laub; Federspiel, Birgitte; Møller, Anne Kirstine; Madsen, Mette; Hansen, Niels Richard; Friis-Hansen, Lennart; Nielsen, Finn Cilius; Daugaard, Gedske

    2015-01-01

    Identification of the primary tumor site in patients with metastatic cancer is clinically important, but remains a challenge. Hence, efforts have been made towards establishing new diagnostic tools. Molecular profiling is a promising diagnostic approach, but tissue heterogeneity and inadequacy may negatively affect the accuracy and usability of molecular classifiers. We have developed and validated a microRNA-based classifier, which predicts the primary tumor site of liver biopsies, containing a limited number of tumor cells. Concurrently we explored the influence of surrounding normal tissue on classification. MicroRNA profiling was performed using quantitative Real-Time PCR on formalin-fixed paraffin-embedded samples. 278 primary tumors and liver metastases, representing nine primary tumor classes, as well as normal liver samples were used as a training set. A statistical model was applied to adjust for normal liver tissue contamination. Performance was estimated by cross-validation, followed by independent validation on 55 liver core biopsies with a tumor content as low as 10%. A microRNA classifier developed, using the statistical contamination model, showed an overall classification accuracy of 74.5% upon independent validation. Two-thirds of the samples were classified with high-confidence, with an accuracy of 92% on high-confidence predictions. A classifier trained without adjusting for liver tissue contamination, showed a classification accuracy of 38.2%. Our results indicate that surrounding normal tissue from the biopsy site may critically influence molecular classification. A significant improvement in classification accuracy was obtained when the influence of normal tissue was limited by application of a statistical contamination model. PMID:25131495

  5. Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses

    PubMed Central

    Lee, Sang Hoon; Lee, Hee Seung; Lee, Hyun Jik; Park, Jeong Yup; Park, Seung Woo; Song, Si Young; Kim, Hoguen; Chung, Jae Bock; Bang, Seungmin

    2016-01-01

    Background and Aims Although thicker needles theoretically allow more tissue to be collected, their decreased flexibility can cause mechanical damage to the endoscope, technical failure, and sample blood contamination. The effects of needle gauge on diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of pancreatic mass lesions remain unknown. This study compared procurement rates of histologic cores obtained from EUS-FNB of pancreatic masses using 25- and 22-gauge core biopsy needles. Patients and Methods From March 2014 to July 2014, 66 patients with solid pancreatic mass underwent EUS-FNB with both 25- and 22-gauge core biopsy needles. Among them, 10 patients were excluded and thus 56 patients were eligible for the analyses. Needle sequences were randomly assigned, and two passes were made with each needle, consisting of 10 uniform to-and-fro movements on each pass with 10 mL syringe suction. A pathologist blinded to needle sequence evaluated specimens for the presence of histologic core. Results The mean patient age was 65.8 ± 9.5 years (range, 44–89 years); 35 patients (62.5%) were men. The mean pancreatic mass size was 35.3 ± 17.1 mm (range 14–122.3 mm). Twenty-eight patients (50%) had tumors at the pancreas head or uncinate process. There were no significant differences in procurement rates of histologic cores between 25-gauge (49/56, 87.5%) and 22-gauge (46/56, 82.1%, P = 0.581) needles or diagnostic accuracy using only histologic cores (98% and 95%). There were no technical failures or procedure-related adverse events. Conclusions The 25-gauge core biopsy needle could offer acceptable and comparable outcomes regarding diagnostic performance including histologic core procurement rates compared to the 22-gauge core biopsy needle, although the differences were not statistically significant. Trial Registration ClinicalTrials.gov NCT01795066 PMID:27149404

  6. Real-Time 3D Fluoroscopy-Guided Large Core Needle Biopsy of Renal Masses: A Critical Early Evaluation According to the IDEAL Recommendations

    SciTech Connect

    Kroeze, Stephanie G. C.; Huisman, Merel; Verkooijen, Helena M.; Diest, Paul J. van; Ruud Bosch, J. L. H.; Bosch, Maurice A. A. J. van den

    2012-06-15

    Introduction: Three-dimensional (3D) real-time fluoroscopy cone beam CT is a promising new technique for image-guided biopsy of solid tumors. We evaluated the technical feasibility, diagnostic accuracy, and complications of this technique for guidance of large-core needle biopsy in patients with suspicious renal masses. Methods: Thirteen patients with 13 suspicious renal masses underwent large-core needle biopsy under 3D real-time fluoroscopy cone beam CT guidance. Imaging acquisition and subsequent 3D reconstruction was done by a mobile flat-panel detector (FD) C-arm system to plan the needle path. Large-core needle biopsies were taken by the interventional radiologist. Technical success, accuracy, and safety were evaluated according to the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) recommendations. Results: Median tumor size was 2.6 (range, 1.0-14.0) cm. In ten (77%) patients, the histological diagnosis corresponded to the imaging findings: five were malignancies, five benign lesions. Technical feasibility was 77% (10/13); in three patients biopsy results were inconclusive. The lesion size of these three patients was <2.5 cm. One patient developed a minor complication. Median follow-up was 16.0 (range, 6.4-19.8) months. Conclusions: 3D real-time fluoroscopy cone beam CT-guided biopsy of renal masses is feasible and safe. However, these first results suggest that diagnostic accuracy may be limited in patients with renal masses <2.5 cm.

  7. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  8. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist.

  9. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature.

    PubMed

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  10. Benign Papillomas Without Atypia Diagnosed on Core Needle Biopsy: Experience From a Single Institution and Proposed Criteria for Excision

    PubMed Central

    Nayak, Anupma; Carkaci, Selin; Gilcrease, Michael Z.; Liu, Ping; Middleton, Lavinia P.; Bassett, Roland L.; Zhang, Jinxia; Zhang, Hong; Coyne, Robin L.; Bevers, Therese B.; Sneige, Nour; Huo, Lei

    2015-01-01

    The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. We describe the clinicopathologic features of 80 patients with such lesions in our institution, with an upgrade rate to malignancy of 3.8%. A multidisciplinary approach to select patients for surgical excision is recommended. Background The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade. Methods Through our pathology database search, we studied 80 BPs without atypia identified on CNB from 80 patients from 1997 to 2010, including 30 lesions that had undergone excision and 50 lesions that had undergone ≥ 2 years of radiologic follow-up. Associations between surgery or upgrade to malignancy and clinical, radiologic, and pathologic features were analyzed. Results Mass lesions, lesions sampled by ultrasound-guided CNB, and palpable lesions were associated with surgical excision. All 3 upgraded cases were mass lesions sampled by ultrasound-guided CNB. None of the lesions with radiologic follow-up only were upgraded to malignancy. The overall upgrade rate was 3.8%. None of the clinical, radiologic, or histologic features were predictive of upgrade. Conclusion Because the majority of patients can be safely managed with radiologic surveillance, a selective approach for surgical excision is recommended. Our proposed criteria for excision include pathologic/radiologic discordance or sampling by ultrasound-guided CNB without vacuum assistance when the patient is symptomatic or lesion size is ≥ 1.5 cm. PMID:24119786

  11. Ductal carcinoma in situ in core needle biopsies and its association with extensive in situ component in the surgical specimen

    PubMed Central

    2012-01-01

    Background We evaluated the presence of ductal carcinoma in situ (DCIS) in core needle biopsies (CNB) from invasive ductal lesions. Methods Retrospective study, which analyzed 90 cases of invasive ductal carcinoma lesions. The percentage of DCIS was quantified in each specimens obtained from CNB, which were compared to the surgical specimens. CNB and surgical specimens were evaluated by the same pathologist, and the percentage of DCIS in CNB was evaluated (percentage) and divided into categories. We considered the following parameters regarding the amount of DCIS: 1 = 0; 2 = 1 for 5%; 3 = 6 for 24%; 4 = 25 for 50%; 5 = 51 for 75% and 6 = 76 for 99%. The number of fragments and the histological pattern of DCIS was found. Results We found the following results regarding the distribution of the percentage of DCIS in the CNB: 1 = 63.3%; 2 = 12.2%; 3 = 12.2%; 4 = 5.6%; 5 = 1.1% and 6 = 5.6%. The logistic regression analysis showed that CNB percentages above 45% reflected the presence of DCIS in the surgical specimen in 100% of the cases (p < 0.001), with a specificity of 100%, accuracy of 83.3% and false positive rate of 0% (p <0.001). Conclusion There is direct relationship between extensive intraductal component in the surgical specimen when the core biopsy shows 45% or more of the DCI or microinvasive in the material examined. PMID:22715888

  12. A Combined Scintimammography/Stereotactic Core Biopsy Digital X-ray System

    SciTech Connect

    A. G. Weisenberger; F. Barbosa; T. D. Green; R. Hoefer; C. Keppel; B. Kross; S. Majewski; V. Popov; R. Wojcik; D. C. Wymer

    2000-10-20

    Jefferson Lab, Hampton University and the Riverside Regional Medical Center are collaborating in a clinical study employing a dual modality imaging system utilizing scintimammography and digital radiography. The purpose of the study is to obtain clinical data on the reliability of scintimammography in predicting the malignancy of suspected breast lesions with the ultimate goal to reduce the number of false positives associated with conventional x-ray mammography. The scintimammography gamma camera is a custom built mini gamma camera with an active area of 5.3 cm x 5.3 cm based on a 2x2 array of Hamamatsu R7600-C8 position sensitive photomultiplier tubes. The spatial resolution of the gamma camera at the collimator surface is <4 mm FWHM and the sensitivity is 4000 cps/mCi. Preliminary results are that of the six cases that indicated a lesion with high uptake of MiraLuma ({sup 99m}Tc-sestamibi) five were positive for cancer. Out of a total of 25 patients in the study, all cases negative for MiraLuma uptake were confirmed negative via the biopsy pathology. The scintimammography results indicate that the lesions become visible with the mini gamma camera within 3 minutes post injection of MiraLuma.

  13. Rapid diagnostic imaging and pathologic evaluation of whole core biopsies at the point-of-care using structured illumination microscopy

    NASA Astrophysics Data System (ADS)

    Wang, Mei; Sholl, Andrew B.; Kimbrell, Hillary; Tulman, David B.; Elfer, Katherine N.; Brown, J. Quincy

    2015-07-01

    Video-rate structured illumination microscopy (VR-SIM) of fluorescently stained prostate biopsies is demonstrated as a potential tool for rapid diagnosis of prostate biopsies at the point of care. Images of entire biopsies at 1.3 micron lateral resolution are rendered in seconds, and pathologist review of the resulting images achieves 90% accuracy as compared to gold standard histopathology.

  14. Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

    SciTech Connect

    Vance, Sean M.; Stenmark, Matthew H.; Blas, Kevin; Halverson, Schulyer; Hamstra, Daniel A.; Feng, Felix Y.

    2012-07-01

    Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75-79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6-12), median PCV was 10% (interquartile range, 2.5-25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log-rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.

  15. Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

    SciTech Connect

    Laredo, Jean-Denis Hamze, Bassam; Jeribi, Riadh

    2009-09-15

    Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. The Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.

  16. Diagnostic underestimation of atypical ductal hyperplasia and ductal carcinoma in situ at percutaneous core needle and vacuum-assisted biopsies of the breast in a Brazilian reference institution*

    PubMed Central

    Badan, Gustavo Machado; Roveda Júnior, Decio; Piato, Sebastião; Fleury, Eduardo de Faria Castro; Campos, Mário Sérgio Dantas; Pecci, Carlos Alberto Ferreira; Ferreira, Felipe Augusto Trocoli; D'Ávila, Camila

    2016-01-01

    Objective To determine the rates of diagnostic underestimation at stereotactic percutaneous core needle biopsies (CNB) and vacuum-assisted biopsies (VABB) of nonpalpable breast lesions, with histopathological results of atypical ductal hyperplasia (ADH) or ductal carcinoma in situ (DCIS) subsequently submitted to surgical excision. As a secondary objective, the frequency of ADH and DCIS was determined for the cases submitted to biopsy. Materials and Methods Retrospective review of 40 cases with diagnosis of ADH or DCIS on the basis of biopsies performed between February 2011 and July 2013, subsequently submitted to surgery, whose histopathological reports were available in the internal information system. Biopsy results were compared with those observed at surgery and the underestimation rate was calculated by means of specific mathematical equations. Results The underestimation rate at CNB was 50% for ADH and 28.57% for DCIS, and at VABB it was 25% for ADH and 14.28% for DCIS. ADH represented 10.25% of all cases undergoing biopsy, whereas DCIS accounted for 23.91%. Conclusion The diagnostic underestimation rate at CNB is two times the rate at VABB. Certainty that the target has been achieved is not the sole determining factor for a reliable diagnosis. Removal of more than 50% of the target lesion should further reduce the risk of underestimation. PMID:26929454

  17. Small Field of View Scintimammography Gamma Camera Integrated to a Stereotactic Core Biopsy Digital X-ray System

    SciTech Connect

    Andrew Weisenberger; Fernando Barbosa; T. D. Green; R. Hoefer; Cynthia Keppel; Brian Kross; Stanislaw Majewski; Vladimir Popov; Randolph Wojcik

    2002-10-01

    A small field of view gamma camera has been developed for integration with a commercial stereotactic core biopsy system. The goal is to develop and implement a dual-modality imaging system utilizing scintimammography and digital radiography to evaluate the reliability of scintimammography in predicting the malignancy of suspected breast lesions from conventional X-ray mammography. The scintimammography gamma camera is a custom-built mini gamma camera with an active area of 5.3 cm /spl times/ 5.3 cm and is based on a 2 /spl times/ 2 array of Hamamatsu R7600-C8 position-sensitive photomultiplier tubes. The spatial resolution of the gamma camera at the collimator surface is < 4 mm full-width at half-maximum and a sensitivity of /spl sim/ 4000 Hz/mCi. The system is also capable of acquiring dynamic scintimammographic data to allow for dynamic uptake studies. Sample images of preliminary clinical results are presented to demonstrate the performance of the system.

  18. Phyllodes tumors of the breast: ultrasonographic findings and diagnostic performance of ultrasound-guided core needle biopsy.

    PubMed

    Youn, Inyoung; Choi, Seon Hyeong; Moon, Hee Jung; Kim, Min Jung; Kim, Eun-Kyung

    2013-06-01

    We evaluated ultrasonography (US) findings between benign and malignant phyllodes tumors and analyzed diagnostic performance of US-guided core needle biopsy (CNB) for phyllodes tumors. Surgically removed phyllodes tumors of 168 women were divided into two groups according to the benign and malignant (including borderline tumor) groups and 116 were benign and 52 were malignant. On US, the complex cystic echogenicity (p = 0.021), presence of cleft (p = 0.005) and higher final US assessment (p = 0.008) were more frequent in the malignant group. The sensitivity of CNB including fibroepithelial tumors was 67.9% (114/168) and the concordant rate between CNB and surgical excision was 82.1% (32/39) and 5.8% (3/52) in the benign and malignant group. Our results suggested that the US findings of complex cystic echogenicity, cleft, higher final US assessment were more frequent in malignant phyllodes tumors. The sensitivity of CNB was 67.9% (114/168) and malignant phyllodes tumors were rarely diagnosed as malignant by US-guided CNB.

  19. Clear cell papillary renal cell carcinoma: a potential mimic of conventional clear cell renal carcinoma on core biopsy.

    PubMed

    Liddell, Heath; Mare, Anton; Heywood, Sean; Bennett, Genevieve; Chan, Hin Fan

    2015-01-01

    Clear cell papillary renal cell carcinoma (CCP-RCC) is a recently described, relatively uncommon variant of renal cell carcinoma (RCC) with a reported incidence of 4.1%. Thought to only arise in those with end stage renal disease, CCP-RCC is increasingly identified in those without renal impairment. CCP-RCCs have unique morphologic, genetic, and immunohistochemical features distinguishing them from both conventional clear cell renal cell carcinomas and papillary renal cell carcinomas. Immunohistochemically, these tumors are positive for CK7 and negative for CD10 and racemase. This is in contrast to conventional cell renal cell carcinomas (CK7 negative, CD10 positive) and papillary cell carcinomas (CK7, CD10, and racemase positive). These tumours appear to be indolent in nature, with no current documented cases of metastatic spread. We present the case of a 42-year-old female who presented with an incidental finding of a renal mass that on a core biopsy was reported as clear cell carcinoma, Fuhrman grade 1. She subsequently underwent a radical nephrectomy and further histological examination revealed the tumor to be a clear cell papillary renal cell carcinoma, Fuhrman grade 1. PMID:25709850

  20. Prognostic Importance of Gleason 7 Disease Among Patients Treated With External Beam Radiation Therapy for Prostate Cancer: Results of a Detailed Biopsy Core Analysis

    SciTech Connect

    Spratt, Daniel E.; Zumsteg, Zach; Ghadjar, Pirus; Pangasa, Misha; Pei, Xin; Fine, Samson W.; Yamada, Yoshiya; Kollmeier, Marisa; Zelefsky, Michael J.

    2013-04-01

    Purpose: To analyze the effect of primary Gleason (pG) grade among a large cohort of Gleason 7 prostate cancer patients treated with external beam radiation therapy (EBRT). Methods and Materials: From May 1989 to January 2011, 1190 Gleason 7 patients with localized prostate cancer were treated with EBRT at a single institution. Of these patients, 613 had a Gleason 7 with a minimum of a sextant biopsy with nonfragmented cores and full biopsy core details available, including number of cores of cancer involved, percentage individual core involvement, location of disease, bilaterality, and presence of perineural invasion. Median follow-up was 6 years (range, 1-16 years). The prognostic implication for the following outcomes was analyzed: biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific mortality (PCSM). Results: The 8-year bRFS rate for pG3 versus pG4 was 77.6% versus 61.3% (P<.0001), DMFS was 96.8% versus 84.3% (P<.0001), and PCSM was 3.7% versus 8.1% (P=.002). On multivariate analysis, pG4 predicted for significantly worse outcome in all parameters. Location of disease (apex, base, mid-gland), perineural involvement, maximum individual core involvement, and the number of Gleason 3+3, 3+4, or 4+3 cores did not predict for distant metastases. Conclusions: Primary Gleason grade 4 independently predicts for worse bRFS, DMFS, and PCSM among Gleason 7 patients. Using complete core information can allow clinicians to utilize pG grade as a prognostic factor, despite not having the full pathologic details from a prostatectomy specimen. Future staging and risk grouping should investigate the incorporation of primary Gleason grade when complete biopsy core information is used.

  1. Kidney biopsy

    MedlinePlus

    Renal biopsy; Biopsy - kidney ... Barisoni L, Arend LJ, Thomas DB. Introduction to renal biopsy. In: Zhou M, Mari-Galluzzi C, eds. ... Saunders; 2015:chap 7. Topham PS, Chen Y. Renal biopsy. In: Johnson RJ, Feehally J, Floege J, ...

  2. Gum biopsy

    MedlinePlus

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  3. Preoperative Assessment of TERT Promoter Mutation on Thyroid Core Needle Biopsies Supports Diagnosis of Malignancy and Addresses Surgical Strategy.

    PubMed

    Crescenzi, A; Trimboli, P; Modica, D C; Taffon, C; Guidobaldi, L; Taccogna, S; Rainer, A; Trombetta, M; Papini, E; Zelano, G

    2016-03-01

    In the last decade, several molecular markers have been proposed to improve the diagnosis of thyroid nodules. Among these, mutations in the telomerase reverse transcriptase (TERT) promoter have been correlated to malignant tumors, characterized by highest recurrence and decreased patients' survival. This suggests an important role of TERT mutational analysis in the clinical diagnosis and management of thyroid cancer patients. The aim of the study was to demonstrate the adequacy of core needle biopsy (CNB) for the preoperative assessment of TERT mutational status, to reach a more accurate definition of malignancy and a more appropriate surgical planning. Indeed, CNB is gaining momentum for improving diagnosis of thyroid nodules deemed inconclusive by fine needle aspirate (FNA). The study included 50 patients submitted to CNB due to inconclusive FNA report. TERT mutational status was correlated with BRAF mutation, definitive histology, and post-operative TNM staging of the neoplasia. C228T mutation of the TERT promoter was reported in 10% of the papillary carcinomas (PTC) series. When compared with final histology, all cases harboring TERT mutation resulted as locally invasive PTCs. The prevalence of TERT mutated cases was 17.6% among locally advanced PTCs. TERT analysis on CNB allows the assessment of the pathological population on paraffin sections before DNA isolation, minimizing the risk of false negatives due to poor sampling that affects FNA, and gathering aggregate information about morphology and TERT mutational status. Data indicating a worse outcome of the tumor might be used to individualize treatment decision, surgical option, and follow-up design. PMID:25951319

  4. Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy.

    PubMed

    Lang, Elvira V; Berbaum, Kevin S; Faintuch, Salomao; Hatsiopoulou, Olga; Halsey, Noami; Li, Xinyu; Berbaum, Michael L; Laser, Eleanor; Baum, Janet

    2006-12-15

    Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients' self-ratings at 1 min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women's anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 min/161 dollars for standard care, 43 min/163 dollars for empathy, and 39 min/152 dollars for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.

  5. Retrieval Rate and Accuracy of Ultrasound-Guided 14-G Semi-Automated Core Needle Biopsy of Breast Microcalcifications

    PubMed Central

    Yi, Jisook; Kwak, Jeong Ja; Cha, Jang Gyu; Jung, Sun Hye

    2014-01-01

    Objective To evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast. Materials and Methods US-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared. Results Thirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05). Conclusion US-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography. PMID:24497787

  6. Short-term imaging follow-up of patients with concordant benign breast core needle biopsies: is it really worth it?

    PubMed Central

    Adams, Michelle C.; Falcon, Shannon; Mooney, Blaise P.; Laronga, Christine; Chau, Alec; Drukteinis, Jennifer S.

    2014-01-01

    PURPOSE Women with histologically proven concordant benign breast disease are often followed closely after biopsy for a period of two years, and they are considered to be at high-risk for cancer development. Our goal was to evaluate the utility of short-term (six-month) imaging follow-up and determine the incidence of breast cancer development in this population. METHODS Retrospective review of concordant benign breast pathology was performed in 558 patients who underwent multi-modality breast core biopsy. A total of 339 patients (60.7%) with 393 biopsies qualified for the study. The six-, 12-, and 24-month incidence rates of breast cancer development were estimated with 95% confidence intervals (CI), using the exact method binomial proportions. RESULTS No cancer was detected in 285 of 339 patients (84.1%) returning for the six-month follow-up. No cancer was detected in 271 of 339 patients (79.9%) returning for the 12-month follow-up. Among 207 follow-up exams (61.1%) performed at 24 months, three patients were detected to have cancer in the ipsilateral breast (1.45% [95% CI, 0.30%–4.18%]) and two patients were detected to have cancer in the contralateral breast (0.97% [95% CI, 0.12%–3.45%]). Subsequent patient biopsy rate was 30 of 339 (8.85%, [95% CI, 6.05%–12.39%]). Three ipsilateral biopsies occurred as a sole result of the six-month follow-up of 285 patients (1.05%, [95% CI, 0.22%–3.05%]). CONCLUSION Short-term imaging follow-up did not contribute to improved breast cancer detection, as all subsequent cancers were detected on annual mammography. Annual diagnostic mammography after benign breast biopsy may be sufficient. PMID:25205024

  7. Magnetic Resonance Imaging/Transrectal Ultrasonography Fusion Prostate Biopsy Significantly Outperforms Systematic 12–Core Biopsy for Prediction of Total Magnetic Resonance Imaging Tumor Volume in Active Surveillance Patients

    PubMed Central

    Okoro, Chinonyerem; George, Arvin K.; Siddiqui, M. Minhaj; Rais–Bahrami, Soroush; Walton–Diaz, Annerleim; Shakir, Nabeel A.; Rothwax, Jason T.; Raskolnikov, Dima; Stamatakis, Lambros; Su, Daniel; Turkbey, Baris; Choyke, Peter L.; Merino, Maria J.; Parnes, Howard L.; Wood, Bradford J.

    2015-01-01

    Abstract Objective: To correlate the highest percentage core involvement (HPCI) and corresponding tumor length (CTL) on systematic 12-core biopsy (SBx) and targeted magnetic resonance imaging/transrectal ultrasonography (MRI/TRUS) fusion biopsy (TBx), with total MRI prostate cancer (PCa) tumor volume (TV). Patients and Methods: Fifty patients meeting criteria for active surveillance (AS) based on outside SBx, who underwent 3.0T multiparametric prostate MRI (MP–MRI), followed by SBx and TBx during the same session at our institution were examined. PCa TVs were calculated using MP-MRI and then correlated using bivariate analysis with the HPCI and CTL for SBx and TBx. Results: For TBx, HPCI and CTL showed a positive correlation (R2=0.31, P<0.0001 and R2=0.37, P<0.0001, respectively) with total MRI PCa TV, whereas for SBx, these parameters showed a poor correlation (R2=0.00006, P=0.96 and R2=0.0004, P=0.89, respectively). For detection of patients with clinically significant MRI derived tumor burden greater than 500 mm3, SBx was 25% sensitive, 90.9% specific (falsely elevated because of missed tumors and extremely low sensitivity), and 54% accurate in comparison with TBx, which was 53.6% sensitive, 86.4% specific, and 68% accurate. Conclusions: HPCI and CTL on TBx positively correlates with total MRI PCa TV, whereas there was no correlation seen with SBx. TBx is superior to SBx for detecting tumor burden greater than 500 mm3. When using biopsy positive MRI derived TVs, TBx better reflects overall disease burden, improving risk stratification among candidates for active surveillance. PMID:25897467

  8. Bone marrow biopsy

    MedlinePlus

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may ... This captures a tiny sample, or core, of bone marrow within the needle. The sample and needle are ...

  9. Liver biopsy

    MedlinePlus

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  10. Biopsy - polyps

    MedlinePlus

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  11. 78 FR 66932 - Scientific Information Request on Core Needle and Open Surgical Biopsy for Diagnosis of Breast...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-07

    ... for all KQs is women who have been referred for biopsy for the diagnosis of primary breast cancer... mammography. Studies carried out in women at high baseline risk of breast cancer (e.g., due to BRCA mutations... with breast cancer and are being examined for recurrence will be excluded \\a\\. Interventions For...

  12. A needle guidance system for biopsy and therapy using two-dimensional ultrasound

    SciTech Connect

    Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat; Del Rey Fernandez, David; Downey, Donal; Fenster, Aaron

    2008-02-15

    radiologists and inexperienced resident radiologists using free-hand US and the needle guidance system. Cylindrical polyvinyl alcohol cryogel lesions, colored blue, were embedded in chicken tissue. Radiologists identified the lesions, visible as hypoechoic masses in the US images, and performed biopsy using a 14-gauge needle. Procedure times were compared based on experience and the technique performed. Using a pair-wise t test, lower biopsy procedure times were observed when using the guidance system versus the free-hand technique (t=12.59, p<0.001). The authors believe that with this improved biopsy guidance they will be able to reduce the ''false negative'' rate of biopsies, especially in the hands of less experienced physicians.

  13. Diagnosis of Ovarian Carcinoma Histotype Based on Limited Sampling: A Prospective Study Comparing Cytology, Frozen Section, and Core Biopsies to Full Pathologic Examination.

    PubMed

    Hoang, Lien N; Zachara, Susanna; Soma, Anita; Köbel, Martin; Lee, Cheng-Han; McAlpine, Jessica N; Huntsman, David; Thomson, Thomas; van Niekerk, Dirk; Singh, Naveena; Gilks, C Blake

    2015-11-01

    Growing insights into the biological features and molecular underpinnings of ovarian cancer has prompted a shift toward histotype-specific treatments and clinical trials. As a result, the preoperative diagnosis of ovarian carcinomas based on small tissue sampling is rapidly gaining importance. The data on the accuracy of ovarian carcinoma histotype-specific diagnosis based on small tissue samples, however, remains very limited in the literature. Herein, we describe a prospective series of 30 ovarian tumors diagnosed using cytology, frozen section, core needle biopsy, and immunohistochemistry (p53, p16, WT1, HNF-1β, ARID1A, TFF3, vimentin, and PR). The accuracy of histotype diagnosis using each of these modalities was 52%, 81%, 85%, and 84% respectively, using the final pathology report as the reference standard. The accuracy of histotype diagnosis using the Calculator for Ovarian Subtype Prediction (COSP), which evaluates immunohistochemical stains independent of histopathologic features, was 85%. Diagnostic accuracy varied across histotype and was lowest for endometrioid carcinoma across all diagnostic modalities (54%). High-grade serous carcinomas were the most overdiagnosed on core needle biopsy (accounting for 45% of misdiagnoses) and clear cell carcinomas the most overdiagnosed on frozen section (accounting for 36% of misdiagnoses). On core needle biopsy, 2/30 (7%) cases had a higher grade lesion missed due to sampling limitations. In this study, we identify several challenges in the diagnosis of ovarian tumors based on limited tissue sampling. Recognition of these scenarios can help improve diagnostic accuracy as we move forward with histotype-specific therapeutic strategies.

  14. Consecutive CT-guided core needle tissue biopsy of lung lesions in the same dog at different phases of radiation-induced lung injury

    PubMed Central

    Yin, Zhongyuan; Deng, Sisi; Liang, Zhiwen; Wang, Qiong

    2016-01-01

    This project aimed to set up a Beagle dog model of radiation-induced lung injury in order to supply fresh lung tissue samples in the different injury phases for gene and protein research. Three dogs received 18 Gy X-ray irradiation in one fraction, another three dogs received 8 Gy in each of three fractions at weekly intervals, and one control dog was not irradiated. Acute pneumonitis was observed during the first 3 months after radiation, and chronic lung fibrosis was found during the next 4–12 months in all the dogs exposed to radiation. CT-guided core needle lung lesion biopsies were extracted from each dog five times over the course of 1 year. The dogs remained healthy after each biopsy, and 50–100 mg fresh lung lesion tissues were collected in each operation. The incidence of pneumothorax and hemoptysis was 20% and 2.8%, respectively, in the 35 tissue biopsies. A successful and stable radiation-induced lung injury dog model was established. Lung lesion tissue samples from dogs in acute stage, recovery stage and fibrosis stage were found to be sufficient to support cytology, genomics and proteomics research. This model safely supplied fresh tissue samples that would allow future researchers to more easily explore and develop treatments for radiation-induced lung injury. PMID:27422930

  15. Analysis of Clinical and Pathologic Factors of Pure, Flat Epithelial Atypia on Core Needle Biopsy to Aid in the Decision of Excision or Observation

    PubMed Central

    Berry, John S; Trappey, Alfred F; Vreeland, Timothy J; Pattyn, Adam R; Clifton, Guy T; Berry, Elizabeth A; Schneble, Erika J; Kirkpatrick, Aaron D; Saenger, Jeffrey S; Peoples, George E

    2016-01-01

    Background: The optimal treatment of flat epithelial atypia (FEA) found on breast core needle biopsy (CNB) is controversial. We performed a retrospective review of our institutional experience with FEA to determine if excisional biopsy may be deferred. Methods: Surgical records from 2009 to 2012 were reviewed for FEA diagnosis. After exclusion for concomitant lesions, CNBs of pure FEA were classified using a previously agreed upon descriptor of “focal” versus “prominent”. Data was analyzed with the Fisher's Exact and Student-t test as appropriate. Results: Of 71 CNBs evaluated, pure FEA was identified on 27 CNBs. Final excisional biopsy was benign in 24 of 27 cases (88%) with associated ductal carcinoma in-situ (DCIS) in 3 of 27 cases (11%). Eighteen of 27 (67%) CNBs were classified as focal while 9 (33%) were described as prominent. Zero of the 18 focal patients had a malignancy compared to 3 of the 9 in the prominent group (0% vs 33%, p=0.02). Of the 27 pure FEA CNBs, 6 patients had a personal history of breast carcinoma, five DCIS and one invasive ductal carcinoma. No malignancies were found in the 21 patients without a personal history of breast carcinoma versus three in the patients with a positive history (0/21 v 3/6, p=0.007). Conclusions: Our data suggests those women who have adequate sampling and sectioning of CNBs, with focal, pure FEA on pathology, and are without a personal history of breast cancer may undergo a period of imaging surveillance. Conversely, patients with a history of breast cancer or pure, prominent FEA on CNB disease should proceed to excisional biopsy. PMID:26722353

  16. Invasive lung cancer staging: influence of CT-guided core needle biopsy on onset of pleural carcinomatosis.

    PubMed

    Flechsig, Paul; Kunz, Josef; Heussel, Claus-Peter; Bozorgmehr, Farastuk; Schnabel, Philipp; Dienemann, Hendrik; Kauczor, Hans-Ulrich; Sedlaczek, Oliver

    2015-01-01

    In lung cancer patients with single peripheral lesions, CT-guided needle biopsies (CTNBs) are common for histological sampling. Recently published studies showed conflicting results for the influence of CTNB on the onset of pleural carcinomatosis (PC). In order to estimate the influence of CTNB on pleural tumor spread, 146 histologically confirmed cases of lung cancer diagnosed by CTNB were retrospectively compared to 112 control lung cancer patients diagnosed by non-CTNB. CTNB was not associated with an earlier onset of PC, identifying CTNB as a safe procedure for minimally invasive lung cancer staging.

  17. Kidney Biopsy

    MedlinePlus

    ... right diagnosis. [ Top ] What should a person do days before a kidney biopsy? Days before the procedure, ... Top ] What can a person expect on the day of the kidney biopsy? A person should arrive ...

  18. Tongue biopsy

    MedlinePlus

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  19. Liver Biopsy

    MedlinePlus

    ... PDF, 341 KB)​​​​. Alternate Language URL Español Liver Biopsy Page Content On this page: What is a ... to Remember Clinical Trials What is a liver biopsy? A liver biopsy is a procedure that involves ...

  20. Outcome Analysis of 9-Gauge Magnetic Resonance Imaging-Guided Vacuum-Assisted Core Needle Breast Biopsies

    PubMed Central

    Rauch, Gaiane M.; Dogan, Basak E.; Smith, Taletha B.; Liu, Ping; Yang, Wei T.

    2014-01-01

    Purpose To correlate 9-gauge Magnetic Resonance imaging-guided Vacuum-Assisted breast Biopsy (MRVAB) with surgical histology to determine the upgrade rate and to correlate the frequency of MRVAB cancer diagnosis with breast MRI indications and enhancement characteristics of targeted lesions. Materials and Methods The HIPAA compliant study was approved by the institutional review board. A database search was performed of all MRVABs performed from January 1, 2005 to September 31, 2010. The breast MRI indications, history, age, risk factors, lesion size, enhancement characteristics, pathology at MRVAB and at surgery were documented. Fisher's exact test and Analysis of Variance were used for statistical analysis. Results A total of 218 lesions underwent MRVAB in 197 women (mean age 52 years, range 28 - 76 years), of which 85 (39%) had surgical correlation. (R1, #3) There were 48/218 (22%) malignant, 133/218 (61%) benign, and 37/218 (17%) high-risk lesions at MRVAB. Ten (12%) of 85 lesions were upgraded to malignancy at surgery, with a final malignancy rate of 25%. The frequency of malignancy was significantly higher in patients presenting for diagnostic (50/177, 28%) versus screening (4/41, 10%, P<0.05) evaluation, patients with ipsilateral cancer (22/49, 45%, P<0.001), lesions with washout kinetics (34/103, 33%, P < 0.05); and relatively higher in lesions with non-mass-like enhancement (26/76, 34%, P=0.07), which represented ductal carcinoma in situ in the majority (17/26, 65%, P<0.005). Conclusion Patients with ipsilateral cancer who have additional suspicious lesions identified on MRI require careful evaluation and biopsy to exclude additional sites of cancer that may impact surgical management. PMID:22268171

  1. Hepatic angiomyolipoma: a series of six cases with emphasis on pathological-radiological correlations and unusual variants diagnosed by core needle biopsy

    PubMed Central

    Agaimy, Abbas; Vassos, Nikolaos; Croner, Roland S; Strobel, Deike; Lell, Michael

    2012-01-01

    Hepatic angiomyolipoma is rare and may pose differential diagnostic difficulty, particularly if encountered in core needle biopsy. We studied 6 cases from 5 males and one female (median age, 48.6 yrs). All presented with non-specific symptoms or an incidentally discovered tumor mass. Two patients had a remote history of chemotherapy for hematological neoplasms (acute lymphoblastic leukemia and Hodgkin lymphoma respectively) and another had clear cell renal cell carcinoma and anaplastic pancreatic carcinoma diagnosed at autopsy without definable syndrome. None of the patients had evidence of the tuberous sclerosis complex or renal or other extra-renal angiomyolipoma. Three tumors were resected completely and three have been only biopsied and followed up. None of the resected cases recurred at a mean follow-up of 35 months. Histologically, tumors were classified as classical triphasic (1), lipomatous (2), epithelioid/oncocytoid (1), epithelioid trabecular (1) and myelolipoma-like (1). The adjacent liver parenchyma was normal in 3 cases, showed pigment cirrhosis in one case and mild fatty change in another case. One case had clinically diagnosed but histologically unverified cirrhosis. The initial diagnostic impression/frozen section was misleading in 5 of the cases and included vascular lesion, focal fatty change, myelolipoma, hepatocellular tumor and oncocytic neoplasm. All tumors expressed HMB45 and variably desmin. One epithelioid lesion expressed HMB45 and TFE3, but lacked desmin expression. In conclusion, hepatic angiomyolipomas are increasingly recognized as incidental findings during surveillance for cirrhosis or investigations for unrelated conditions. Awareness of their diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis as hepatocellular carcinoma, metastatic melanoma or other malignant neoplasms. PMID:22949933

  2. Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran

    PubMed Central

    Rabbani, Masoud; Sarrami, Amir Hossein

    2016-01-01

    Background: Computed tomography-guided percutaneous core needle biopsy (PCNB) is a diagnostic technique for initial assessment of mediastinal mass lesions. This study was conducted to evaluate its diagnostic yield and its complication rate. Materials and Methods: We reviewed the records of CT-guided PCNB in 110 patients with mediastinal mass lesions performed in Kashani and Alzahra Hospitals, Isfahan, from 2006 to 2012. Gender, age at biopsy, size, and anatomic location of the lesion, number of passes, site of approach, complications, and final diagnosis were extracted. Results: Our series encompasses 52 (47.2%) females and 58 (52/7%) males with mean age of 41 ± 8 years. The most common site of involvement was the anterior mediastinum (91.8% of cases). An average of 3/5 passes per patient has been taken for tissue sampling. Parasternal site was the most frequent approach taken for PCNB (in 78.1% of cases). Diagnostic tissue was obtained in 99 (90%) biopsies while, in 11 (10%) cases, specimen materials were inadequate. Lymphoma (49.5%) and bronchogenic carcinoma (33.3%) were the most frequent lesions in our series. The overall complication rate was 17.2% from which 10.9% was pneumothorax, 5.4% was hemoptysis, and 0.9% was vasovagal reflex. Conclusion: CT-guided PCNB is a safe and reliable procedure that can provide a precise diagnosis for patients with both benign and malignant mediastinal masses, and it is considered the preferred first diagnostic procedure use for this purpose. PMID:27713873

  3. The Percent of Positive Biopsy Cores Improves Prediction of Prostate Cancer-Specific Death in Patients Treated With Dose-Escalated Radiotherapy

    SciTech Connect

    Qian Yushen; Feng, Felix Y.; Halverson, Schuyler; Blas, Kevin; Sandler, Howard M.; Hamstra, Daniel A.

    2011-11-01

    Purpose: To examine the prognostic utility of the percentage of positive cores (PPC) at the time of prostate biopsy for patients treated with dose-escalated external beam radiation therapy. Methods and Materials: We performed a retrospective analysis of patients treated at University of Michigan Medical Center to at least 75 Gy. Patients were stratified according to PPC by quartile, and freedom from biochemical failure (nadir + 2 ng/mL), freedom from metastasis (FFM), cause-specific survival (CSS), and overall survival (OS) were assessed by log-rank test. Receiver operator characteristic (ROC) curve analysis was used to determine the optimal cut point for PPC stratification. Finally, Cox proportional hazards multivariate regression was used to assess the impact of PPC on clinical outcome when adjusting for National Comprehensive Cancer Network (NCCN) risk group and androgen deprivation therapy. Results: PPC information was available for 651 patients. Increasing-risk features including T stage, prostate-specific antigen, Gleason score, and NCCN risk group were all directly correlated with increasing PPC. On log-rank evaluation, all clinical endpoints, except for OS, were associated with PPC by quartile, with worse clinical outcomes as PPC increased, with the greatest impact seen in the highest quartile (>66.7% of cores positive). ROC curve analysis confirmed that a cut point using two-thirds positive cores was most closely associated with CSS (p = 0.002; area under ROC curve, 0.71). On univariate analysis, stratifying patients according to PPC less than or equal to 66.7% vs. PPC greater than 66.7% was prognostic for freedom from biochemical failure (p = 0.0001), FFM (p = 0.0002), and CSS (p = 0.0003) and marginally prognostic for OS (p = 0.055). On multivariate analysis, after adjustment for NCCN risk group and androgen deprivation therapy use, PPC greater than 66.7% increased the risk for biochemical failure (p = 0.0001; hazard ratio [HR], 2.1 [95% confidence

  4. Application of Ultrasound-Guided Core Biopsy to Minimal-Invasively Diagnose Supraclavicular Fossa Tumors and Minimize the Requirement of Invasive Diagnostic Surgery.

    PubMed

    Chen, Chun-Nan; Lin, Che-Yi; Chi, Fan-Hsiang; Chou, Chen-Han; Hsu, Ya-Ching; Kuo, Yen-Lin; Lin, Chih-Feng; Chen, Tseng-Cheng; Wang, Cheng-Ping; Lou, Pei-Jen; Ko, Jenq-Yuh; Hsiao, Tzu-Yu; Yang, Tsung-Lin

    2016-01-01

    Tumors of the supraclavicular fossa (SC) is clinically challenging because of anatomical complexity and tumor pathological diversity. Because of varied diseases entities and treatment choices of SC tumors, making the accurate decision among numerous differential diagnoses is imperative. Sampling by open biopsy (OB) remains the standard procedure for pathological confirmation. However, complicated anatomical structures of SC always render surgical intervention difficult to perform. Ultrasound-guided core biopsy (USCB) is a minimally invasive and office-based procedure for tissue sampling widely applied in many diseases of head and neck. This study aims to evaluate the clinical efficacy and utility of using USCB as the sampling method of SC tumors. From 2009 to 2014, consecutive patients who presented clinical symptoms and signs of supraclavicular tumors and were scheduled to receive sampling procedures for diagnostic confirmation were recruited. The patients received USCB or OB respectively in the initial tissue sampling. The accurate diagnostic rate based on pathological results was 90.2% for USCB, and 93.6% for OB. No significant difference was noted between USCB and OB groups in terms of diagnostic accuracy and the percentage of inadequate specimens. All cases in the USCB group had the sampling procedure completed within 10  minutes, but not in the OB group. No scars larger than 1  cm were found in USCB. Only patients in the OB groups had the need to receive general anesthesia and hospitalization and had scars postoperatively. Accordingly, USCB can serve as the first-line sampling tool for SC tumors with high diagnostic accuracy, minimal invasiveness, and low medical cost. PMID:26825877

  5. Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience

    PubMed Central

    Moghadamfalahi, Mana; Podoll, Mirna; Frey, Amy B.; Alatassi, Houda

    2014-01-01

    Background: Computed tomography (CT) guided core needle biopsy (CT-guided CNB) is a minimally invasive, safe and effective manner of tissue sampling in many organs. The aim of our study is to determine the impact of on-site evaluation of touch imprint cytology (TIC) to minimize the number of passes required to obtain adequate tissue for diagnosis. Design: A retrospective review of all CT-guided CNBs performed during 4 year period, where pathologists were present for on-site TIC evaluation. Each case was evaluated for the number of passes required before TIC was interpreted as adequate for diagnosis. Results: A total of 140 CT-guided CNBs were included in the study (liver, lung, kidney, sacral, paraspinal, omental, splenic and adrenal masses). Of the 140 cases, 109 were diagnosed as malignant, 28 as benign and three insufficient. In 106 cases (75.7%), the biopsies were determined adequate by TIC on the first pass, 19 cases (13%) on the second pass and 7 cases (5%) on the third pass. Only in 5 cases (3.6%), more than three passes were required before diagnostic material was obtained. Three cases (2.14%) were interpreted as inadequate both on TIC and on the final diagnosis. Of the biopsies deemed adequate on the first pass, 71% resulted in either termination of the procedure, or only one additional pass was obtained. In five cases, based on the TIC evaluation, a portion of the sample was sent for either flow cytometric analysis or cytogenetic studies. Conclusions: In the majority of cases, adequate material was obtained in the first pass of CT-guided CNB and once this was obtained, either no additional passes, or one additional pass was performed. This study demonstrates the utility of on-site evaluation in minimizing the number of passes required for obtaining adequate diagnostic material and for proper specimen triage for ancillary studies, which in turn decreases the risk to the patient and costs. However, tumor exhaustion in the tissue as a result of TIC is an

  6. Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens: An Unnecessary Exercise That Costs the United States $35 Million/y.

    PubMed

    VandenBussche, Christopher J; Cimino-Mathews, Ashley; Park, Ben Ho; Emens, Leisha A; Tsangaris, Theodore N; Argani, Pedram

    2016-08-01

    Most institutions reflexively test all breast core needle biopsy specimens showing ductal carcinoma in situ (DCIS) for estrogen receptor (ER) and progesterone receptor (PR). However, 5 factors suggest that this reflex testing unnecessarily increases costs. First, ER/PR results do not currently impact the next step in standard therapy; namely, surgical excision. Second, a subset of surgical excisions performed for DCIS diagnosed on core needle biopsy will harbor infiltrating mammary carcinoma, which will then need to be retested for ER/PR. Third, because ER and PR labeling is often heterogeneous in DCIS, negative results for ER/PR on small core needle biopsy specimens should logically be repeated on surgical excision specimens with larger amounts of DCIS to be sure that the result is truly negative. Fourth, many patients with pure ER/PR-positive DCIS after surgical excision will decline hormone therapy, so any ER/PR testing of their DCIS is unnecessary. Fifth, PR status in DCIS has no proven independent value. We now examine the unnecessary added costs associated with reflex ER/PR testing of DCIS on core needle biopsy specimens due to these factors. We reviewed 58 core needle biopsies showing pure DCIS that also had a resulting surgical excision specimen at our institution over a period of 2 years. No patient received neoadjuvant hormone therapy. On surgical excision, 5 (8.6%) had only benign findings, 44 (75.9%) had pure DCIS, and 9 (15.5%) had DCIS with invasive mammary carcinoma. The 9 cases with invasive mammary carcinoma in the surgical excision specimen (16%) and the 4 pure DCIS in surgical excision specimens that were ER/PR negative on core needle biopsy would need repeat ER/PR testing. The total unnecessary increased cost of core needle biopsy specimen testing of these 13 cases was $8148.92 ($140/patient for the 58 patients in the study). We found that ER/PR testing results impacted patient management in only 16/49 pure DCIS cases after surgical excision (33

  7. Discontinuous foci of cancer in a single core of prostatic biopsy: when it occurs and performance of quantification methods in a private-practice setting.

    PubMed

    Schultz, Luciana; Maluf, Carlos E; da Silva, Rogério C; Falashi, Rodrigo de H; da Costa, Matheus V; Schultz, Maria Ines O

    2013-12-01

    In addition to clinical data, prostatic biopsy (Bx) reports orient urologists in outlining the patient's treatment options. Discontinuous involvement of a core by multiple foci of cancer is not infrequent; however, there is currently no consensus as to which method of quantification should be the standard. We applied 2 distinct approaches to quantify the length of cancer foci in the Bx and compared the results to prostatectomy (RP) parameters. All patients with matched Bx and RP treated by the same medical team between 2006 and 2010 were consecutively included in the study. Tumor extent in the Bx was estimated by multiple approaches, and the length was measured in millimeters. The subset of cases with discontinuous foci of cancer in a single core was initially reported by adding each foci and ignoring the benign intervening prostatic tissue, which was designated as additive quantification (AQ). Upon slide review, these foci were reassessed as a single focus and measured by linear quantification (LQ). RPs were partially embedded according to the International Society of Urological Pathology recommendations, and the percentage of tumor was evaluated with graphic precision. Mean percentage of the tumor in RP (%RP) and in the Bx were arbitrarily classified as limited (<6%) and nonlimited (≥6%). Bx parameters were then correlated with %RP and margin status. All methods of quantification of the tumor in the Bx obtained excellent correlation with %RP. LQ and AQ diverged in 14/38 patients, with a mean total length of cancer of 5.8 mm more than the length obtained by LQ in the same population, accurately upgrading 6/14 cases to nonlimited. This subset (LQ>AQ) was more often seen in Bx with significantly more positive cores (P=0.003) of predominantly Gleason score 7 and associated with positive surgical margins in RP (P=0.034) independent of %RP (21% vs. 19% in the margin-negative cases). However, in the subset of Bx in which the tumor infiltration was continuous (AQ

  8. Synovial biopsy

    MedlinePlus

    ... small incision. After anesthesia, an instrument called a trocar is inserted into the joint space. This tool ... area. A biopsy grasper is inserted through the trocar and turned to cut out a tissue segment. ...

  9. Immunohistochemistry for BRAF(V600E) antibody VE1 performed in core needle biopsy samples identifies mutated papillary thyroid cancers.

    PubMed

    Crescenzi, A; Guidobaldi, L; Nasrollah, N; Taccogna, S; Cicciarella Modica, D D; Turrini, L; Nigri, G; Romanelli, F; Valabrega, S; Giovanella, L; Onetti Muda, A; Trimboli, P

    2014-05-01

    BRAF(V600E) is the most frequent genetic mutation in papillary thyroid cancer (PTC) and has been reported as an independent predictor of poor prognosis of these patients. Current guidelines do not recommend the use of BRAF(V600E) mutational analysis on cytologic specimens from fine needle aspiration due to several reasons. Recently, immunohistochemistry using VE1, a mouse anti-human BRAF(V600E) antibody, has been reported as a highly reliable technique in detecting BRAF-mutated thyroid and nonthyroid cancers. The aim of this study was to test the reliability of VE1 immunohistochemistry on microhistologic samples from core needle biopsy (CNB) in identifying BRAF-mutated PTC. A series of 30 nodules (size ranging from 7 to 22 mm) from 30 patients who underwent surgery following CNB were included in the study. All these lesions had had inconclusive cytology. In all cases, both VE1 and BRAF(V600E) genotypes were evaluated. After surgery, final histology demonstrated 21 cancers and 9 benign lesions. CNB correctly diagnosed 20/20 PTC and 5/5 adenomatous nodules. One follicular thyroid cancer and 4 benign lesions were assessed at CNB as uncertain follicular neoplasm. VE1 immunohistochemistry revealed 8 mutated PTC and 22 negative cases. A 100% agreement was found when positive and negative VE1 results were compared with BRAF mutational status. These data are the first demonstration that VE1 immunohistochemistry performed on thyroid CNB samples perfectly matches with genetic analysis of BRAF status. Thus, VE1 antibody can be used on thyroid microhistologic specimens to detect BRAF(V600E)-mutated PTC before surgery.

  10. C-arm cone-beam CT-guided transthoracic lung core needle biopsy as a standard diagnostic tool: an observational study.

    PubMed

    Jaconi, Marta; Pagni, Fabio; Vacirca, Francesco; Leni, Davide; Corso, Rocco; Cortinovis, Diego; Bidoli, Paolo; Bono, Francesca; Cuttin, Maria S; Valente, Maria G; Pesci, Alberto; Bedini, Vittorio A; Leone, Biagio E

    2015-03-01

    C-arm cone-beam computed tomography (CT)-guided transthoracic lung core needle biopsy (CNB) is a safe and accurate procedure for the evaluation of patients with pulmonary nodules. This article will focus on the clinical features related to CNB in terms of diagnostic performance and complication rate. Moreover, the concept of categorizing pathological diagnosis into 4 categories, which could be used for clinical management, follow-up, and quality assurance is also introduced. We retrospectively collected data regarding 375 C-arm cone-beam CT-guided CNBs from January 2010 and June 2014. Clinical and radiological variables were evaluated in terms of success or failure rate. Pathological reports were inserted in 4 homogenous groups (nondiagnostic--L1, benign--L2, malignant not otherwise specified--L3, and malignant with specific histotype--L4), defining for each category a hierarchy of suggested actions. The sensitivity, specificity, and positive and negative predictive value and accuracy for patients subjected to CNBs were of 96.8%, 100%, 100%, 100%, and 97.2%, respectively. Roughly 75% of our samples were diagnosed as malignant, with 60% lung adenocarcinoma diagnoses. Molecular analyses were performed on 85 malignant samples to verify applicability of targeted therapy. The rate of "nondiagnostic" samples was 12%. C-arm cone-beam CT-guided transthoracic lung CNB can represent the gold standard for the diagnostic evaluation of pulmonary nodules. A clinical and pathological multidisciplinary evaluation of CNBs was needed in terms of integration of radiological, histological, and oncological data. This approach provided exceptional performances in terms of specificity, positive and negative predictive values; sensitivity in our series was lower compared with other large studies, probably due to the application of strong criteria of adequacy for CNBs (L1 class rate). The satisfactory rate of collected material was evaluated not only in terms of merely diagnostic

  11. Pathology in a tube: Step 1. Fixing, staining, and transporting pancreatic core biopsies in a microfluidic device for 3D imaging

    NASA Astrophysics Data System (ADS)

    Das, Ronnie; Burfeind, Chris W.; Kramer, Greg M.; Seibel, Eric J.

    2014-03-01

    A minimally-invasive diagnosis of pancreatic cancer is accomplished by obtaining a fine needle aspirate and observing the cell preparations under conventional optical microscopy. As an unavoidable artifact, native tissue architecture is lost, making definite diagnosis of malignancy, or invasive neoplasm, impossible. One solution is the preparation of core biopsies (CBs) within a microfluidic device that are subsequently imaged in 3D. In this paper, porcine pancreas CBs (L = 1-2 cm, D = 0.4-2.0 mm) were formalin-fixed, stained and optically cleared (FocusClear®). In brightfield at 40x, light transmission through the ordinarily opaque CBs was increased 5-15x, and internal islet structures were easily identified 250-300 μm beneath the tissue surface. Typically, specimen preparation is time intensive and requires precise handling since CBs are delicate; thus, fixative, absorptive stain and FocusClear® diffusion were done slowly and manually. To significantly speed up tissue processing, we developed a microfluidic device consisting of both a main channel (L = 12.5 cm, D = 1.415 mm) with a circular cross section used for fixing and transporting the CB and an intersecting U-channel employed for staining. Space between the CB and channel wall provided a key feature not traditionally employed in microfluidic devices, such that at low flow rates (5-10 mL/min) CBs were fixed and stained while the specimen remained stationary. By switching quickly to higher flow rates (15-20 mL/min), we could precisely overcome adhesion and transport the specimen within the channel towards the imaging platform for 3D pathology.

  12. Lymph node biopsy

    MedlinePlus

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... then sent to the laboratory for examination. A needle biopsy involves inserting a needle into a lymph ...

  13. Testicular biopsy

    MedlinePlus

    ... egg in the lab. This process is called in vitro fertilization. Testicular biopsy may also be done if you have found a lump during testicular self-examination . If tests ... the lump may be in the testicle, surgery may be needed to look ...

  14. Adequate histologic sectioning of prostate needle biopsies.

    PubMed

    Bostwick, David G; Kahane, Hillel

    2013-08-01

    No standard method exists for sampling prostate needle biopsies, although most reports claim to embed 3 cores per block and obtain 3 slices from each block. This study was undertaken to determine the extent of histologic sectioning necessary for optimal examination of prostate biopsies. We prospectively compared the impact on cancer yield of submitting 1 biopsy core per cassette (biopsies from January 2010) with 3 cores per cassette (biopsies from August 2010) from a large national reference laboratory. Between 6 and 12 slices were obtained with the former 1-core method, resulting in 3 to 6 slices being placed on each of 2 slides; for the latter 3-core method, a limit of 6 slices was obtained, resulting in 3 slices being place on each of 2 slides. A total of 6708 sets of 12 to 18 core biopsies were studied, including 3509 biopsy sets from the 1-biopsy-core-per-cassette group (January 2010) and 3199 biopsy sets from the 3-biopsy-cores-percassette group (August 2010). The yield of diagnoses was classified as benign, atypical small acinar proliferation, high-grade prostatic intraepithelial neoplasia, and cancer and was similar with the 2 methods: 46.2%, 8.2%, 4.5%, and 41.1% and 46.7%, 6.3%, 4.4%, and 42.6%, respectively (P = .02). Submission of 1 core or 3 cores per cassette had no effect on the yield of atypical small acinar proliferation, prostatic intraepithelial neoplasia, or cancer in prostate needle biopsies. Consequently, we recommend submission of 3 cores per cassette to minimize labor and cost of processing. PMID:23764163

  15. Simulated prostate biopsy: prostate cancer distribution and clinical correlation

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Zhang, Wei; Sesterhenn, Isabell A.; Dean, Robert; Moul, Judd W.; Mun, Seong K.

    2000-04-01

    Our group has recently obtained data based upon whole- mounted step-sectioned radical prostatectomy specimens using a 3D computer assisted prostate biopsy simulator that suggests an increased detection rate is possible using laterally placed biopsies. A new 10-core biopsy pattern was demonstrated to be superior to the traditional sextant biopsy. This patter includes the traditional sextant biopsy cores and four laterally placed biopsies in the right and left apex and mid portion of the prostate gland. The objective of this study is to confirm the higher prostate cancer defection rate obtained using our simulated 10-core biopsy pattern in a small clinical trial. We retrospectively reviewed 35 consecutive patients with a pathologic diagnosis of prostate cancer biopsied by a single urologist using the 10-core prostate biopsy patterns were compared with respect to prostate cancer detection rate. Of the 35 patients diagnosed with prostate cancer, 54.3 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent were diagnosed when reviewing the sextant biopsy data only. Review of the 10-core pattern revealed that an additional 45.7 percent of patients were diagnosed solely with the laterally placed biopsies. Our results suggest that biopsy protocols that use laterally placed biopsies based upon a five region anatomical model are superior to the routinely used sextant prostate biopsy pattern.

  16. Nasal mucosal biopsy

    MedlinePlus

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  17. Biopsy - biliary tract

    MedlinePlus

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  18. SISH/CISH or qPCR as alternative techniques to FISH for determination of HER2 amplification status on breast tumors core needle biopsies: a multicenter experience based on 840 cases

    PubMed Central

    2013-01-01

    Background Until now, FISH has been the gold standard technique to identify HER2 amplification status in ambiguous cases of breast cancer. Alternative techniques have been developed to increase the capacities of investigating HER2 amplification status. The aims of this multicenter study in a large series of breast cancer patients were to prospectively compare the level of performance of CISH, SISH, and qPCR alternative techniques on paraffin-embedded core biopsies with “gold standard FISH” for evaluation of HER2 amplification status. Methods This study was performed on 840 cases scored by immunohistochemistry (IHC): 0=317 (38%), 1+=183 (22%), 2+=109 (13%), 3+=231 (27%). Each of the 15 French centers participating in the study analyzed 56 breast carcinoma cases diagnosed on fixed paraffin-embedded core biopsies. HER2 amplification status was determined by commercially available FISH used as the reference technique with determination of the HER2/CEN17 ratio or HER2 copy number status. The alternative techniques performed on the same cases were commercially available SISH or CISH and a common qPCR method especially designed for the study including a set of 10 primer pairs: 2 for HER2 (exons 8 and 26), 5 to evaluate chromosome 17 polysomy TAOK1, UTP6, MRM1, MKS1, SSTR2 and 3 for diploidy control TSN, LAP3 and ADAMTS16. Results The concordance between IHC and FISH was 96% to 95% based on the HER2/CEN17 ratio (n=766) or HER2 copy number (n=840), respectively. The concordance of the alternative techniques with FISH was excellent: 97% and 98% for SISH (498 and 587 cases), 98% and 75% for CISH (108 and 204 cases) and 95% and 93% (699 and 773 cases) for qPCR based on the HER2/CEN17 ratio or HER2 copy number, respectively. Similarly, sensitivity ranged from 99% to 95% for SISH, 100% to 99% for CISH and 89% to 80% for qPCR. The concordance with FISH (ratio) in the 2+ cases was 89% for SISH, 100% for CISH and 93% for qPCR. Conclusion These alternative techniques showed an

  19. Adequacy and complication rates with 14- vs. 16-gauge automated needles in percutaneous renal biopsy of native kidneys.

    PubMed

    Chunduri, Svetha; Whittier, William L; Korbet, Stephen M

    2015-01-01

    In performing percutaneous renal biopsy (PRB) of native kidneys, an increasing use of 16-gauge automated biopsy needles has been observed. We compare the adequacy and safety of PRBs in adults performed with a 14-gauge (n = 82) vs. 16-gauge (n = 55) automated needle using real-time ultrasound (US) from 1/2010 to 12/2013. Baseline clinical and laboratory data along with outcome data (renal US 1-hour postbiopsy, biopsy adequacy, and safety) were collected prospectively. There was no difference in age, gender, blood pressure, serum creatinine, or pre-PRB hemoglobin at baseline for PRBs performed with a 14- vs. 16-gauge needle. The number of glomeruli obtained per biopsy was similar (29 ± 11 vs. 31 ± 14, p = 0.6) and adequate tissue for diagnosis was obtained in 99% and 100% of biopsies. The clinical complication (8.5% vs. 9.1%, p = 1.0), transfusion (7.3% vs. 7.2%, p = 1.0), and embolization (3.7% vs. 1.8%, p = 0.6) rates were not significantly different for 14- vs. 16-gauge needles, but by routine renal US 1-hour post-PRB, a perinephric hematoma was demonstrated more often in biopsies done with the 14-gauge needle (39% vs. 22%, P 0.04). Thus, while the success of PRB of native kidneys is similar for both needle gauges, the potential for complication may be less using a 16-gauge automated needle.

  20. Salivary Gland Biopsy Shows Promise to Helping to Diagnose Parkinson's

    MedlinePlus

    ... Parkinson's HelpLine Learn More Science News Salivary Gland Biopsy Shows Promise to Helping to Diagnose Parkinson’s - Mar ... team performed a procedure called a needle core biopsy of the submandibular glands in 15 people who ...

  1. Open lung biopsy

    MedlinePlus

    Biopsy - open lung ... An open lung biopsy is done in the hospital using general anesthesia , which means you are asleep and pain- ... The open lung biopsy is done to evaluate lung problems seen on x-ray or CT scan .

  2. Bone biopsy (image)

    MedlinePlus

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  3. Muscle biopsy (image)

    MedlinePlus

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  4. Skin biopsy: Biopsy issues in specific diseases.

    PubMed

    Elston, Dirk M; Stratman, Erik J; Miller, Stanley J

    2016-01-01

    Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

  5. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    PubMed

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure. PMID:24797801

  6. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    PubMed

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

  7. Optimization of prostate biopsy

    NASA Astrophysics Data System (ADS)

    Bauer, John J.; Zeng, Jianchao; Weir, James; Zhang, Wei; Sesterhenn, Isabell A.; Connelly, Roger R.; Moul, Judd W.; Mun, Seong K.

    1999-05-01

    Urologists routinely use the systematic sextant needle biopsy technique to detect prostate cancer. However, recent evidence suggests that this technique has a significant sampling error. We have developed a novel 3D computer assisted prostate biopsy simulator based upon 201 whole- mounted step-sectioned radical prostatectomy specimens to compare the diagnostic accuracy of various prostate needle biopsy protocols. Computerized prostate models have been developed to accurately depict the anatomy of the prostate and all individual tumor foci. We obtained 18-biopsies of each prostate model to determine the detection rates of various biopsy protocols. As a result, the 10- and 12- pattern biopsy protocols had a 99.0 percent detection rate, while the traditional sextant biopsy protocol rate was only 72.6 percent. The 5-region biopsy protocol had a 90.5 percent detection rate. the lateral sextant pattern revealed a detection rate of 95.5 percent, whereas the 4-pattern lateral biopsy protocol had a 93.5 percent detection rate. Our results suggest that all the biopsy protocols that use laterally placed biopsies based upon the five region anatomical model are superior to the routinely used sextant prostate biopsy pattern. Lateral biopsies in the mid and apical zones of the gland are the most important.

  8. Utilization trends and positive biopsy rates for prostate biopsies in the United States: 2005 to 2011.

    PubMed

    Kapoor, Deepak A; Bostwick, David G; Mendrinos, Savvas E; Anderson, Ann E; Olsson, Carl A

    2013-01-01

    This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in > 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%-this was identical at both the NRL and UPL (P = .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P = .03). For the most recent 3-year period (2009-2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P = 0.08). Positive biopsy rate correlated strongly (P < .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009 to

  9. Utilization Trends and Positive Biopsy Rates for Prostate Biopsies in the United States: 2005 to 2011

    PubMed Central

    Kapoor, Deepak A; Bostwick, David G; Mendrinos, Savvas E; Anderson, Ann E; Olsson, Carl A

    2013-01-01

    This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in > 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%-this was identical at both the NRL and UPL (P = .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P = .03). For the most recent 3-year period (2009–2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P = 0.08). Positive biopsy rate correlated strongly (P < .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009

  10. Cold knife cone biopsy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003910.htm Cold knife cone biopsy To use the sharing features on this page, please enable JavaScript. A cold knife cone biopsy (conization) is surgery to remove ...

  11. Nerve biopsy (image)

    MedlinePlus

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  12. Percutaneous liver biopsy.

    PubMed

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  13. A new apparatus for standardized rat kidney biopsy.

    PubMed

    Schirutschke, Holger; Gladrow, Lars; Norkus, Christian; Parmentier, Simon Paul; Hohenstein, Bernd; Hugo, Christian P M

    2014-01-01

    Survival biopsies are frequently applied in rat kidney disease models, but several drawbacks such as surgical kidney trauma, bleeding risk and variable loss of kidney tissue are still unsolved. Therefore, we developed an easy-to-use core biopsy instrument and evaluated whether two consecutive kidney biopsies within the same kidney can be carried out in a standardized manner. On day 0, 18 Lewis rats underwent a right nephrectomy and 9 of these rats a subsequent first biopsy of the left kidney (Bx group). 9 control rats had a sham biopsy of the left kidney (Ctrl group). On day 7, a second kidney biopsy/sham biopsy was performed. On day 42, all animals were sacrificed and their kidneys were removed for histology. Biopsy cylinders contained 57±28 glomeruli per transversal section, representing an adequate sample size. PAS staining showed that the biopsy depth was limited to the renal cortex whereas surgical tissue damage was limited to the area immediately adjacent to the taken biopsy cylinder. On day 42, the reduction of functional renal mass after two biopsies was only 5.2% and no differences of body weight, blood pressure, proteinuria, serum creatinine, glomerulosclerosis, interstitial fibrosis or number of ED-1 positive macrophages were found between both groups. In summary, our apparatus offers a safe method to perform repetitive kidney biopsies with minimal trauma and sufficient sample size and quality even in experimental disease models restricted to one single kidney.

  14. A New Apparatus for Standardized Rat Kidney Biopsy

    PubMed Central

    Schirutschke, Holger; Gladrow, Lars; Norkus, Christian; Parmentier, Simon Paul; Hohenstein, Bernd; Hugo, Christian P. M.

    2014-01-01

    Survival biopsies are frequently applied in rat kidney disease models, but several drawbacks such as surgical kidney trauma, bleeding risk and variable loss of kidney tissue are still unsolved. Therefore, we developed an easy-to-use core biopsy instrument and evaluated whether two consecutive kidney biopsies within the same kidney can be carried out in a standardized manner. On day 0, 18 Lewis rats underwent a right nephrectomy and 9 of these rats a subsequent first biopsy of the left kidney (Bx group). 9 control rats had a sham biopsy of the left kidney (Ctrl group). On day 7, a second kidney biopsy/sham biopsy was performed. On day 42, all animals were sacrificed and their kidneys were removed for histology. Biopsy cylinders contained 57±28 glomeruli per transversal section, representing an adequate sample size. PAS staining showed that the biopsy depth was limited to the renal cortex whereas surgical tissue damage was limited to the area immediately adjacent to the taken biopsy cylinder. On day 42, the reduction of functional renal mass after two biopsies was only 5.2% and no differences of body weight, blood pressure, proteinuria, serum creatinine, glomerulosclerosis, interstitial fibrosis or number of ED-1 positive macrophages were found between both groups. In summary, our apparatus offers a safe method to perform repetitive kidney biopsies with minimal trauma and sufficient sample size and quality even in experimental disease models restricted to one single kidney. PMID:25506931

  15. Salivary gland biopsy

    MedlinePlus

    Biopsy - salivary gland ... You have several pairs of salivary glands that drain into your mouth: A major pair in front of the ears (parotid glands) Another major pair beneath your jaw (submandibular ...

  16. Colposcopy - directed biopsy

    MedlinePlus

    ... squamous cells - colposcopy; Pap smear - colposcopy; HPV - colposcopy; Human papilloma virus - colposcopy; Cervix - colposcopy; Colposcopy ... also called cervical dysplasia) Cervical warts (infection with human papilloma virus , or HPV) If the biopsy does not determine ...

  17. Mediastinoscopy with biopsy

    MedlinePlus

    ... procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders . Normal Results Biopsies of lymph ... findings may indicate: Hodgkin disease Lung cancer Lymphoma Sarcoidosis The spread of disease from one body part ...

  18. Biopsy catheter (image)

    MedlinePlus

    ... examination, a heart biopsy can be performed. A catheter is carefully threaded into an artery or vein to gain access into the heart. A bioptome (catheter with jaws in its tip) is then introduced. ...

  19. Breast Biopsy System

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Charge Coupled Devices (CCDs) are high technology silicon chips that connect light directly into electronic or digital images, which can be manipulated or enhanced by computers. When Goddard Space Flight Center (GSFC) scientists realized that existing CCD technology could not meet scientific requirements for the Hubble Space Telescope Imagining Spectrograph, GSFC contracted with Scientific Imaging Technologies, Inc. (SITe) to develop an advanced CCD. SITe then applied many of the NASA-driven enhancements to the manufacture of CCDs for digital mammography. The resulting device images breast tissue more clearly and efficiently. The LORAD Stereo Guide Breast Biopsy system incorporates SITe's CCD as part of a digital camera system that is replacing surgical biopsy in many cases. Known as stereotactic needle biopsy, it is performed under local anesthesia with a needle and saves women time, pain, scarring, radiation exposure and money.

  20. Thyroid gland biopsy (image)

    MedlinePlus

    The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating ... sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During ...

  1. Comparison of prostate MRI-3D transrectal ultrasound fusion biopsy for first-time and repeat biopsy patients with previous atypical small acinar proliferation

    PubMed Central

    Cool, Derek W.; Romagnoli, Cesare; Izawa, Jonathan I.; Chin, Joseph; Gardi, Lori; Tessier, David; Mercado, Ashley; Mandel, Jonathan; Ward, Aaron D.; Fenster, Aaron

    2016-01-01

    Introduction: This study evaluates the clinical benefit of magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy over systematic biopsy between first-time and repeat prostate biopsy patients with prior atypical small acinar proliferation (ASAP). Materials: 100 patients were enrolled in a single-centre prospective cohort study: 50 for first biopsy, 50 for repeat biopsy with prior ASAP. Multiparameteric magnetic resonance imaging (MP-MRI) and standard 12-core ultrasound biopsy (Std-Bx) were performed on all patients. Targeted biopsy using MRI-TRUS fusion (Fn-Bx) was performed f suspicious lesions were identified on the pre-biopsy MP-MRI. Classification of clinically significant disease was assessed independently for the Std-Bx vs. Fn-Bx cores to compare the two approaches. Results: Adenocarcinoma was detected in 49/100 patients (26 first biopsy, 23 ASAP biopsy), with 25 having significant disease (17 first, 8 ASAP). Fn-Bx demonstrated significantly higher per-core cancer detection rates, cancer involvement, and Gleason scores for first-time and ASAP patients. However, Fn-Bx was significantly more likely to detect significant cancer missed on Std-Bx for ASAP patients than first-time biopsy patients. The addition of Fn-Bx to Std-Bx for ASAP patients had a 166.7% relative risk reduction for missing Gleason ≥ 3 + 4 disease (number needed to image with MP-MRI=10 patients) compared to 6.3% for first biopsy (number to image=50 patients). Negative predictive value of MP-MRI for negative biopsy was 79% for first-time and 100% for ASAP patients, with median followup of 32.1 ± 15.5 months. Conclusions: MR-TRUS Fn-Bx has a greater clinical impact for repeat biopsy patients with prior ASAP than biopsy-naïve patients by detecting more significant cancers that are missed on Std-Bx. PMID:27800057

  2. Stereotactic (Mammographically Guided) Breast Biopsy

    MedlinePlus

    ... Z Stereotactic Breast Biopsy Stereotactic breast biopsy uses mammography – a specific type of breast imaging that uses ... the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not ...

  3. Celiac Disease Diagnosis: Endoscopic Biopsy

    MedlinePlus

    ... This is done in a procedure called a biopsy: the physician eases a long, thin tube called ... the tissue using instruments passed through the endoscope. Biopsy of the small intestine is the only way ...

  4. Is magnetic resonance/ultrasound fusion prostate biopsy better than systematic prostate biopsy? an updated meta- and trial sequential analysis

    PubMed Central

    Xie, Bo; Wang, Xiao; Zhu, Yi; Wang, Junyuan; Yu, Yasai; Zheng, Xiangyi; Liu, Ben; Xie, Liping

    2015-01-01

    We systematically reviewed the literature to determine whether Magnetic Resonance/Ultrasound (MR/US) fusion prostate biopsy is better than systematic biopsy for making a definitive diagnosis of prostate cancer. The two strategies were also compared for their ability to detect lesions with different degrees of suspicion on MRI and clinically significant prostate cancer, and the number of cores needed for diagnosis. The Cochrane Library, Embase, Web of Knowledge, and Medline were searched from inception until May 1, 2015. Meta-analysis was conducted via RevMan 5.2 software. Data was expressed as risk ratio (RR) and 95% confidence interval. Trial sequential analysis was used to assess risk of random errors. Fourteen trials were included, encompassing a total of 3105 participants. We found that MR/US fusion biopsy detected more prostate cancers than systematic biopsy (46.9% vs. 44.2%, p=0.03). In men with moderate/high MRI suspicion, MR/US fusion biopsy did better than systematic biopsy (RR = 1.46; p < 0.05) for making a diagnosis. Moreover, MR/US fusion biopsy detected more clinically significant cancers than systematic biopsy (RR = 1.19; p < 0.05). We recommend that MR/US fusion prostate biopsy be used to better detect prostate cancer, particularly in patients with moderate/high suspicion lesions on MRI. PMID:26498362

  5. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Help a Friend Who Cuts? Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow Print A A A Text Size What's in ... Risks If You Have Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone ...

  6. Clinical role of the renal transplant biopsy

    PubMed Central

    Williams, Winfred W.; Taheri, Diana; Tolkoff-Rubin, Nina; Colvin, Robert B.

    2013-01-01

    Percutaneous needle core biopsy is the definitive procedure by which essential diagnostic and prognostic information on acute and chronic renal allograft dysfunction is obtained. The diagnostic value of the information so obtained has endured for over three decades and has proven crucially important in shaping strategies for therapeutic intervention. This Review provides a broad outline of the utility of performing kidney graft biopsies after transplantation, highlighting the relevance of biopsy findings in the immediate and early post-transplant period (from days to weeks after implantation), the first post-transplant year, and the late period (beyond the first year). We focus on how biopsy findings change over time, and the wide variety of pathological features that characterize the major clinical diagnoses facing the clinician. This article also includes a discussion of acute cellular and humoral rejection, the toxic effects of calcineurin inhibitors, and the widely varying etiologies and characteristics of chronic lesions. Emerging technologies based on gene expression analyses and proteomics, the in situ detection of functionally relevant molecules, and new bioinformatic approaches that hold the promise of improving diagnostic precision and developing new, refined molecular pathways for therapeutic intervention are also presented. PMID:22231130

  7. High-frequency ultrasound imaging for breast cancer biopsy guidance.

    PubMed

    Cummins, Thomas; Yoon, Changhan; Choi, Hojong; Eliahoo, Payam; Kim, Hyung Ham; Yamashita, Mary W; Hovanessian-Larsen, Linda J; Lang, Julie E; Sener, Stephen F; Vallone, John; Martin, Sue E; Kirk Shung, K

    2015-10-01

    Image-guided core needle biopsy is the current gold standard for breast cancer diagnosis. Microcalcifications, an important radiographic finding on mammography suggestive of early breast cancer such as ductal carcinoma in situ, are usually biopsied under stereotactic guidance. This procedure, however, is uncomfortable for patients and requires the use of ionizing radiation. It would be preferable to biopsy microcalcifications under ultrasound guidance since it is a faster procedure, more comfortable for the patient, and requires no radiation. However, microcalcifications cannot reliably be detected with the current standard ultrasound imaging systems. This study is motivated by the clinical need for real-time high-resolution ultrasound imaging of microcalcifications, so that biopsies can be accurately performed under ultrasound guidance. We have investigated how high-frequency ultrasound imaging can enable visualization of microstructures in ex vivo breast tissue biopsy samples. We generated B-mode images of breast tissue and applied the Nakagami filtering technique to help refine image output so that microcalcifications could be better assessed during ultrasound-guided core biopsies. We describe the preliminary clinical results of high-frequency ultrasound imaging of ex vivo breast biopsy tissue with microcalcifications and without Nakagami filtering and the correlation of these images with the pathology examination by hematoxylin and eosin stain and whole slide digital scanning. PMID:26693167

  8. The endomyocardial biopsy.

    PubMed

    Schneiderman, H; Hager, W D; Gondos, B

    1986-01-01

    Endomyocardial biopsy (EMB) provides a safe, simple method of gathering unique information. Although the role of EMB continues to evolve rapidly, present consensus includes the following indications, based on the ability of EMB to provide diagnoses unobtainable by other means: assessment of early rejection following cardiac transplantation; determination of myocarditis as etiology of clinically obscure cardiac dysfunction; quantification of chemotherapeutic (especially anthracycline) cardiotoxicity; and distinction between constrictive and restrictive heart disease. Each of these indications carries major therapeutic as well as prognostic implications. Methods of processing EMB are presented, complications listed, artifacts described, findings and uses illustrated, and suggestions for future development addressed briefly.

  9. Telepathology and Optical Biopsy

    PubMed Central

    Ferrer-Roca, Olga

    2009-01-01

    The ability to obtain information about the structure of tissue without taking a sample for pathology has opened the way for new diagnostic techniques. The present paper reviews all currently available techniques capable of producing an optical biopsy, with or without morphological images. Most of these techniques are carried out by physicians who are not specialized in pathology and therefore not trained to interpret the results as a pathologist would. In these cases, the use of telepathology or distant consultation techniques is essential. PMID:20339507

  10. Methodology of stereotactic biopsy.

    PubMed

    Carapella, C M; Mastrostefano, R; Raus, L; Riccio, A

    1989-01-01

    The great technological improvement in the neurosurgical tools and in the neuroradiological imaging has brought about the diffusion of the stereotactic techniques. They are crucial for the diagnosis and treatment of intracranial expanding lesions of small dimensions or located in sites inaccessible to conventional techniques. The Authors describe the most common systems and methodologies for the stereotactic biopsy. They stress the importance of performing serial explorations which can provide evidence of the heterogeneity of the neoplastic lesion and of the infiltration of the brain adjacent to the tumor.

  11. Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer

    PubMed Central

    Siddiqui, M. Minhaj; Rais-Bahrami, Soroush; Turkbey, Baris; George, Arvin K.; Rothwax, Jason; Shakir, Nabeel; Okoro, Chinonyerem; Raskolnikov, Dima; Parnes, Howard L.; Linehan, W. Marston; Merino, Maria J.; Simon, Richard M.; Choyke, Peter L.; Wood, Bradford J.; Pinto, Peter A.

    2015-01-01

    Importance Targeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been shown to detect prostate cancer. The implications of targeted biopsy alone vs standard extended-sextant biopsy or the 2 modalities combined are not well understood. Objective To assess targeted vs standard biopsy and the 2 approaches combined for the diagnosis of intermediate- to high-risk prostate cancer. Design, Setting, And Participants Prospective cohort study of 1003 men undergoing both targeted and standard biopsy concurrently from 2007 through 2014 at the National Cancer Institute in the United States. Patients were referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results, often with prior negative biopsy results. Risk categorization was compared among targeted and standard biopsy and, when available, whole-gland pathology after prostatectomy as the “gold standard.” Interventions Patients underwent multiparametric prostate magnetic resonance imaging to identify regions of prostate cancer suspicion followed by targeted MR/ultrasound fusion biopsy and concurrent standard biopsy. Main Outcomes And Measures The primary objective was to compare targeted and standard biopsy approaches for detection of high-risk prostate cancer (Gleason score ≥4 + 3); secondary end points focused on detection of low-risk prostate cancer (Gleason score 3 + 3 or low-volume 3 + 4) and the biopsy ability to predict whole-gland pathology at prostatectomy. Results Targeted MR/ultrasound fusion biopsy diagnosed 461 prostate cancer cases, and standard biopsy diagnosed 469 cases. There was exact agreement between targeted and standard biopsy in 690 men (69%) undergoing biopsy. Targeted biopsy diagnosed 30% more high-risk cancers vs standard biopsy (173 vs 122 cases, P < .001) and 17% fewer low-risk cancers (213 vs 258 cases, P < .001). When standard biopsy cores were combined with the targeted approach, an additional 103 cases (22%) of mostly low

  12. Strategies for prevention of ultrasound-guided prostate biopsy infections

    PubMed Central

    Lu, Diane D; Raman, Jay D

    2016-01-01

    Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to) prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. PMID:27468242

  13. Drill biopsy in the diagnosis of lung lesions.

    PubMed

    Shatapathy, P; Sahoo, R C; Rao, K M; Krishnan, K V; Rau, P V; Padhee, A

    1987-11-01

    A high speed pneumatic drill was used to perform 190 percutaneous transthoracic biopsies in 161 patients. The resultant cores of tissue provided a definite diagnosis in 146 patients, giving a success rate of 90.7%. Complications occurred in 58 patients, subcutaneous emphysema being the most common, though only seven patients required active treatment, giving a rate of 3.7% for important complications. One patient died within 24 hours of the biopsy procedure owing to asphyxia resulting from aspiration of the contents of an acutely dilated stomach. Our experience clearly establishes that the drill biopsy as used by us is simple and safe and can be carried out in an outpatient department, yielding better overall results than any other procedure for closed biopsy of the lung currently practised.

  14. Magnetic Resonance Imaging-Guided Prostate Biopsy: Present and Future

    PubMed Central

    2015-01-01

    Systemic transrectal ultrasound-guided biopsy (TRUSBx) is the standard procedure for diagnosing prostate cancer (PCa), but reveals a limited accuracy for the detection of cancer. Currently, multiparametric MR imaging (mp-MRI) is increasingly regarded as a promising method to detect PCa with an excellent positive predictive value. The use of mp-MRI during a MRI-guided biopsy (MRGB) procedure improves the quality of a targeted biopsy. The aim of this article is to provide an overview about the MRGB technique for PCa detection, to review the accuracy and clinical indications of MRGB and discuss its current issues and further directions. A MRGB seems accurate and efficient for the detection of clinically significant PCa in men with previous negative TRUSBx. Moreover, it may decrease the detection of clinically insignificant cancers with fewer biopsy cores. PMID:25598677

  15. Renal biopsy: methods and interpretation.

    PubMed

    Vaden, Shelly L

    2004-07-01

    Renal biopsy most often is indicated in the management of dogs and cats with glomerular disease or acute renal failure. Renal biopsy can readily be performed in dogs and cats via either percutaneous or surgical methods. Care should be taken to ensure that proper technique is used. When proper technique is employed and patient factors are properly addressed, renal biopsy is a relatively safe procedure that minimally affects renal function. Patients should be monitored during the post biopsy period for severe hemorrhage, the most common complication. Accurate diagnosis of glomerular disease, and therefore, accurate treatment planning,requires that the biopsy specimens not only be evaluated by light microscopy using special stains but by electron and immunofluorescent microscopy. PMID:15223207

  16. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?

    PubMed Central

    Pepe, Pietro; Pennisi, Michele; Fraggetta, Filippo

    2015-01-01

    ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa) in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years) underwent initial (285 cases) and repeat (115 cases) prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy) and 31 cores (repeat biopsy) were transperineally performed including 4 cores of the anterior zone (AZ) and 4 cores of the AZ plus 2 cores of the transition zone (TZ), respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45%) patients: in 135 (47.4%) and 45 (36%) of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy) vs 13.3% (repeat biopsy) of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5%) and 5 (71.5%) men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases), the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases). PMID:26689509

  17. Emergent Embolization of Arterial Bleeding after Vacuum-Assisted Breast Biopsy

    SciTech Connect

    Fischman, Aaron M.; Epelboym, Yan; Siegelbaum, Robert H. Weintraub, Joshua L. Kim, Edward Nowakowski, Francis S. Lookstein, Robert A.

    2012-02-15

    Vacuum-assisted core breast biopsy has become important in evaluating patients with suspicious breast lesions. It has proven to be a relatively safe procedure that in rare cases can result in vascular complications. These are the first reported cases of transcatheter embolization of uncontrolled breast hemorrhage after vacuum-assisted breast biopsy. With increased use of biopsy and larger-gauge devices, breast imaging groups may consider embolotherapy as a safe alternative for treatment of hemorrhage in a select group of patients.

  18. Human breast cancer biopsies induce eosinophil recruitment and enhance adjacent cancer cell proliferation.

    PubMed

    Szalayova, Gabriela; Ogrodnik, Aleksandra; Spencer, Brianna; Wade, Jacqueline; Bunn, Janice; Ambaye, Abiy; James, Ted; Rincon, Mercedes

    2016-06-01

    Chronic inflammation is known to facilitate cancer progression and metastasis. Less is known about the effect of acute inflammation within the tumor microenvironment, resulting from standard invasive procedures. Recent studies in mouse models have shown that the acute inflammatory response triggered by a biopsy in mammary cancer increases the frequency of distal metastases. Although tumor biopsies are part of the standard clinical practice in breast cancer diagnosis, no studies have reported their effect on inflammatory response. The objective of this study is to (1) determine whether core needle biopsies in breast cancer patients trigger an inflammatory response, (2) characterize the type of inflammatory response present, and (3) evaluate the potential effect of any acute inflammatory response on residual tumor cells. The biopsy wound site was identified in the primary tumor resection tissue samples from breast cancer patients. The inflammatory response in areas adjacent (i.e., immediately around previous biopsy site) and distant to the wound biopsy was investigated by histology and immunohistochemistry analysis. Proliferation of tumor cells was also assayed. We demonstrate that diagnostic core needle biopsies trigger a selective recruitment of inflammatory cells at the site of the biopsy, and they persist for extended periods of time. While macrophages were part of the inflammatory response, an unexpected accumulation of eosinophils at the edge of the biopsy wound was also identified. Importantly, we show that biopsy causes an increase in the proliferation rate of tumor cells located in the area adjacent to the biopsy wound. Diagnostic core needle biopsies in breast cancer patients do induce a unique acute inflammatory response within the tumor microenvironment and have an effect on the surrounding tumor cells. Therefore, biopsy-induced inflammation could have an impact on residual tumor cell progression and/or metastasis in human breast cancer. These findings

  19. How does prostate biopsy guidance error impact pathologic cancer risk assessment?

    NASA Astrophysics Data System (ADS)

    Martin, Peter R.; Gaed, Mena; Gómez, José A.; Moussa, Madeleine; Gibson, Eli; Cool, Derek W.; Chin, Joseph L.; Pautler, Stephen; Fenster, Aaron; Ward, Aaron D.

    2016-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy, but still has a substantial false negative rate. This could be improved via biopsy needle target optimization, accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As an initial step toward the broader goal of optimized prostate biopsy targeting, in this study we elucidated the impact of biopsy needle delivery error on the probability of obtaining a tumor sample, and on the core involvement. These are both important parameters to patient risk stratification and the decision for active surveillance vs. definitive therapy. We addressed these questions for cancer of all grades, and separately for high grade (>= Gleason 4+3) cancer. We used expert-contoured gold-standard prostatectomy histology to simulate targeted biopsies using an isotropic Gaussian needle delivery error from 1 to 6 mm, and investigated the amount of cancer obtained in each biopsy core as determined by histology. Needle delivery error resulted in variability in core involvement that could influence treatment decisions; the presence or absence of cancer in 1/3 or more of each needle core can be attributed to a needle delivery error of 4 mm. However, our data showed that by making multiple biopsy attempts at selected tumor foci, we may increase the probability of correctly characterizing the extent and grade of the cancer.

  20. Bone biopsy in haematological disorders.

    PubMed Central

    Burkhardt, R; Frisch, B; Bartl, R

    1982-01-01

    Bone marrow biopsies are now widely used in the investigation and follow-up of many diseases. Semi-thin sections of 8216 undecalcified biopsies of patients with haematological disorders were studied. Observations were made on the cytopenias and the myelodysplastic syndromes, the acute leukaemias the myeloproliferative disorders, Hodgkin's disease and the malignant lymphomas including multiple myeloma, hairy cell leukaemia and angioimmunoblastic lymphadenopathy. Bone marrow biopsies are essential for the differential diagnosis of most cytopenias and for the early recognition of fibrosis which most frequently occurred as a consequence of megakaryocytic proliferation in the myeloproliferative disorders. Different patterns of bone marrow involvement were found in the lymphoproliferative disorders and both their type and extent constituted factors of prognostic significance. A survey of the literature is given and the conclusion is drawn that bone marrow biopsies provide indispensible information for the diagnostic evaluation and the follow-up of patients with haematological disorders. Images PMID:7040489

  1. Gram stain of tissue biopsy

    MedlinePlus

    ... stain of tissue biopsy test involves using crystal violet stain to test a sample of tissue taken ... microscope slide. The specimen is stained with crystal violet stain and goes through more processing before it ...

  2. Experience with transjugular liver biopsy.

    PubMed Central

    Bull, H J; Gilmore, I T; Bradley, R D; Marigold, J H; Thompson, R P

    1983-01-01

    The results of 193 transjugular liver biopsies performed with a modified needle are described. An adequate specimen was obtained in 97%, and complications were rare, although puncture of the liver capsule does occur and caused bleeding in two patients. Fever after the procedure was reduced by ultrasonic cleaning of the needle. Although not easy, this technique is safe and preferable in the management of selected patients, but in most patients percutaneous biopsy is to be preferred. PMID:6629116

  3. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    SciTech Connect

    Oppenheimer, Jason D. Kasuganti, Deepa; Nayar, Ritu; Chrisman, Howard B.; Lewandowski, Robert J.; Nemcek, Albert A.; Ryu, Robert K.

    2010-08-15

    Results of thyroid biopsy determine whether thyroid nodule resection is appropriate and the extent of thyroid surgery. At our institution we use 20/22-gauge core biopsy (CBx) in conjunction with fine-needle aspiration (FNA) to decrease the number of passes and improve adequacy. Occasionally, both ultrasound (US)-guided FNA and CBx yield unsatisfactory specimens. To justify clinical recommendations for these unsatisfactory thyroid biopsies, we compare rates of malignancy at surgical resection for unsatisfactory biopsy results against definitive biopsy results. We retrospectively reviewed a database of 1979 patients who had a total of 2677 FNA and 663 CBx performed by experienced interventional radiologists under US guidance from 2003 to 2006 at a tertiary-care academic center. In 451 patients who had surgery following biopsy, Fisher's exact test was used to compare surgical malignancy rates between unsatisfactory and malignant biopsy cohorts as well as between unsatisfactory and benign biopsy cohorts. We defined statistical significance at P = 0.05. We reported an overall unsatisfactory thyroid biopsy rate of 3.7% (100/2677). A statistically significant higher rate of surgically proven malignancies was found in malignant biopsy patients compared to unsatisfactory biopsy patients (P = 0.0001). The incidence of surgically proven malignancy in unsatisfactory biopsy patients was not significantly different from that in benign biopsy patients (P = 0.8625). In conclusion, an extremely low incidence of malignancy was associated with both benign and unsatisfactory thyroid biopsy results. The difference in incidence between these two groups was not statistically significant. Therefore, patients with unsatisfactory biopsy specimens can be reassured and counseled accordingly.

  4. Accuracy evaluation of a 3D ultrasound-guided biopsy system

    NASA Astrophysics Data System (ADS)

    Wooten, Walter J.; Nye, Jonathan A.; Schuster, David M.; Nieh, Peter T.; Master, Viraj A.; Votaw, John R.; Fei, Baowei

    2013-03-01

    Early detection of prostate cancer is critical in maximizing the probability of successful treatment. Current systematic biopsy approach takes 12 or more randomly distributed core tissue samples within the prostate and can have a high potential, especially with early disease, for a false negative diagnosis. The purpose of this study is to determine the accuracy of a 3D ultrasound-guided biopsy system. Testing was conducted on prostate phantoms created from an agar mixture which had embedded markers. The phantoms were scanned and the 3D ultrasound system was used to direct the biopsy. Each phantom was analyzed with a CT scan to obtain needle deflection measurements. The deflection experienced throughout the biopsy process was dependent on the depth of the biopsy target. The results for markers at a depth of less than 20 mm, 20-30 mm, and greater than 30 mm were 3.3 mm, 4.7 mm, and 6.2 mm, respectively. This measurement encapsulates the entire biopsy process, from the scanning of the phantom to the firing of the biopsy needle. Increased depth of the biopsy target caused a greater deflection from the intended path in most cases which was due to an angular incidence of the biopsy needle. Although some deflection was present, this system exhibits a clear advantage in the targeted biopsy of prostate cancer and has the potential to reduce the number of false negative biopsies for large lesions.

  5. Optimizing prostate needle biopsy through 3D simulation

    NASA Astrophysics Data System (ADS)

    Zeng, Jianchao; Kaplan, Charles; Xuan, Jian Hua; Sesterhenn, Isabell A.; Lynch, John H.; Freedman, Matthew T.; Mun, Seong K.

    1998-06-01

    Prostate needle biopsy is used for the detection of prostate cancer. The protocol of needle biopsy that is currently routinely used in the clinical environment is the systematic sextant technique, which defines six symmetric locations on the prostate surface for needle insertion. However, this protocol has been developed based on the long-term observation and experience of urologists. Little quantitative or scientific evidence supports the use of this biopsy technique. In this research, we aim at developing a statistically optimized new prostate needle biopsy protocol to improve the quality of diagnosis of prostate cancer. This new protocol will be developed by using a three-dimensional (3-D) computer- based probability map of prostate cancer. For this purpose, we have developed a computer-based 3-D visualization and simulation system with prostate models constructed from the digitized prostate specimens, in which the process of prostate needle biopsy can be simulated automatically by the computer. In this paper, we first develop an interactive biopsy simulation mode in the system, and evaluate the performance of the automatic biopsy simulation with the sextant biopsy protocol by comparing the results by the urologist using the interactive simulation mode with respect to 53 prostate models. This is required to confirm that the automatic simulation is accurate and reliable enough for the simulation with respect to a large number of prostate models. Then we compare the performance of the existing protocols using the automatic biopsy simulation system with respect to 107 prostate models, which will statistically identify if one protocol is better than another. Since the estimation of tumor volume is extremely important in determining the significance of a tumor and in deciding appropriate treatment methods, we further investigate correlation between the tumor volume and the positive core volume with 89 prostate models. This is done in order to develop a method to

  6. Transurethral needle biopsy: a novel technique for pathologic diagnosis of bladder tumors in children.

    PubMed

    Lightfoot, Michelle; Li, Roger; Alsyouf, Muhannad; Nicolay, Lesli; Chamberlin, David

    2014-12-01

    Although rare, both benign and malignant bladder tumors are occasionally encountered in the pediatric population. In the present article, the technique of transurethral needle biopsy, which utilizes an 18-gauge core biopsy instrument inserted through a 9.5 French offset pediatric cystoscope to obtain diagnostic biopsies, is described. This technique has been used successfully in two patients, both of whom had an inflammatory myofibroblastic tumor on biopsy and on final pathology from partial cystectomy. This provides an alternative technique, which may be used when a pediatric resectoscope is not available or in patients with a small caliber urethra.

  7. Toward 3D-guided prostate biopsy target optimization: an estimation of tumor sampling probabilities

    NASA Astrophysics Data System (ADS)

    Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

    2014-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the ~23% false negative rate of clinical 2D TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsy still yields false negatives. Therefore, we propose optimization of biopsy targeting to meet the clinician's desired tumor sampling probability, optimizing needle targets within each tumor and accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. We obtained multiparametric MRI and 3D TRUS images from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D surfaces that were registered to 3D TRUS. We estimated the probability, P, of obtaining a tumor sample with a single biopsy. Given an RMS needle delivery error of 3.5 mm for a contemporary fusion biopsy system, P >= 95% for 21 out of 81 tumors when the point of optimal sampling probability was targeted. Therefore, more than one biopsy core must be taken from 74% of the tumors to achieve P >= 95% for a biopsy system with an error of 3.5 mm. Our experiments indicated that the effect of error along the needle axis on the percentage of core involvement (and thus the measured tumor burden) was mitigated by the 18 mm core length.

  8. Confirmatory biopsy for the assessment of prostate cancer in men considering active surveillance: reference centre experience

    PubMed Central

    Bosco, Cecilia; Cozzi, Gabriele; Kinsella, Janette; Bianchi, Roberto; Acher, Peter; Challacombe, Benjamin; Popert, Rick; Brown, Christian; George, Gincy; Van Hemelrijck, Mieke; Cahill, Declan

    2016-01-01

    Objectives To evaluate how accurate a 12-core transrectal biopsy derived low-risk prostate cancer diagnosis is for an active surveillance programme by comparing the histological outcome with that from confirmatory transperineal sector biopsy. Subjects and methods The cohort included 166 men diagnosed with low volume Gleason score 3+3 prostate cancer on initial transrectal biopsy who also underwent a confirmatory biopsy. Both biopsy techniques were performed according to standard protocols and samples were taken for histopathology analysis. Subgroup analysis was performed according to disease severity at baseline to determine possible disease parameters of upgrading at confirmatory biopsy. Results After confirmatory biopsy, 34% demonstrated Gleason score upgrade, out of which 25% were Gleason score 3+4 and 8.5% primary Gleason pattern 4. Results remained consistent for the subgroup analysis and a weak positive association, but not statistically significant, between prostate specific antigen (PSA), age, and percentage of positive cores, and PCa upgrading at confirmatory biopsy was found. Conclusion In our single centre study, we found that one-third of patients had higher Gleason score at confirmatory biopsy. Furthermore 8.5% of these upgraders had a primary Gleason pattern 4. Our results together with previously published evidence highlight the need for the revision of current guidelines in prostate cancer diagnosis for the selection of men for active surveillance. PMID:27170833

  9. [Flexible bronchoscopy techniques: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy].

    PubMed

    Escribano Montaner, A; Moreno Galdó, A

    2005-04-01

    This article completes previous recommendations of the Techniques Group of the Spanish Society of Pediatric Pulmonologists on the practice of flexible bronchoscopy in children. We review the most frequently performed diagnostic and therapeutic procedures applied through the flexible bronchoscope: bronchoalveolar lavage, bronchial biopsy and transbronchial biopsy. Recommendations are also provided on the practice of nonbronchoscopic bronchoalveolar lavage. We review the indications and contraindications of these techniques, the equipment required, and the preparation and monitoring of the patient before, during and after the procedure. The complications of these techniques are also discussed. These recommendations may be adopted, modified or rejected according to clinical needs and constraints.

  10. Development of a 3D ultrasound-guided prostate biopsy system

    NASA Astrophysics Data System (ADS)

    Cool, Derek; Sherebrin, Shi; Izawa, Jonathan; Fenster, Aaron

    2007-03-01

    Biopsy of the prostate using ultrasound guidance is the clinical gold standard for diagnosis of prostate adenocarinoma. However, because early stage tumors are rarely visible under US, the procedure carries high false-negative rates and often patients require multiple biopsies before cancer is detected. To improve cancer detection, it is imperative that throughout the biopsy procedure, physicians know where they are within the prostate and where they have sampled during prior biopsies. The current biopsy procedure is limited to using only 2D ultrasound images to find and record target biopsy core sample sites. This information leaves ambiguity as the physician tries to interpret the 2D information and apply it to their 3D workspace. We have developed a 3D ultrasound-guided prostate biopsy system that provides 3D intra-biopsy information to physicians for needle guidance and biopsy location recording. The system is designed to conform to the workflow of the current prostate biopsy procedure, making it easier for clinical integration. In this paper, we describe the system design and validate its accuracy by performing an in vitro biopsy procedure on US/CT multi-modal patient-specific prostate phantoms. A clinical sextant biopsy was performed by a urologist on the phantoms and the 3D models of the prostates were generated with volume errors less than 4% and mean boundary errors of less than 1 mm. Using the 3D biopsy system, needles were guided to within 1.36 +/- 0.83 mm of 3D targets and the position of the biopsy sites were accurately localized to 1.06 +/- 0.89 mm for the two prostates.

  11. Oral biopsy: oral pathologist's perspective.

    PubMed

    Kumaraswamy, K L; Vidhya, M; Rao, Prasanna Kumar; Mukunda, Archana

    2012-01-01

    Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

  12. An approach to duodenal biopsies

    PubMed Central

    Serra, S; Jani, P A

    2006-01-01

    The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis. PMID:16679353

  13. Vacuum enhanced cutaneous biopsy instrument

    DOEpatents

    Collins, Joseph

    2000-01-01

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  14. Biopsy techniques for intraocular tumors

    PubMed Central

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-01-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88–95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  15. Vacuum Enhanced Cutaneous Biopsy Instrument

    SciTech Connect

    Collins, Joseph

    1999-06-25

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  16. [The Diagnostic Value of Pre-Biopsy Magnetic Resonance Imaging (MRI) for Detecting Prostate Cancer].

    PubMed

    Mori, Kohei; Miyoshi, Yasuhide; Yoneyama, Shuko; Ishida, Hiroaki; Hattori, Yusuke; Teranishi, Jun-ichi; Kondo, Keiichi; Noguchi, Kazumi

    2016-01-01

    We examined the value of pre-biopsy magnetic resonance imaging (MRI) for detecting prostate cancer. We analyzed 267 men with prostate-specific antigen (PSA) levels of 3-10 ng/ml who underwent systematic prostate needle biopsy. From April 2009 to March 2011, a total of 98 male patients underwent 16-core prostatic biopsies without pre-biopsy magnetic resonance imaging (MRI) (nonenforcement group). From April 2011 to March 2013, 169 men underwent pre-biopsy MRI [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] (enforcement group). When MRI findings indicated cancer in the latter group, in addition to the systematic 16-core biopsy one or two targeted biopsies were performed. Patients without suspicious MRI findings underwent only systematic 16-core biopsy. Cancer detection rates in the nonenforcement and enforcement groups were 42.9% (48/92) and 46. 2% (78/169), respectively. The difference did not reach significance (p=0.612). Although the cancer detection rates were 39.4% (41/104) in the MRI-negative group and 56. 9% (37/65) in the MRI-positive group (p=0.039), the sensitivity and specificity for cancer detection by MRI were relatively low: 47.4% and 69.2%, respectively. By receiver-operating curve analysis, the area under the curve for cancer detection by MRI was only 0.583. There were two study limitations. First, the patient sample size was small. Second, it is unclear whether an adequate sample of the suspicious lesion was obtained by biopsy. We thus demonstrated that it might be improper to base a diagnosis solely on pre-biopsy MRI (T2WI and DWI) findings in men with serum PSA levels of 3-10 ng/ml.

  17. Transjugular Renal Biopsy: Our Experience and Technical Considerations

    SciTech Connect

    See, Teik Choon; Thompson, Barbara C.; Howie, Alexander J.; Karamshi, M.; Papadopoulou, Anthie M.; Davies, Neil; Tibballs, Jonathan

    2008-09-15

    The purpose of this study was to describe the indications for and technique of transjugular renal biopsy (TJRB) and evaluate the efficacy and complications of this method. We performed a retrospective review of 59 patients who underwent TJRB using the Quick-core needle biopsy system (Cook, Letchworth, UK) over a 4-year period. The indications for obtaining renal biopsy included acute renal failure, chronic renal failure, nephrotic syndrome, and proteinuria with or without other associated disease. Indications for the transjugular approach included coagulopathy, biopsy of a solitary kidney or essentially single functioning kidney, simultaneous renal and hepatic biopsy, morbid obesity, and failed percutaneous biopsy. All but four cases were performed via the right internal jugular vein. The right, left, or both renal veins were cannulated in 41, 14, and 4 cases, respectively. Combined liver and renal biopsies were obtained in seven cases. Diagnostic biopsy specimens were obtained in 56 of 59 patients (95%). The number and size of tissue cores ranged from 1 to 9 mm and from 1 to 20 mm, respectively. The mean numbers of glomeruli per procedure on light microscopy and electron microscopy were 10.3 and 2.6, respectively. Specimens for immunohistology were acquired in 49 cases, of which 40 were adequate. Of the 56 successful TJRB procedures, 34 (61%) were associated with isolated capsular perforation (19), contained subcapsular leak (10), isolated collecting system puncture (1), and concurrent collecting system and capsular perforation (4). There was a significant increase in capsular perforation with six or more needle passes, although no significant correlation was seen between number of needle passes and complication. Six patients had minor complications defined as hematuria or loin pain. Seven patients developed major complications, of whom five received blood transfusion alone. Two required intervention: in one an arteriocalyceal fistula was embolized and the patient

  18. Ultrasound image-guided core biopsy of the breast.

    PubMed

    Klimberg, V Suzanne; Rivere, Amy

    2016-06-01

    Results of partial mastectomy or lumpectomy including margin negativity are improved when preoperative diagnosis is obtained. This article describes the various techniques, instruments, utility and complications of the techniques. Emphasis is given to ultrasound (US) usefulness and effectiveness.

  19. Biopsies

    MedlinePlus

    ... computed tomography (CT) , fluoroscopy , ultrasound , or MRI . A mammography unit is a rectangular box that houses the ... seen. Some lesions, such as clustered calcifications on mammography are not as clearly shown with ultrasound as ...

  20. Biopsy

    MedlinePlus

    ... Sections of the JAOCD JAOCD Archive Published Members Online Dermatology Journals Edit This Favorite Name: Category: Share: Yes ... 2/2017 2017 AOCD Spring Current Concepts in Dermatology Meeting more Latest News ... Surveys About AOCD The AOCD was recognized in ...

  1. Liquid biopsy in liver cancer.

    PubMed

    Labgaa, Ismail; Villanueva, Augusto

    2015-04-01

    Liver cancer has become the second cause of cancer-related death worldwide. Most patients are still diagnosed at intermediate or advanced stage, where potentially curative treatment options are not recommended. Unlike other solid tumors, there are no validated oncogenic addiction loops and the only systemic agent to improve survival in advanced disease is sorafenib. All phase 3 clinical trials testing molecular therapies after sorafenib have been negative, none of which selected patients based on predictive biomarkers of response. Theoretically, analysis of circulating cancer byproducts (e.g., circulating tumor cells, cell-free nucleic acids), namely "liquid biopsy," could provide easy access to molecular tumor information, improve patients' stratification and allow to assess tumor dynamics over time. Recent technical developments and preliminary data from other malignancies indicate that liquid biopsy might have a role in the future management of cancer patients. PMID:25977189

  2. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DUE TO PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a... does not have pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence of the presence of pneumoconiosis....

  3. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... DUE TO PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a... does not have pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence of the presence of pneumoconiosis....

  4. Testing Biopsy and Cytology Specimens for Cancer

    MedlinePlus

    ... articles window. My Saved Articles » My ACS » Testing Biopsy and Cytology Specimens for Cancer Download Printable Version [ ... on the topics below to get started. Testing Biopsy and Cytology Specimens for Cancer How is cancer ...

  5. Interventional Optical Molecular Imaging Guidance during Percutaneous Biopsy

    PubMed Central

    Sheth, Rahul A.; Heidari, Pedram; Esfahani, Shadi A.; Wood, Bradford J.

    2014-01-01

    Purpose To investigate indocyanine green (ICG) as a molecular beacon for malignant lesions within the liver and evaluate the ability of a developed handheld imaging system to allow measurement of ICG fluorescence within focal hepatic lesions with high target-to-background ratios in a mouse model. Materials and Methods All animal experiments were approved by the institutional animal care committee. A handheld optical molecular imaging device was constructed to pass through the introducer needle of a standard percutaneous biopsy kit. An ex vivo phantom system was constructed to quantify tissue attenuation properties of ICG in liver parenchyma. Subsequently, intrahepatic colorectal cancer metastases were generated in nude mice, and epifluorescence imaging of ICG, as well as histologic analysis of the explanted livers, was performed at 3 weeks after implantation (n = 6). Epifluorescence imaging with the handheld imaging device was then performed on intrahepatic colorectal metastases after the administration of ICG (n = 15) at 3, 6, and 24 hours after injection. Target-to-background ratios were calculated for each time point. Subsequently, a core biopsy of intrahepatic colorectal metastases was performed by using a standard clinical 18-gauge biopsy needle. Results There was avid localization of ICG to the focal lesions at all time points. Similarly, fluorescence within the tumors was greater than that within normal liver, as detected with the handheld imaging system (mean target-to-background ratio ± standard deviation, 3.9 ± 0.2 at 24 hours). A core biopsy of tumor and normal adjacent liver by using a standard biopsy needle demonstrated a sharp margin of fluorescence intensity at the tumor-liver interface. Conclusion The custom-designed molecular imaging device, in combination with ICG, readily allowed differentiation between normal and malignant tissue in a murine model of intrahepatic colorectal metastasis. © RSNA, 2014 PMID:24520946

  6. Trans-rectal interventional MRI: initial prostate biopsy experience

    NASA Astrophysics Data System (ADS)

    Greenwood, Bernadette M.; Behluli, Meliha R.; Feller, John F.; May, Stuart T.; Princenthal, Robert; Winkel, Alex; Kaminsky, David B.

    2010-02-01

    Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland when evaluated along with T2-weighted images, diffusion-weighted images (DWI) and their corresponding apparent diffusion coefficient (ADC) maps can yield valuable information in patients with rising or elevated serum prostate-specific antigen (PSA) levels1. In some cases, patients present with multiple negative trans-rectal ultrasound (TRUS) biopsies, often placing the patient into a cycle of active surveillance. Recently, more patients are undergoing TRIM for targeted biopsy of suspicious findings with a cancer yield of ~59% compared to 15% for second TRUS biopsy2 to solve this diagnostic dilemma and plan treatment. Patients were imaged in two separate sessions on a 1.5T magnet using a cardiac phased array parallel imaging coil. Automated CAD software was used to identify areas of wash-out. If a suspicious finding was identified on all sequences it was followed by a second imaging session. Under MRI-guidance, cores were acquired from each target region3. In one case the microscopic diagnosis was prostatic intraepithelial neoplasia (PIN), in the other it was invasive adenocarcinoma. Patient 1 had two negative TRUS biopsies and a PSA level of 9ng/mL. Patient 2 had a PSA of 7.2ng/mL. He underwent TRUS biopsy which was negative for malignancy. He was able to go on to treatment for his prostate carcinoma (PCa)4. MRI may have an important role in a subset of patients with multiple negative TRUS biopsies and elevated or rising PSA.

  7. Can Confirmatory Biopsy be Omitted in Prostate Cancer Active Surveillance Patients with Favorable Diagnostic Features?

    PubMed Central

    Satasivam, Prassannah; Poon, Bing Ying; Ehdaie, Behfar; Vickers, Andrew J.; Eastham, James A.

    2016-01-01

    Purpose We evaluated whether initial diagnostic parameters could predict the confirmatory biopsy result in patients initiating active surveillance for prostate cancer, to determine whether some men at low risk of reclassification could be spared unnecessary biopsy. Materials and Methods The cohort included 392 men with Gleason 6 prostate cancer on initial biopsy undergoing confirmatory biopsy. We used univariate and multivariable logistic regression to assess if high-grade cancer (Gleason ≥ 7) on confirmatory biopsy could be predicted from initial diagnostic parameters (prostate-specific antigen density, magnetic resonance imaging result, percent positive cores, percent cancer in positive cores, and total tumor length). Results Median age was 62 years (IQR 56–66) and 47% of patients were found to have a dominant or focal lesion on magnetic resonance imaging. Of the 392 patients, 44 (11%) were found to have high-grade cancer on confirmatory biopsy, among whom 39 had 3+4, 1 had 4+3, 3 had Gleason 8, and 1 patient had Gleason 9 disease. All predictors were significantly associated with high-grade cancer at confirmatory biopsy on univariate analysis. However, in the multivariable model only prostate-specific antigen density and total tumor length were significantly associated (AUC of 0.85). Using this model to select patients for confirmatory biopsy would generally provide a higher net benefit than performing confirmatory biopsy in all patients, across a wide range of threshold probabilities. Conclusion If externally validated, a model based on initial diagnostic criteria could be used to avoid confirmatory biopsy in many patients initiating active surveillance. PMID:26192258

  8. Biopsy of parotid masses: Review of current techniques

    PubMed Central

    Haldar, Sananda; Sinnott, Joseph D; Tekeli, Kemal M; Turner, Samuel S; Howlett, David C

    2016-01-01

    Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology (FNAC) or ultrasound guided core biopsy (USCB) should be the standard for obtaining a biopsy. The aim of this review is to assess the current evidence available to assess the benefits of each technique and also to assess the use of intra-operative frozen section (IOFS). Literature searches were performed using pubmed and google scholar. The literature has been reviewed and the evidence is presented. FNAC is an accepted and widely used technique. It has been shown to have variable diagnostic capabilities depending on centres and experience of staff. USCB has a highly consistent diagnostic accuracy and can help with tumour grading and staging. However, the technique is more invasive and there is a question regarding potential for seeding. Furthermore, USCB is less likely to be offered as part of a one-stop clinic. IOFS has no role as a first line diagnostic technique but may be reserved as an adjunct or for lesions not amenable to percutaneous biopsy. On balance, USCB seems to be the method of choice. The current evidence suggests it has superior diagnostic potential and is safe. With time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice. PMID:27247715

  9. Ultrasound-guided biopsies: tricks, needle tips, and other fine points.

    PubMed

    Feld, Rick I

    2004-09-01

    Ultrasound (US)-guided biopsy of thyroid nodules, abdominal masses, liver masses, random core liver biopsies, as well as aspiration of abdominal or pleural fluid is now routine practice. The ability of US to guide biopsy of abnormalities seen on cross-sectional imaging studies is well recognized as an efficient and effective means of achieving a tissue diagnosis. Its use requires basic knowledge of US image analysis, but clinically useful intuitive and nonintuitive methods can enhance its strengths. The purpose of this review is to provide a practical guide to some of these tricks that may be useful in everyday clinical practice. PMID:15322386

  10. A MEMS-Based Micro Biopsy Actuator for the Capsular Endoscope Using LiGA Process

    NASA Astrophysics Data System (ADS)

    Park, Sunkil; Koo, Kyo-In; Kim, Gil-Sub; Bang, Seoung Min; Song, Si Young; Chu, Chong Nam; Jeon, Doyoung; Cho, Dongil ``Dan''

    2007-01-01

    This paper presents a LiGA (German acronym for LIthografie, Galvanoformung, Abformung) based micro biopsy actuator for the capsular endoscope. The proposed fabricated actuator aims to extract sample tissues inside small gastric intestines, that cannot be reached by conventional biopsy. The actuator size is 10 mm in diameter and 1.8 mm in length. The mechanism is of a slider-crank type. The actuator consists of trigger, rotational module, and micro biopsy tool. The core components are fabricated using the LiGA process, for overcoming the limitations in accuracy of conventional precision machining.

  11. Upgrading the Gleason Score in Extended Prostate Biopsy: Implications for Treatment Choice

    SciTech Connect

    Moreira Leite, Katia Ramos Camara-Lopes, Luiz H.A.; Dall'Oglio, Marcos F.; Cury, Jose; Antunes, Alberto A.; Sanudo, Adriana; Srougi, Miguel

    2009-02-01

    Purpose: To determine the incidence of overestimation of Gleason score (GS) in extended prostate biopsy, and consequently circumventing unnecessary aggressive treatment. Methods and Materials: This is a retrospective study of 464 patients who underwent prostate biopsy and radical prostatectomy between January 2001 and November 2007. The GS from biopsy and radical prostatectomy were compared. The incidence of overestimation of GS in biopsies and tumor volume were studied. Multivariate analysis was applied to find parameters that predict upgrading the GS in prostate biopsy. Results: The exact agreement of GS between prostate biopsy and radical prostatectomy occurred in 56.9% of cases. In 29.1% cases it was underestimated, and it was overestimated in 14%. One hundred and six (22.8%) patients received a diagnosis of high GS (8, 9, or 10) in a prostate biopsy. In 29.2% of cases, the definitive Gleason Score was 7 or lower. In cases in which GS was overestimated in the biopsy, tumors were significantly smaller. In multivariate analysis, the total percentage of tumor was the only independent factor in overestimation of GS. Tumors occupying less than 33% of cores had a 5.6-fold greater chance of being overestimated. Conclusion: In the extended biopsy era and after the International Society of Urological Pathology consensus on GS, almost one third of tumors considered to have high GS at the biopsy may be intermediate-risk cancers. In that condition, tumors are smaller in biopsy. This should be remembered by professionals involved with prostate cancer to avoid overtreatment and undesirable side effects.

  12. PRELIMINARY EVALUATION OF SPIROTOME® DEVICE FOR LIVER BIOPSY IN GREEN IGUANAS (IGUANA IGUANA): A PILOT STUDY.

    PubMed

    Nardini, Giordano; Origgi, Francesco C; Leopardi, Stefania; Zaghini, Anna; Saunders, Jimmy H; Vignoli, Massimo

    2016-06-01

    The aim of this study was to evaluate a large-core manual biopsy device (Spirotome(®), Medinvents, 3500 Hasselt, Belgium) for liver sampling and histologic diagnosis in green iguanas (Iguana iguana). The study included eight green iguanas, and two ultrasound-guided biopsies were collected for each lizard, for 16 biopsies in total. The procedure was carried out under general anesthesia induced by intravenous injection of propofol (10 mg/kg) maintained with a mixture of 2.0% isoflurane and 0.8-1.2 L/min oxygen after tracheal intubation. Fourteen (87.5%) of the 16 biopsies were considered diagnostic. Liver biopsy quality was assessed according to sample size and tissue preservation. In particular, mean length (16.2 ± 4.5 mm), width (2.2 ± 0.5 mm), area (34.8 ± 6.9 mm(2)), and number of portal areas (9.4 ± 3.9) of each biopsy were recorded for all green iguanas. The total available surface of the sections obtained from the biopsies and their grade of preservation enabled a satisfactory evaluation of the parenchymal architecture. One of the green iguanas in the study died the day after the procedure due to severe hemocoeloma. Risk assessment evaluation suggested that small green iguanas may not be suitable for this biopsy procedure. PMID:27468023

  13. PRELIMINARY EVALUATION OF SPIROTOME® DEVICE FOR LIVER BIOPSY IN GREEN IGUANAS (IGUANA IGUANA): A PILOT STUDY.

    PubMed

    Nardini, Giordano; Origgi, Francesco C; Leopardi, Stefania; Zaghini, Anna; Saunders, Jimmy H; Vignoli, Massimo

    2016-06-01

    The aim of this study was to evaluate a large-core manual biopsy device (Spirotome(®), Medinvents, 3500 Hasselt, Belgium) for liver sampling and histologic diagnosis in green iguanas (Iguana iguana). The study included eight green iguanas, and two ultrasound-guided biopsies were collected for each lizard, for 16 biopsies in total. The procedure was carried out under general anesthesia induced by intravenous injection of propofol (10 mg/kg) maintained with a mixture of 2.0% isoflurane and 0.8-1.2 L/min oxygen after tracheal intubation. Fourteen (87.5%) of the 16 biopsies were considered diagnostic. Liver biopsy quality was assessed according to sample size and tissue preservation. In particular, mean length (16.2 ± 4.5 mm), width (2.2 ± 0.5 mm), area (34.8 ± 6.9 mm(2)), and number of portal areas (9.4 ± 3.9) of each biopsy were recorded for all green iguanas. The total available surface of the sections obtained from the biopsies and their grade of preservation enabled a satisfactory evaluation of the parenchymal architecture. One of the green iguanas in the study died the day after the procedure due to severe hemocoeloma. Risk assessment evaluation suggested that small green iguanas may not be suitable for this biopsy procedure.

  14. Fluorescence guidance during stereotactic biopsy

    NASA Astrophysics Data System (ADS)

    Stepp, Herbert; Beyer, Wolfgang; Brucker, David; Ehrhardt, Andre; Fischer, Stefan; Goebel, Werner; Goetz, Marcus; Guenther, Bettina; Hennig, Georg; Herms, Jochen; Irion, Klaus-Martin; Johansson, Ann; Kienast, Yvonne; Kniebuehler, Gesa; Li, Pan; Ruehm, Adrian; Sandner, Sabine

    2012-02-01

    Objective: When a stereotactic biopsy is taken to enable histopathological diagnosis of a suspected brain tumor, it is essential to i) do this safely, that is not injure a major blood vessel and ii) to obtain relevant vital material from the tumor. We are investigating the suitability of Indocyanine Green (ICG) fluorescence for blood vessel recognition and 5- Aminolevulinic acid (5-ALA) induced Protoporphyrin IX (PpIX) fluorescence for identification of proliferative brain tumor tissue. Methods: A fiber-optic endoscopic approach was studied to generate and detect both fluorescence signals. PpIX concentrations in brain tumors have been measured by chemical extraction. Preliminary equipment was studied in a mouse model. Results: PpIX-concentrations in glioblastoma tissue showed high inner- and inter-patient variability, but each patient out of 15 with interpretable data showed at least one sample with a PpIX-concentration exceeding 2.4 μmol/l, which is easily detectable by state-of-the-art fiberoptic fluorescence spectroscopy and imaging. The imaging fluoroscope with 30,000 pixels resolution could be introduced through a position controlled stereotactic needle. ICG-fluorescence from vessels with diameters >= 0.1 mm can be detected with a contrast of 2-2.5 against surrounding tissue. Conclusion: Fluorescence detection during stereotactic biopsy might increase safety and precision of the procedure significantly.

  15. DNA adducts in bronchial biopsies.

    PubMed

    Dunn, B P; Vedal, S; San, R H; Kwan, W F; Nelems, B; Enarson, D A; Stich, H F

    1991-06-19

    To investigate the feasibility of measuring DNA-carcinogen adducts in the lungs of non-surgical patients, endobronchial biopsies were obtained from 78 patients undergoing routine diagnostic bronchoscopy. Lung cancer was present in 37 (47%) of the patients. DNA was isolated from the tissues and analyzed by HPLC- or nuclease-PI-enriched 32P-postlabelling, using procedures selective for aromatic adducts. Chromatograms from all 28 current smokers showed a distinctive diagonal adduct zone which was present in only 24 of 40 ex-smokers and 4 of 10 lifetime non-smokers. Adduct levels and chromatographic patterns were similar in bronchial tissue from different lobes of the lung, in bronchial and alveolar tissue, and in tumor and non-tumor bronchial tissue taken from the same subject. Bronchial DNA adduct levels were strongly associated with cigarette smoking status and dropped rapidly after smoking ceased. Higher levels of DNA adducts seen in the lung-cancer patients were mainly due to cigarette smoking. Frequent alcohol intake was the only dietary factor associated with higher levels of bronchial DNA adducts. We conclude that the level of bronchial DNA adducts is strongly associated with cigarette-smoking history and with alcohol intake, but is not associated with lung cancer independently from its relation to smoking. The results indicate the feasibility of using 32P-postlabelling to detect and quantitate genetic damage in bronchial biopsy specimens.

  16. Single-Pass Percutaneous Liver Biopsy for Diffuse Liver Disease Using an Automated Device: Experience in 154 Procedures

    SciTech Connect

    Rivera-Sanfeliz, Gerant Kinney, Thomas B.; Rose, Steven C.; Agha, Ayad K.M.; Valji, Karim; Miller, Franklin J.; Roberts, Anne C.

    2005-06-15

    Purpose: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18G Express core needle biopsy system.Methods: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated.Results: All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to home after 4 hr of postprocedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1-42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%).Conclusions: Single-pass percutaneous US-guided liver biopsy with the INRAD 18G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted.

  17. Basics of kidney biopsy: A nephrologist's perspective

    PubMed Central

    Agarwal, S. K.; Sethi, S.; Dinda, A. K.

    2013-01-01

    The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from Vim–Silverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM) is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations. PMID:23960337

  18. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    PubMed Central

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. Patients and methods. In 14 women (median age 51 years) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data. Results The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics. Conclusions Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only. PMID:23077445

  19. Mechanically assisted 3D ultrasound guided prostate biopsy system.

    PubMed

    Bax, Jeffrey; Cool, Derek; Gardi, Lori; Knight, Kerry; Smith, David; Montreuil, Jacques; Sherebrin, Shi; Romagnoli, Cesare; Fenster, Aaron

    2008-12-01

    There are currently limitations associated with the prostate biopsy procedure, which is the most commonly used method for a definitive diagnosis of prostate cancer. With the use of two-dimensional (2D) transrectal ultrasound (TRUS) for needle-guidance in this procedure, the physician has restricted anatomical reference points for guiding the needle to target sites. Further, any motion of the physician's hand during the procedure may cause the prostate to move or deform to a prohibitive extent. These variations make it difficult to establish a consistent reference frame for guiding a needle. We have developed a 3D navigation system for prostate biopsy, which addresses these shortcomings. This system is composed of a 3D US imaging subsystem and a passive mechanical arm to minimize prostate motion. To validate our prototype, a series of experiments were performed on prostate phantoms. The 3D scan of the string phantom produced minimal geometric distortions, and the geometric error of the 3D imaging subsystem was 0.37 mm. The accuracy of 3D prostate segmentation was determined by comparing the known volume in a certified phantom to a reconstructed volume generated by our system and was shown to estimate the volume with less then 5% error. Biopsy needle guidance accuracy tests in agar prostate phantoms showed that the mean error was 2.1 mm and the 3D location of the biopsy core was recorded with a mean error of 1.8 mm. In this paper, we describe the mechanical design and validation of the prototype system using an in vitro prostate phantom. Preliminary results from an ongoing clinical trial show that prostate motion is small with an in-plane displacement of less than 1 mm during the biopsy procedure.

  20. Identification of Threshold Prostate Specific Antigen Levels to Optimize the Detection of Clinically Significant Prostate Cancer by Magnetic Resonance Imaging/Ultrasound Fusion Guided Biopsy

    PubMed Central

    Shakir, Nabeel A.; George, Arvin K.; Siddiqui, M. Minhaj; Rothwax, Jason T.; Rais-Bahrami, Soroush; Stamatakis, Lambros; Su, Daniel; Okoro, Chinonyerem; Raskolnikov, Dima; Walton-Diaz, Annerleim; Simon, Richard; Turkbey, Baris; Choyke, Peter L.; Merino, Maria J.; Wood, Bradford J.; Pinto, Peter A.

    2015-01-01

    Purpose Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. Materials and Methods We reviewed the records of all patients enrolled in a prospective trial who underwent 12-core transrectal ultrasound and magnetic resonance imaging/ultrasound targeted biopsies from August 2007 through February 2014. Patients were stratified by each of 4 prostate specific antigen cutoffs. The greatest Gleason score using either biopsy method was compared in and across groups as well as across the population prostate specific antigen range. Clinically significant prostate cancer was defined as Gleason 7 (4 + 3) or greater. Univariate and multivariate analyses were performed. Results A total of 1,003 targeted and 12-core transrectal ultrasound biopsies were performed, of which 564 diagnosed prostate cancer for a 56.2% detection rate. Targeted biopsy led to significantly more upgrading to clinically significant disease compared to 12-core biopsy. This trend increased more with increasing prostate specific antigen, specifically in patients with prostate specific antigen 4 to 10 and greater than 10 ng/ml. Prostate specific antigen 5.2 ng/ml or greater captured 90% of upgrading by targeted biopsy, corresponding to 64% of patients who underwent multiparametric magnetic resonance imaging and subsequent fusion biopsy. Conversely a greater proportion of clinically insignificant disease was detected by 12-core vs targeted biopsy overall. These differences persisted when controlling for potential confounders on multivariate analysis. Conclusions Prostate

  1. Brain astrocytomas: biopsy, then irradiation.

    PubMed

    Lunsford, L D; Somaza, S; Kondziolka, D; Flickinger, J C

    1995-01-01

    We believe that every patient who has clinical symptoms and neurodiagnostic imaging signs suggesting a low-grade glial neoplasm should undergo early diagnosis and treatment. Observation is not warranted for a tumor that has a median survival of 5 years. The value of cytoreductive surgery for many patients has yet to be proven. It is incumbent on neurosurgeons who advocate this approach to show that this more aggressive treatment strategy is preferable to minimally invasive techniques, such as stereotactic biopsy followed by radiation therapy. Clearly, some patients who have a glial tumor require early cytoreductive surgery: those with mass effect and significant neurologic deficits. Otherwise, they will not be able to tolerate fractionated radiation therapy. Because the long-term survival rate is very poor, observation is not warranted in patients with suspected glial neoplasm. Early stereotactic biopsy immediately identifies those patients who, in fact, have more anaplastic tumors and a much worse prognosis. Such patients may benefit from early, aggressive treatments such as cytoreductive surgery, chemotherapy, and radiation. Applying this philosophy, we have achieved a median survival of more than 10 years in patients with astrocytoma. Most patients maintain a high KPS rating, and most do not require delayed cytoreductive surgery. Although we believe that the outcomes of future patients with astrocytomas will improve, we must establish whether such improvement is related to better therapeutic options, earlier recognition enabled by advanced neuroimaging, or the availability of corticosteroids (28, 30). We also believe that neurosurgeons and neuro-oncologists should stop arguing over whether cytoreductive surgery is warranted. For some patients it is, and for others it is not. This prolonged controversy indicates the basic impotence with which neurosurgeons approach glial tumors. Our energy and efforts should be devoted toward more concrete and positive goals in

  2. Image-Guided Adrenal and Renal Biopsy

    PubMed Central

    Sharma, Karun V.; Venkatesan, Aradhana M.; Swerdlow, Daniel; DaSilva, Daniel; Beck, Avi; Jain, Nidhi; Wood, Bradford J.

    2010-01-01

    Image-guided biopsy is a safe and well-established technique that is familiar to most interventional radiologists (IRs). Improvements in image-guidance, biopsy tools and biopsy techniques now routinely allow for safe biopsy of renal and adrenal lesions which traditionally were considered difficult to reach or technically challenging. Image-guided biopsy is used to establish the definitive tissue diagnosis in adrenal mass lesions that can not be fully characterized with imaging or laboratory tests alone. It is also used to establish definitive diagnosis in some cases of renal parenchymal disease and has an expanding role in diagnosis and characterization of renal masses prior to treatment. Although basic principles and techniques for image-guided needle biopsy are similar regardless of organ, this paper will highlight some technical considerations, indications and complications which are unique to the adrenal gland and kidney because of their anatomic location and physiologic features. PMID:20540919

  3. Parotid gland biopsy for investigation of xerostomia.

    PubMed

    Ferguson, J W; Edwards, J L; Christmas, P I; Ferguson, M M

    1990-08-01

    A technique is described for biopsy of the parotid salivary gland under local anaesthesia, which has been undertaken for a series of 59 patients who presented with suspected inflammatory exocrinopathy. The procedure is reliable and is associated with negligible postoperative discomfort. The advantages of the technique suggest that parotid gland biopsy is an acceptable alternative to conventional lower lip biopsy of minor salivary glands in the investigation of xerostomia.

  4. Photoacoustic biopsy: a feasibility study

    NASA Astrophysics Data System (ADS)

    Xu, Guan; Tomlins, Scott A.; Siddiqui, Javed; Davis, Mandy A.; Kunju, Lakshmi P.; Wei, John T.; Wang, Xueding

    2015-03-01

    Photoacoustic (PA) measurements encode the information associated with both physical microstructures and chemical contents in biological tissues. A two-dimensional physio-chemical spectrogram (PCS) can be formulated by combining the power spectra of PA signals acquired at a series of optical wavelengths. The analysis of PCS, or namely PA physio-chemical analysis (PAPCA), enables the quantification of the concentrations and the spatial distributions of a variety of chemical components in the tissue. The chemical components and their distribution are the two major features observed in the biopsy procedures which have been regarded as the gold standard of the diagnosis of many diseases. Taking non-alcoholic fatty liver disease and prostate cancer for example, this study investigates the feasibility of PAPCA in characterizing the histopathological changes in the diseased conditions in biological tissue. A catheter based setup facilitating measurement in deep tissues was also proposed and tested.

  5. High efficiency for prostate biopsy qualification with full-field OCT after training

    NASA Astrophysics Data System (ADS)

    Yang, C.; Ricco, R.; Sisk, A.; Duc, A.; Sibony, M.; Beuvon, F.; Dalimier, E.; Delongchamps, N. B.

    2016-02-01

    Full-field optical coherence tomography (FFOCT) offers a fast and non-destructive method of obtaining images of biological tissues at ultrahigh resolution, approaching traditional histological sections. In the context of prostate cancer diagnosis involving multiple biopsies, FFOCT could be used to validate the cores just after they are obtained in order to guide the number of biopsies to be performed. The aim of the study was to define and test a training protocol for efficient FFOCT prostate biopsy assessment. Three readers (a pathologist with previous experience with FFOCT, a pathologist new to FFOCT, and a urologist new to FFOCT) were trained to read FFOCT images of prostate biopsies on a set of 20 commented zooms (1 mm field of view) and 25 complete images. They were later tested on a set of 115 anonymized and randomized images of prostate biopsies. The results showed that an extra 30 images were necessary for more complete training as compared to prior studies. After training, pathologists obtained 100% sensitivity on high-grade cancer detection and 96% overall specificity; the urologist obtained 88% sensitivity on high-grade cancer and 89% overall specificity. Overall, the readers obtained a mean of 93% accuracy of qualifying malignancy on prostate biopsies. Moreover, the two pathologists showed a steeper learning curve than the urologist. This study demonstrates that a training protocol for such a new imaging modality may be implemented and yield very high efficiency for the pre-histologic detection of malignancy on prostate biopsies.

  6. Patients with Persistently Elevated PSA and Negative Results of TRUS-Biopsy: Does 6-Month Treatment with Dutasteride can Indicate Candidates for Re-Biopsy. What is the Best of Saturation Schemes: Transrectal or Transperineal Approach?

    PubMed

    Kravchick, Sergey; Lobik, Leonid; Cytron, Shmuel; Kravchenko, Yakov; Dor, David Ben; Peled, Ronit

    2015-09-01

    To identify patients who actually need a re - biopsy, based on alterations in PSA readings after 6-month treatment with Dutasteride. We also sought to bring out the most beneficial re-biopsy scheme. We have reviewed the records of patients with persistently elevated PSA and at least one set of TRUS biopsies. Patients who were treated with alpha -blockers/Dutasteride combination were considered as the study group, while patients in control received alpha-blockers alone. Patients in both groups underwent re-biopsy 6 months later. The two protocols of re-biopsies were used at that time: 20-24 cores saturation transrectal (ST)) and ≥ 40 cores saturation transperineal template-guided (STT) biopsies. One hundred thirty-three patients were included in this study. In 86.7 % of the patients in the study group mean PSA decreased from 7.4 ± 2.69 to 4.037 ± 1.53 (p-0.001). The overall cancer detection rate was 29 % (n-39: 19 v/s 20, control and study groups, respectively). In the study group PSA decreased to 26.73 ± 11.26 % in patients with cancer, compared with 40.54 ± 13.3 % in patients without. It must be emphasized that STT-biopsies detected significantly more cancers (38.46 v/s 20.59 %, p- 0.005). Mean cores number got to 21 ± 2.45 and 45 ± 5.65 in ST and STT biopsies, respectively. Six-month treatment with Dutasteride decreases PSA readings in 86.7 % of the patients. A PSA decline of less than 40% (cutoff) should be considered as an indicator for re-biopsy. Transperineal template-guided biopsies had a higher cancer detection rate. PMID:25753982

  7. Multiparametric MRI in Biopsy Guidance for Prostate Cancer: Fusion-Guided

    PubMed Central

    Rothwax, Jason T.; George, Arvin K.; Wood, Bradford J.; Pinto, Peter A.

    2014-01-01

    Prostate cancer (PCa) is the most common solid-organ malignancy among American men and the second most deadly. Current guidelines recommend a 12-core systematic biopsy following the finding of an elevated serum prostate-specific antigen (PSA). However, this strategy fails to detect an unacceptably high percentage of clinically significant cancers, leading researchers to develop new, innovative methods to improve the effectiveness of prostate biopsies. Multiparametric-MRI (MP-MRI) has emerged as a promising instrument in identifying suspicious regions within the prostate that require special attention on subsequent biopsy. Fusion platforms, which incorporate the MP-MRI into the biopsy itself and provide active targets within real-time imaging, have shown encouraging results in improving the detection rate of significant cancer. Broader applications of this technology, including MRI-guided focal therapy for prostate cancer, are in early phase trials. PMID:25126559

  8. 20 CFR 718.106 - Autopsy; biopsy.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Autopsy; biopsy. 718.106 Section 718.106 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND... pneumoconiosis. However, where positive findings are obtained on biopsy, the results will constitute evidence...

  9. The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

    PubMed Central

    Bayar, Göksel; Horasanlı, Kaya; Acinikli, Hüseyin; Tanrıverdi, Orhan; Dalkılıç, Ayhan; Arısan, Serdar

    2016-01-01

    Objective To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. Material and methods In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005–2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level <10 ng/mL, number of positive cores <3, maximum cancer involvement ratio <50% each core. Immediate re-biopsy (within 3 months) was performed to 65 patients who accepted AS. Finally, 43 patients who met re-biopsy criteria were included in the study. Prostate biopsy specimens were harvested from 12 cores under the guidance of transrectal ultrasound (TRUS). Re-biopsy was performed within 3 months (1–12 weeks). In re-biopsy, a total of 20 core biopsies were performed including the far lateral (6 cores) and transition zone (2 cores) in addition to standard 12 core biopsy. Our follow-up protocol is PSA measurement and digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens. Results Patients’ median age was 61 years and PSA level was 5 (2.7–9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active

  10. Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection

    PubMed Central

    Krammer, Julia; Dutschke, Anja; Kaiser, Clemens G.; Schnitzer, Andreas; Gerhardt, Axel; Radosa, Julia C.; Brade, Joachim; Schoenberg, Stefan O.; Wasser, Klaus

    2016-01-01

    Background To evaluate whether tumor localization and method of preoperative biopsy affect sentinel lymph node (SLN) detection after periareolar nuclide injection in breast cancer patients. Methods and Findings 767 breast cancer patients were retrospectively included. For lymphscintigraphy periareolar nuclide injection was performed and the SLN was located by gamma camera. Patient and tumor characteristics were correlated to the success rate of SLN mapping. SLN marking failed in 9/61 (14.7%) patients with prior vacuum-assisted biopsy and 80/706 (11.3%) patients with prior core needle biopsy. Individually evaluated, biopsy method (p = 0.4) and tumor localization (p = 0.9) did not significantly affect the SLN detection rate. Patients with a vacuum-assisted biopsy of a tumor in the upper outer quadrant had a higher odds ratio of failing in SLN mapping (OR 3.8, p = 0.09) compared to core needle biopsy in the same localization (OR 0.9, p = 0.5). Conclusions Tumor localization and preoperative biopsy method do not significantly impact SLN mapping with periareolar nuclide injection. However, the failure risk tends to rise if vacuum-assisted biopsy of a tumor in the upper outer quadrant is performed. PMID:26867137

  11. Determination of Optimum Formalin Fixation Duration for Prostate Needle Biopsies for Immunohistochemistry and Quantum Dot FISH Analysis.

    PubMed

    Sathyanarayana, Ubaradka G; Birch, Chandler; Nagle, Raymond B; Tomlins, Scott A; Palanisamy, Nallasivam; Zhang, Wenjun; Hubbard, Antony; Brunhoeber, Patrick; Wang, Yixin; Tang, Lei

    2015-01-01

    Prostate biopsy is the key clinical specimen for disease diagnosis. However, various conditions used during biopsy processing for histologic analysis may affect the performance of diagnostic tests, such as hematoxylin and eosin (H&E) staining, immunohistochemistry (IHC), or in situ hybridization (ISH). One such condition that may affect diagnostic test performance is fixation duration in 10% neutral buffered formalin (NBF). For example, prostate needle biopsies are often <1 mm in diameter and thus overfixed. It is important to understand the impact of tissue fixation duration on diagnostic test performance to enable optimized assay procedures. This study was designed to study the effect of 10% NBF fixation duration of prostate needle biopsy on multiplexed quantum dot (QD) ISH assay of ERG and PTEN, 2 genes commonly altered in prostate cancer. The samples were also evaluated for H&E staining and ERG and PTEN IHC. H&E staining and ERG and PTEN IHC were acceptable for all the durations of fixation tested. For QD ISH, we observed good signals with biopsy samples fixed from 4 to 120 hours. Biopsy specimens fixed between 8 and 72 hours gave the best signal as scored by the study pathologist. In a separate cohort of 18 routinely processed prostate biopsy cores, all cores were stained successfully with the QD ISH assay, and results were 100% concordant to ERG and PTEN IHC. We conclude that 8 to 72 hours duration of fixation for prostate needle biopsies in 10% NBF results in optimal QD ISH assay performance.

  12. Optimizing MRI-targeted fusion prostate biopsy: the effect of systematic error and anisotropy on tumor sampling

    NASA Astrophysics Data System (ADS)

    Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

    2015-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsy still has a substantial false negative rate. Therefore, we propose optimization of biopsy targeting to meet the clinician's desired tumor sampling probability, optimizing needle targets within each tumor and accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As a step toward this optimization, we obtained multiparametric MRI (mpMRI) and 3D TRUS images from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D surfaces that were registered to 3D TRUS. We estimated the probability, P, of obtaining a tumor sample with a single biopsy, and investigated the effects of systematic errors and anisotropy on P. Our experiments indicated that a biopsy system's lateral and elevational errors have a much greater effect on sampling probabilities, relative to its axial error. We have also determined that for a system with RMS error of 3.5 mm, tumors of volume 1.9 cm3 and smaller may require more than one biopsy core to ensure 95% probability of a sample with 50% core involvement, and tumors 1.0 cm3 and smaller may require more than two cores.

  13. Transjugular liver biopsy: indications, technique and results.

    PubMed

    Dohan, A; Guerrache, Y; Boudiaf, M; Gavini, J-P; Kaci, R; Soyer, P

    2014-01-01

    Transjugular liver biopsy is a safe, effective and well-tolerated technique to obtain liver tissue specimens in patients with diffuse liver disease associated with severe coagulopathies or massive ascites. Transjugular liver biopsy is almost always feasible. The use of ultrasonographic guidance for percutaneous puncture of the right internal jugular vein is recommended to decrease the incidence of local cervical minor complications. Semiautomated biopsy devices are very effective in obtaining optimal tissue samples for a precise and definite histological diagnosis with a very low rate of complication. The relative limitations of transjugular liver biopsy are the cost, the radiation dose given to the patient, the increased procedure time by comparison with the more common percutaneous liver biopsy, and the need of a well-trained interventional radiologist. PMID:24007769

  14. Biopsy needle detection in transrectal ultrasound.

    PubMed

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  15. Open lung biopsy in immunocompromised patients.

    PubMed

    McKenna, R J; Mountain, C F; McMurtrey, M J

    1984-11-01

    Increased use of open lung biopsy in the search for a treatable etiology of acute interstitial pneumonitis (AIP) in immunocompromised patients is based on the assumption that examination and cultures from biopsy specimens will yield significant information leading to beneficial treatment of the condition. To assess the true impact of the results of open lung biopsy on the subsequent treatment and outcome in such patients, a retrospective study was done of 64 consecutive patients undergoing the procedure in a recent five-year period. When open lung biopsy was performed for the diagnosis of AIP in immunocompromised patients after empiric broad spectrum treatment failed, it rarely missed a specific, treatable etiology, if present. However, the results from open lung biopsy infrequently lead to a change in the treatment that improves the patient's clinical course.

  16. Delayed culture of Leishmania in skin biopsies.

    PubMed

    Dedet, J P; Pratlong, F; Pradinaud, R; Moreau, B

    1999-01-01

    Between January 1997 and October 1998, 16 skin biopsies collected from 13 patients with cutaneous leishmaniasis in French Guiana were inoculated in culture medium after travel for 3-17 days from the place of biopsy to the culture laboratory in France. Each biopsy fragment was introduced near the flame of a Bunsen burner into the transport medium (RPMI medium supplemented with 10% fetal calf serum) which was maintained at ambient temperature during postal delivery to France. In France the biopsies were ground in sterile saline before being inoculated into NNN culture tubes. The cultures were incubated at 25 degrees C and subcultured every week until the 5th week. The cultures were positive in 9 cases, remained negative in 4, and were contaminated in 3 cases. Positive results were obtained at all seasons and for 3 different Leishmania species. The study indicates that delayed culture can yield useful results from biopsies taken in field conditions.

  17. Transplant biopsy beyond light microscopy.

    PubMed

    Adam, Benjamin; Mengel, Michael

    2015-01-01

    Despite its long-standing status as the diagnostic "gold standard", the renal transplant biopsy is limited by a fundamental dependence on descriptive, empirically-derived consensus classification. The recent shift towards personalized medicine has resulted in an increased demand for precise, mechanism-based diagnoses, which is not fully met by the contemporary transplantation pathology standard of care. The expectation is that molecular techniques will provide novel pathogenetic insights that will allow for the identification of more accurate diagnostic, prognostic, and therapeutic targets. Here we review the current state of molecular renal transplantation pathology. Despite significant research activity and progress within the field, routine adoption of clinical molecular testing has not yet been achieved. The recent development of novel molecular platforms suitable for use with formalin-fixed paraffin-embedded tissue will offer potential solution for the major barriers to implementation. The recent incorporation of molecular diagnostic criteria into the 2013 Banff classification is a reflection of progress made and future directions in the area of molecular transplantation pathology. Transcripts related to endothelial injury and NK cell activation have consistently been shown to be associated with antibody-mediated rejection. Prospective multicenter validation and implementation of molecular diagnostics for major entities remains an unmet clinical need in transplantation. It is expected that an integrated system of transplantation pathology diagnosis comprising molecular, morphological, serological, and clinical variables will ultimately provide the greatest diagnostic precision. PMID:26249165

  18. Prevention of sepsis prior to prostate biopsy

    PubMed Central

    Toner, Liam; Bolton, Damien M

    2016-01-01

    Purpose Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%–3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy. Materials and Methods A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. Results Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel. Conclusions The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice. PMID:26981590

  19. PET-Based Percutaneous Needle Biopsy.

    PubMed

    El-Haddad, Ghassan

    2016-07-01

    PET can be used to guide percutaneous needle biopsy to the most metabolic lesion, improving diagnostic yield. PET biopsy guidance can be performed using visual or software coregistration, electromagnetic needle tracking, cone-beam computed tomography (CT), and intraprocedural PET/CT guidance. PET/CT-guided biopsies allow the sampling of lesions that may not be clearly visible on anatomic imaging, or of lesions that are morphologically normal. PET can identify suspicious locations within complex tumors that are most likely to contain important diagnostic and prognostic information. PMID:27321036

  20. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    MedlinePlus

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  1. Magnetic Resonance (MR)-Guided Breast Biopsy

    MedlinePlus

    ... the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not ... considered if the lesion can be seen on mammography or on ultrasound , where the biopsy can be ...

  2. The relationship between prostate-specific antigen and prostate cancer risk: the Prostate Biopsy Collaborative Group

    PubMed Central

    Vickers, Andrew J.; Cronin, Angel M.; Roobol, Monique J.; Hugosson, Jonas; Jones, J. Stephen; Kattan, Michael W.; Klein, Eric; Hamdy, Freddie; Neal, David; Donovan, Jenny; Parekh, Dipen J.; Ankerst, Donna; Bartsch, George; Klocker, Helmut; Horninger, Wolfgang; Benchikh, Amine; Salama, Gilles; Villers, Arnauld; Freedland, Steve J.; Moreira, Daniel M.; Schröder, Fritz H.; Lilja, Hans

    2010-01-01

    PURPOSE The relationship between prostate specific antigen (PSA) level and prostate cancer risk remains subject to fundamental disagreements. We hypothesize that the risk of prostate cancer on biopsy for a given PSA level is affected by identifiable characteristics of the cohort under study. EXPERIMENTAL DESIGN We used data from 5 European and 3 US cohorts of men undergoing biopsy for prostate cancer; six were population-based studies and two were clinical cohorts. The association between PSA and prostate cancer was calculated separately for each cohort using locally-weighted scatterplot smoothing. RESULTS The final data set included 25,772 biopsies and 8,503 cancers. There were gross disparities between cohorts with respect to both the prostate cancer risk at a given PSA level and the shape of the risk curve. These disparities were associated with identifiable differences between cohorts: for a given PSA level, a greater number of biopsy cores increased risk of cancer (odds ratio for >6 vs. 6 core biopsy 1.35; 95% C.I. 1.18, 1.54; p<0.0005); recent screening led to a smaller increase in risk per unit change in PSA (p=0.001 for interaction term) and US cohorts had higher risk than the European cohorts (2.14; 95% C.I. 1.99, 2.30; p<0.0005). CONCLUSIONS Our results suggest that the relationship between PSA and risk of a positive prostate biopsy varies, both in terms of the probability of prostate cancer at a given PSA value and the shape of the risk curve. This poses challenges to the use of PSA-driven algorithms to determine whether biopsy is indicated. PMID:20736330

  3. Breast Microcalcifications: Diagnostic Outcomes According to Image-Guided Biopsy Method

    PubMed Central

    Bae, Sohi; Yoon, Jung Hyun; Moon, Hee Jung; Kim, Min Jung

    2015-01-01

    Objective To evaluate the diagnostic outcomes of ultrasonography-guided core needle biopsy (US-CNB), US-guided vacuum-assisted biopsy (US-VAB), and stereotactic-guided vacuum-assisted biopsy (S-VAB) for diagnosing suspicious breast microcalcification. Materials and Methods We retrospectively reviewed 336 cases of suspicious breast microcalcification in patients who subsequently underwent image-guided biopsy. US-CNB was performed for US-visible microcalcifications associated with a mass (n = 28), US-VAB for US-visible microcalcifications without an associated mass (n = 59), and S-VAB for mammogram-only visible lesions (n = 249). Mammographic findings, biopsy failure rate, false-negative rate, and underestimation rate were analyzed. Histological diagnoses and the Breast Imaging Reporting and Data System (BI-RADS) categories were reported. Results Biopsy failure rates for US-CNB, US-VAB, and S-VAB were 7.1% (2/28), 0% (0/59), and 2.8% (7/249), respectively. Three false-negative cases were detected for US-CNB and two for S-VAB. The rates of biopsy-diagnosed ductal carcinoma in situ that were upgraded to invasive cancer at surgery were 41.7% (5/12), 12.9% (4/31), and 8.6% (3/35) for US-CNB, US-VAB, and S-VAB, respectively. Sonographically visible lesions were more likely to be malignant (66.2% [51/77] vs. 23.2% [46/198]; p < 0.001) or of higher BI-RADS category (61.0% [47/77] vs. 22.2% [44/198]; p < 0.001) than sonographically invisible lesions. Conclusion Ultrasonography-guided vacuum-assisted biopsy is more accurate than US-CNB when suspicious microcalcifications are detected on US. Calcifications with malignant pathology are significantly more visible on US than benign lesions. PMID:26357494

  4. Hematoma in Retzius' space following US-guided prostate biopsy: evidence of the diagnostic accuracy using transrectal end-fire probe in the anterior prostate gland.

    PubMed

    Dell'atti, Lucio

    2014-03-01

    We report a rare case of hematoma in Retzius' space in a 62-year-old man who underwent transrectal prostate biopsy using an endocavitary, end-fire, convex probe. Clinical symptoms resolved spontaneously after catheter placement and appropriate antibiotic therapy. Transrectal ultrasound 1 month later showed partial resolution of the hematoma. Based on the analysis of this unusual complication, we demonstrate the effectiveness of transrectal biopsy as compared to transperineal biopsy in detecting cancer of the anterior prostate. We have also analyzed the various factors that may be the reason why core biopsy harvested in this "hidden" area may be inadequate.

  5. MO-G-17A-09: Quantitative Autoradiography of Biopsy Specimens Extracted Under PET/CT Guidance

    SciTech Connect

    Fanchon, L; Carlin, S; Schmidtlein, C; Humm, J; Yorke, E; Solomon, S; Deasy, J; Kirov, A; Burger, I

    2014-06-15

    Purpose: To develop a procedure for accurate determination of PET tracer concentration with high spatial accuracy in situ by performing Quantitative Autoradiography of Biopsy Specimens (QABS) extracted under PET/CT guidance. Methods: Autoradiography (ARG) standards were produced from a gel loaded with a known concentration of FDG biopsied with 18G and 20G biopsy needles. Specimens obtained with these needles are generally cylindrical: up to 18 mm in length and about 0.8 and 0.6 mm in diameter respectively. These standards, with similar shape and density as biopsy specimens were used to generate ARG calibration curves.Quantitative ARG was performed to measure the activity concentration in biopsy specimens extracted from ten patients. The biopsy sites were determined according to PET/CT's obtained in the operating room. Additional CT scans were acquired with the needles in place to confirm correct needle placements. The ARG images were aligned with the needle tip in the PET/CT images using the open source CERR software. The mean SUV calculated from the specimen activities (SUVarg) were compared to that from PET (SUVpet) at the needle locations. Results: Calibration curves show that the relation between ARG signal and activity concentration in those standards is linear for the investigated range (up to 150 kBq/ml). The correlation coefficient of SUVarg with SUVpet is 0.74. Discrepancies between SUVarg and SUVpet can be attributed to the small size of the biopsy specimens compared to PET resolution. Conclusion: The calibration procedure using surrogate biopsy specimens provided a method for quantifying the activity within the biopsy cores obtained under FDG-PET guidance. QABS allows mapping the activity concentration in such biopsy specimens with a resolution of about 1mm. QABS is a promising tool for verification of biopsy adequacy by comparing specimen activity to that expected from the PET image. A portion of this research was funded by a research grant from

  6. Composite Cores

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Spang & Company's new configuration of converter transformer cores is a composite of gapped and ungapped cores assembled together in concentric relationship. The net effect of the composite design is to combine the protection from saturation offered by the gapped core with the lower magnetizing requirement of the ungapped core. The uncut core functions under normal operating conditions and the cut core takes over during abnormal operation to prevent power surges and their potentially destructive effect on transistors. Principal customers are aerospace and defense manufacturers. Cores also have applicability in commercial products where precise power regulation is required, as in the power supplies for large mainframe computers.

  7. 3T MR Guided in bore transperineal prostate biopsy: A Comparison of robotic and manual needle-guidance templates

    PubMed Central

    Tilak, Gaurie; Tuncali, Kemal; Song, Sang-Eun; Tokuda, Junichi; Olubiyi, Olutayo; Fennessy, Fiona; Fedorov, Andriy; Penzkofer, Tobias; Tempany, Clare; Hata, Nobuhiko

    2014-01-01

    Purpose To demonstrate the utility of a robotic needle-guidance template device as compared to a manual template for in-bore 3T transperineal MR-guided prostate biopsy. Materials and Methods This two-arm mixed retrospective-prospective study included 99 cases of targeted transperineal prostate biopsies. The biopsy needles were aimed at suspicious foci noted on multiparametric 3T MRI using manual template (historical control) as compared with a robotic template. The following data was obtained: the accuracy of average and closest needle placement to the focus, histologic yield, percentage of cancer volume in positive core samples, complication rate, and time to complete the procedure. Results 56 cases were performed using the manual template, and 43 cases were performed using the robotic template. The mean accuracy of the best needle placement attempt was higher in the robotic group (2.39 mm) than the manual group (3.71 mm, p<0.027). The mean core procedure time was shorter in the robotic (90.82min) than the manual group (100.63min, p<0.030). Percentage of cancer volume in positive core samples was higher in robotic group (p<0.001). Cancer yields and complication rates were not statistically different between the two sub-groups (p = 0.557 and p=0.172 respectively). Conclusion The robotic needle-guidance template helps accurate placement of biopsy needles in MRI-guided core biopsy of prostate cancer. PMID:25263213

  8. Experience with the advanced breast biopsy instrumentation system

    PubMed Central

    Perelman, Vsevolod S.; Colapinto, Nicholas D.; Lee, Stephen; Down, Nancy K.; Cook, Dodie M.

    2000-01-01

    Objectives To report early experience with the advanced breast biopsy instrumentation (ABBI) system and to compare the results with those of other published studies. Design A nonrandomized case series. Setting An outpatient breast diagnostic centre at a large urban community hospital. Patients Thirty-four women; 27 had suspicious calcifications, 2 had a nonpalpable mass and 5 had both. Intervention The ABBI procedure to excise a breast lesion or obtain a representative sample for histologic examination. Main outcome measures Success of the procedure with respect to diagnosis, sample quality, technical problems, margins of tumour free tissue and patient satisfaction. Results Malignant tissue was diagnosed in 7 women (21%) and atypical ductal hyperplasia in 2 (6%). In all cancers, the obtained samples had malignant cells present at the margins or less than 1 mm away. Technical problems were encountered in 32% of cases. Manual extraction of the specimen was required in 21% of cases. Conclusions The preliminary data correlate well with those of other published results. Although it is possible that a small number of cases and a relatively high proportion of technical difficulties may represent a normal learning curve, there is a definite need for improvement of some ABBI components. ABBI does not appear to provide adequate margins of uninvolved tissue in patients with cancer and thus should not be used with curative intent. ABBI provides excellent quality samples for pathological study and good patient satisfaction. There are not yet enough data for meaningful comparison of ABBI with stereotactic core biopsy and excisional biopsy with needle localization. PMID:11129832

  9. [Prostate biopsy: Procedure in the clinical routine].

    PubMed

    Enzmann, T; Tokas, T; Korte, K; Ritter, M; Hammerer, P; Franzaring, L; Heynemann, H; Gottfried, H-W; Bertermann, H; Meyer-Schwickerath, M; Wirth, B; Pelzer, A; Loch, T

    2015-12-01

    Over the last decade there has been a 25% decrease in the mortality rates for prostate cancer. The reasons for this significant decrease are most likely associated with the application of urological screening tests. The main tools for early detection are currently increased public awareness of the disease, prostate-specific antigen (PSA) tests and transrectal ultrasound (TRUS) guided topographically assignable biopsy sampling. Together with the histopathological results these features provide essential information for risk stratification, diagnostics and therapy decisions. The evolution of prostate biopsy techniques as well as the use of PSA testing has led to an increased identification of asymptomatic men, where further clarification is necessary. Significant efforts and increased clinical research focus on determining the appropriate indications for a prostate biopsy and the optimal technique to achieve better detection rates. The most widely used imaging modality for the prostate is TRUS; however, there are no clearly defined standards for the clinical approach for each individual biopsy procedure, dealing with continuous technical optimization and in particular the developments in imaging. In this review the current principles, techniques, new approaches and instrumentation of prostate biopsy imaging control are presented within the framework of the structured educational approach. PMID:26704284

  10. Common Data Elements for Muscle Biopsy Reporting

    PubMed Central

    Dastgir, Jahannaz; Rutkowski, Anne; Alvarez, Rachel; Cossette, Stacy A.; Yan, Ke; Hoffmann, Raymond G.; Sewry, Caroline; Hayashi, Yukiko K.; Goebel, Hans-Hilmar; Bonnemann, Carsten; Lawlor, Michael W.

    2016-01-01

    Context There is no current standard among myopathologists for reporting muscle biopsy findings. The National Institute of Neurological Disorders and Stroke has recently launched a common data element (CDE) project to standardize neuromuscular data collected in clinical reports and to facilitate their use in research. Objective To develop a more-uniform, prospective reporting tool for muscle biopsies, incorporating the elements identified by the CDE project, in an effort to improve reporting and educational resources. Design The variation in current biopsy reporting practice was evaluated through a study of 51 muscle biopsy reports from self-reported diagnoses of genetically confirmed or undiagnosed muscle disease from the Congenital Muscle Disease International Registry. Two reviewers independently extracted data from deidentified reports and entered them into the revised CDE format to identify what was missing and whether or not information provided on the revised CDE report (complete/incomplete) could be successfully interpreted by a neuropathologist. Results Analysis of the data highlighted showed (1) inconsistent reporting of key clinical features from referring physicians, and (2) considerable variability in the reporting of pertinent positive and negative histologic findings by pathologists. Conclusions We propose a format for muscle-biopsy reporting that includes the elements in the CDE checklist and a brief narrative comment that interprets the data in support of a final interpretation. Such a format standardizes cataloging of pathologic findings across the spectrum of muscle diseases and serves emerging clinical care and research needs with the expansion of genetic-testing therapeutic trials. PMID:26132600

  11. Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy

    NASA Astrophysics Data System (ADS)

    Sathyavathi, R.; Saha, Anushree; Soares, Jaqueline S.; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

    2015-04-01

    Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93-98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance.

  12. Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy.

    PubMed

    Sathyavathi, R; Saha, Anushree; Soares, Jaqueline S; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

    2015-01-01

    Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93-98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance. PMID:25927331

  13. Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy

    PubMed Central

    Sathyavathi, R.; Saha, Anushree; Soares, Jaqueline S.; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

    2015-01-01

    Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93–98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance. PMID:25927331

  14. Renal Biopsy in Type 2 Diabetic Patients

    PubMed Central

    Espinel, Eugenia; Agraz, Irene; Ibernon, Meritxell; Ramos, Natalia; Fort, Joan; Serón, Daniel

    2015-01-01

    The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients. PMID:26239461

  15. Simulation of punch biopsies: a case study.

    PubMed

    Sessanna, Dennis; Stredney, Don; Hittle, Brad; Lambert, David

    2008-01-01

    As the incidence of skin cancer continues to rise, there is an increasing need for skilled practitioners that are proficient in identifying suspicious lesions and competent in acquiring biopsies that provide for optimal determination of malignancy and staging. We report on the development of a prototype simulation that emulates the basic procedures necessary to acquire a punch biopsy. The objective of this effort is to produce a low-cost, effective method to teach non-specialists, i.e., nurse practitioners, internists, etc., the optimal placement of the punch to obtain a biopsy for pathological analysis. The simulation can be utilized for synchronous sessions with remote experts, as well as asynchronous sessions for deliberate practice. The simulation is designed to allow for easy import of digital images of various lesions to promote use and present the wide pathological variance experienced in the clinic.

  16. Muscle biopsy findings in inflammatory myopathies.

    PubMed

    Dalakas, Marinos C

    2002-11-01

    The inflammatory myopathies encompass a heterogeneous group of acquired muscle diseases characterized clinically, by muscle weakness, and histologically, by inflammatory infiltrates within the skeletal muscles. The group of these myopathies comprise three major and discrete subsets: polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM). Each subset retains its characteristic clinical, immunopathologic, and morphologic features regardless of whether it occurs separately or in connection with other systemic diseases. Although the diagnosis of these disorders is based on the combination of clinical examination, electromyographic data, serum muscle enzyme levels, various autoantibodies, and the muscle biopsy findings, the muscle biopsy offers the most definitive diagnostic information in the majority of the cases. This article summarizes the main histologic features that characterize PM, DM, or IBM and emphasizes the main pitfalls associated with interpretation of the biopsies.

  17. Multimodal optical biopsy probe to improve the safety and diagnostic yield of brain needle biopsies (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Desroches, Joannie; Pichette, Julien; Goyette, Andréanne; Tremblay, Marie-Andrée.; Jermyn, Michael; Petrecca, Kevin; Leblond, Frédéric

    2016-03-01

    Brain needle biopsy (BNB) is performed to collect tissue when precise neuropathological diagnosis is required to provide information about tumor type, grade, and growth patterns. The principal risks associated with this procedure are intracranial hemorrhage (due to clipping blood vessels during tissue extraction), incorrect tumor typing/grading due to non-representative or non-diagnostic samples (e.g. necrotic tissue), and missing the lesion. We present an innovative device using sub-diffuse optical tomography to detect blood vessels and Raman spectroscopy to detect molecular differences between tissue types, in order to reduce the risks of misdiagnosis, incorrect tumour grading, and non-diagnostic samples. The needle probe integrates optical fibers directly onto the external cannula of a commercial BNB needle, and can perform measurements for both optical techniques through the same fibers. This integrated optical spectroscopy system uses diffuse reflectance signals to perform a 360-degree reconstruction of the tissue adjacent to the biopsy needle, based on the optical contrast associated with hemoglobin light absorption, thereby localizing blood vessels. Raman spectra measurements are also performed interstitially for tissue characterization. A detailed sensitivity of the system is presented to demonstrate that it can detect absorbers with diameters <300 µm located up to ˜2 mm from the biopsy needle core, for bulk optical properties consistent with brain tissue. Results from animal experiments are presented to validate blood vessel detection and Raman spectrum measurement without disruption of the surgical workflow. We also present phantom measurements of Raman spectra with the needle probe and a comparison with a clinically validated Raman spectroscopy probe.

  18. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  19. Quantification of prostate deformation due to needle insertion during TRUS-guided biopsy: comparison of hand-held and mechanically stabilized systems

    NASA Astrophysics Data System (ADS)

    De Silva, Tharindu; Bax, Jeffrey; Fenster, Aaron; Samarabandu, Jagath; Ward, Aaron D.

    2011-03-01

    Prostate biopsy is the clinical standard for the definitive diagnosis of prostate cancer. To overcome the limitations of 2D TRUS-guided biopsy systems when targeting pre-planned locations, systems have been developed with 3D guidance to improve the accuracy of cancer detection. Prostate deformation due to needle insertion and biopsy gun firing is a potential source of error that can cause target misalignments during biopsies. We use non-rigid registration of 2D TRUS images to quantify the deformation during the needle insertion and the biopsy gun firing procedure, and compare this effect in biopsies performed using a handheld TRUS probe with those performed using a mechanically assisted 3D TRUS guided biopsy system. Although the mechanically assisted biopsy system had a mean deformation approximately 0.2 mm greater than that of the handheld approach, it yielded a lower relative increase of deformation near the needle axis during the needle insertion stage and greater deformational stability of the prostate during the biopsy gun firing stage. We also analyzed the axial and lateral components of the tissue motion; our results indicated that the motion is weakly biased in the direction orthogonal to the needle, which is less than ideal from a targeting standpoint given the long, narrow cylindrical shape of the biopsy core.

  20. Evaluation of the Efficacy and Safety of Percutaneous Biopsy of Lung

    PubMed Central

    McSweeney, Sean E; O’Regan, Kevin N; Mc Laughlin, Patrick D; Crush, Lee; Maher, Michael M

    2012-01-01

    Introduction: Percutanous needle biopsy of the lung (PNBL), under image guidance, has established itself as a safe and effective minimally-invasive method of obtaining a tissue diagnosis of pulmonary lesions, for selected patients with suspected pathologic processes. The purpose of this study was to evaluate the diagnostic yield and safety of percutaneous core biopsy of the lung (PCBL) without Fine Needle Aspiration Biopsy (FNAB), with specific attention to potential risk factors that may predict post-biopsy pneumothorax. Materials and Methods: A retrospective analysis of 75 consecutive PCBL procedures between January 2006 to March 2008 involving 72 patients with a documented pulmonary nodule or mass lesion on CT scan of Thorax. The study population included 38 males (52.8%) and 34 females (47.2%) aged 20-85 years (mean age 63.6 years). A co-axial cutting system with a 19-gauge outer needle and a 20-gauge inner automated cutting needle (Temno, Allegiance Healthcare Corporation, Ohio, USA) was used in all patients. Results: Lesions varied in size from 0.7cm to 10.7cm (mean maximum trans-axial diameter 3.1cm). The mean number of core biopsy samples obtained was 3.1 (range 1-5). Of the 75 PCBL procedures, 71 yielded specimens adequate for histopathologic evaluation, consistent with a technical success rate of 95%. Malignancy was detected in 48 specimens (64%) and benign diagnoses were identified in 23 specimens (31%). As mentioned, 4 specimens (5%) were nondiagnostic. The most common biopsy-induced complication was pneumothorax, occurring in 15 patients (20%), with 4 (5.3%) requiring thoracostomy tube placement. Conclusion: PCBL without FNAB, under CT fluoroscopy guidance, has an excellent diagnostic accuracy in obtaining a conclusive histologic diagnosis of thoracic lesions and is comparable to FNAB in terms of safety and rates of occurence of complications. PMID:22977650

  1. Best way to perform a punch biopsy.

    PubMed

    Domínguez-Cherit, Judith; Gutiérrez Mendoza, Daniela

    2015-04-01

    Nail punch biopsy is used to obtain a tissue sample for the diagnosis and treatment of nail diseases. The best results will be possible if the surgeon is familiar with the anatomy and physiology of the nail apparatus. A punch biopsy can be used in all regions of the nail apparatus in the presence or absence of nail plate. When the procedure is performed with a careful handling of the anatomic site and specimen, in most cases a successful diagnosis can be achieved. PMID:25828717

  2. Retroperitoneoscopic renal biopsy: still a good indication!

    PubMed

    Micali, Salvatore; Dandrea, Matteo; De Carne, Cosimo; Martorana, Eugenio; De Stefani, Stefano; Cappelli, Gianni; Bianchi, Giampaolo

    2014-01-01

    The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal. We present a case of a Jehovah's Witness patient with severe obesity, in whom conventional retroperitoneal laparoscopic renal biopsy was preferred to the LESS technique. PMID:25198939

  3. Aspiration biopsy cytology of the salivary gland.

    PubMed

    Kline, T S; Merriam, J M; Shapshay, S M

    1981-09-01

    Aspiration biopsy by fine needle from the major salivary glands has been an under-utilized technic in the United States. To evaluate this form of biopsy, 69 patients with salivary gland enlargement were examined by this technic; 47 had confirmative histology. Characteristic ABC patterns were seen in the benign mixed tumor, the papillary cystadenoma lymphomatosum, the mucoepidermoid carcinoma, and malignancy metastatic to the salivary gland. These findings are described. The method proved complication-free and accurate and is recommended for all tumors of the salivary gland.

  4. Case Report: Ischaemic appendicitis post mesenteric biopsy

    PubMed Central

    Zukiwskyj, Marianna; Tun, June; Desai, Shashank

    2016-01-01

    A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach.  There are no reports to date of ischaemia to the appendix as a complication of this procedure.   We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis. PMID:26937277

  5. Prostate needle biopsy: what we do and what should be improved.

    PubMed

    Fraggetta, Filippo; Pepe, Pietro; Improta, Giuseppina; Aragona, Francesco; Colecchia, Maurizio

    2013-06-01

    Prostate cancer (PCa) is the cancer most frequently diagnosed in older men and the second most frequent for incidence of all tumors. With the widespread use of serum prostate-specific antigen (PSA), the detection rate as well as the incidence of localized tumors has been increasing, thus leading to a drop in PCa-related mortality. However, a corresponding estimated rate of overdiagnosis as high as 50% has been reported, and the adverse side effects related to unnecessary treatments make the overall benefit of PSA mass screening unclear. The lower PSA threshold and extended prostate biopsy protocols have led to a marked increase of small, low-grade tumors that will never threaten a patient's survival. Sextant biopsy technique, extended biopsy protocols (12-18 cores) and saturation prostate schemes are already familiar terms, together with quantitative histology in the pathology departments. This brief review will try to focus on what usually is done and what should be improved in prostate needle biopsy in order to answer many critical points such as the clinical implication of different modalities of prostate biopsy (transrectal, transperineal or even targeted), the use of quantitative histology and the importance of the new molecular findings in addition to conventional histological parameters in the era of the active surveillance protocols. PMID:24344499

  6. A biomedical engineering approach to mitigate the errors of prostate biopsy.

    PubMed

    Ahmed, Hashim Uddin; Emberton, Mark; Kepner, Gordon; Kepner, Jeremy

    2012-02-07

    The current protocol for detecting and ruling out prostate cancer involves serum PSA testing followed by sampling of the prostate using a transrectal ultrasonography (TRUS)-guided biopsy. Many specialists have discussed how PSA screening has contributed to underdetection of clinically significant prostate cancer, overdiagnosis of clinically insignificant disease and poor risk stratification; however, little consideration has been given to the role of TRUS-guided biopsy in these errors. The performance of TRUS-guided biopsy is constrained by the biomechanical attributes of the sampling strategy, resulting in suboptimal detection efficiency of each core. By using a biomedical engineering approach, a uniform grid sampling strategy could be used to improve the detection efficiency of prostate biopsy. Moreover, the calibration of the sampling can be adjusted by altering the distance between needle deployments. Our model shows that for any given number of needle trajectories, a uniform grid approach will be superior to a divergent, nonuniform strategy for the detection of clinically important disease. This is an important message that should result in a move away from divergent sampling to a uniform grid approach for prostate biopsy.

  7. The renal biopsy in the genomic era.

    PubMed

    Liapis, Helen; Gaut, Joseph P

    2013-08-01

    Renal biopsy was introduced in the 1950s. By 1980 the pathologic diagnostic criteria for the majority of medical kidney diseases known today, including pediatric diseases, were established using light, electron microscopy and immunohistochemistry. However, it has become clear that there are limitations in the morphologic evaluation, mainly because a given pattern of injury can be caused by different aetiologies and, conversely, a single aetiology may present with more than one histological pattern. An explosion in kidney disease research in the last 20-30 years has brought new knowledge from bench to bedside rapidly and resulted in new molecular and genetic tools that enhance the diagnostic and prognostic power of the renal biopsy. Genomic technologies such as polymerase chain reaction (PCR), in situ hybridization and oligonucleotide microarrays, collectively known as genomics, detect single or multiple genes underscoring the pathologic changes and revealing specific causes of injury that may require different treatment. The aims of this review are to (1) summarize current recommendations for diagnostic renal biopsies encompassing light microscopy, immunofluorescence or immunohistochemistry and electron microscopy; (2) address the limitations of morphology; (3) show current contributions of genomic technologies adjunct to the renal biopsy, and provide examples of how these may transform pathologic interpretation into molecular disease phenotypes.

  8. Frictional insertion kinetics of bone biopsy needles.

    PubMed

    Heiner, A D; Brown, T D; Rossin, V; Buckwalter, J A

    2001-12-01

    Patients undergoing a percutaneous bone biopsy often complain of pain during needle insertion, despite local anesthesia. Bone biopsy needles are typically inserted with combined axial and twisting motions. These motions could cause pain through frictional heating or direct mechanical irritation. The hypothesis of this study is that the insertion energy of bone biopsy needles can be reduced by modifying the insertion kinetics or by adding a friction-lowering coating to the needles. Jamshidi bone biopsy needles were driven into a bone analog model by an MTS materials testing machine operating under axial and rotational displacement control. The load/torque recordings showed that, to significantly decrease insertion energy and peak resistance to needle insertion, axial velocity and angular frequency had to be decreased to one quarter of the baseline, typical-usage parameters. However the increased insertion time may not be acceptable clinically. The majority of the insertion energy was associated with the needle axial thrust rather than with needle twisting. Overcoming friction against the side of the needle consumed much more of the insertion energy than did the process of cutting per se. None of five needle coatings tested succeeded in appreciably lowering the insertion energy, and none achieved a substantial decrease in peak resisting force.

  9. Comparative Effectiveness of Targeted Prostate Biopsy Using MRI-US Fusion Software and Visual Targeting: a Prospective Study

    PubMed Central

    Lee, Daniel J.; Recabal, Pedro; Sjoberg, Daniel D.; Thong, Alan; Lee, Justin K.; Eastham, James A.; Scardino, Peter T.; Vargas, Hebert Alberto; Coleman, Jonathan; Ehdaie, Behfar

    2016-01-01

    Purpose To compare diagnostic outcomes between 2 different techniques for targeting regions-of-interest on prostate multiparametric Magnetic resonance imaging (mpMRI); MRI-ultrasound fusion (MR-F) and visually targeted (VT) biopsy. Materials and Methods Patients presenting for prostate biopsy with regions-of-interest on mpMRI underwent MRI-targeted biopsy. For each region-of-interest two VT cores were obtained, followed by 2 cores using an MR-F device. Our primary endpoint was the difference in the detection of high-grade (Gleason ≥7) and any-grade cancer between VT and MR-F, investigated using McNemar’s method. Secondary endpoints were the difference in detection rate by biopsy location using a logistic regression model, and difference in median cancer length using Wilcoxon sign-rank test. Results We identified 396 regions-of-interest in 286 men. The difference in high-grade cancer detection between MR-F biopsy and VT biopsy was −1.4% (95% CI −6.4% to 3.6%; p=0.6); for any-grade cancer the difference was 3.5% (95% CI −1.9% to 8.9%; p=0.2). Median cancer length detected by MR-F and VT were 5.5mm vs. 5.8mm, respectively (p=0.8). MR-F biopsy detected 15% more cancers in the transition zone (p=0.046), and VT biopsy detected 11% more high-grade cancer at the prostate base (p=0.005). Only 52% of all high-grade cancers were detected by both techniques. Conclusions We found no evidence of a significant difference in the detection of high-grade or any-grade cancer between VT and MR-F biopsy. However, the performance of each technique varied in specific biopsy locations, and the outcomes of both techniques were complementary. Combining VT biopsy and MR-F biopsy may optimize prostate cancer detection. PMID:27038768

  10. Ultrasound-guided biopsy as a diagnostic aid in three horses with a cranial mediastinal lymphosarcoma.

    PubMed

    De Clercq, D; van Loon, G; Lefère, L; Deprez, P

    2004-06-01

    An ultrasound examination of the thorax of three horses which were performing poorly or had mild signs of colic showed that they had a cranial mediastinal mass and a pleural effusion. A cytological examination of the pleural fluid showed that it did not contain neoplastic cells. A histological examination of an ultrasound-guided core biopsy of the cranial mediastinal mass showed that in each of the three horses it was a lymphosarcoma. PMID:15214516

  11. Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors

    NASA Astrophysics Data System (ADS)

    Harmon, Stephanie A.; Tuite, Michael J.; Jeraj, Robert

    2016-10-01

    Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: (1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and (2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.

  12. Integrating machine learning and physician knowledge to improve the accuracy of breast biopsy.

    PubMed

    Dutra, I; Nassif, H; Page, D; Shavlik, J; Strigel, R M; Wu, Y; Elezaby, M E; Burnside, E

    2011-01-01

    In this work we show that combining physician rules and machine learned rules may improve the performance of a classifier that predicts whether a breast cancer is missed on percutaneous, image-guided breast core needle biopsy (subsequently referred to as "breast core biopsy"). Specifically, we show how advice in the form of logical rules, derived by a sub-specialty, i.e. fellowship trained breast radiologists (subsequently referred to as "our physicians") can guide the search in an inductive logic programming system, and improve the performance of a learned classifier. Our dataset of 890 consecutive benign breast core biopsy results along with corresponding mammographic findings contains 94 cases that were deemed non-definitive by a multidisciplinary panel of physicians, from which 15 were upgraded to malignant disease at surgery. Our goal is to predict upgrade prospectively and avoid surgery in women who do not have breast cancer. Our results, some of which trended toward significance, show evidence that inductive logic programming may produce better results for this task than traditional propositional algorithms with default parameters. Moreover, we show that adding knowledge from our physicians into the learning process may improve the performance of the learned classifier trained only on data. PMID:22195087

  13. Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps

    PubMed Central

    Lim, Chul-Hyun; Kim, Won Chul; Kim, Jin Soo; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong; Chung, In-Sik

    2012-01-01

    Background/Aims It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy. Methods Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue. Results Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps. Conclusions Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered. PMID:22741133

  14. Multiple Biopsies and Detection of Cervical Cancer Precursors at Colposcopy

    PubMed Central

    Wentzensen, Nicolas; Walker, Joan L.; Gold, Michael A.; Smith, Katie M.; Zuna, Rosemary E.; Mathews, Cara; Dunn, S. Terence; Zhang, Roy; Moxley, Katherine; Bishop, Erin; Tenney, Meaghan; Nugent, Elizabeth; Graubard, Barry I.; Wacholder, Sholom; Schiffman, Mark

    2015-01-01

    Purpose Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies. Methods The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies. Results In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone. Conclusion Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy. PMID:25422481

  15. 49 CFR 178.337-14 - Gauging devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... See § 173.315(h) of this subchapter. (b) Pressure gauges. (1) See § 173.315(h) of this subchapter. (2... service must be provided with a suitable pressure gauge. A shut-off valve must be installed between the pressure gauge and the cargo tank. (c) Orifices. See § 173.315(h) (3) and (4) of this subchapter....

  16. 49 CFR 178.338-14 - Gauging devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... gauging devices, which accurately indicate the maximum permitted liquid level at the loading pressure, in... trycock line, or a differential pressure liquid level gauge must be used as the primary control for... filling. (2) The design pressure of each liquid level gauging device must be at least that of the tank....

  17. Achromatized endomicroscope objective for optical biopsy

    PubMed Central

    Kyrish, Matthew; Tkaczyk, Tomasz S.

    2013-01-01

    Currently, researchers and clinicians lack achromatized endomicroscope objectives that are as narrow as biopsy needles. We present a proof-of-concept prototype that validates the optical design of an NA0.4 objective. The objective, built with plastic lenses, has a 0.9 mm clear aperture and is achromatized from 452 nm to 623 nm. The objective’s measured Strehl ratio is 0.74 ± 0.05 across a 250 μm FOV. We perform optical sectioning via structured illumination through the objective while capturing fluorescence images of breast carcinoma cells stained with proflavine and cresyl violet. This technology has the potential to improve optical biopsies and provide the next step forward in cancer diagnostics. PMID:23412009

  18. Cerebral Whipple's disease. Diagnosis by brain biopsy.

    PubMed

    Johnson, L; Diamond, I

    1980-10-01

    Whipple's disease, a multisystem chronic granulomatous disease treatable by antibiotics, usually presents clinically with gastrointestinal or joint symptoms. Usually, the diagnosis is substantiated by small intestinal biopsy. This shows diastase-resistant periodic-acid-Schiff-(PAS)-positive inclusions in the cytoplasm of macrophages within the lamina propria. By electron microscopy, this PAS-positive material consists of 1.5 X 0.2-mum bacilli and fine fibrillar material within macrophage phagolysosomes. Rarely, Whipple's disease presents clinically as a primary neurologic disease without gastrointestinal symptoms. Because untreated cerebral Whipple's disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. This report describes a case of cerebral Whipple's disease without gastrointestinal symptoms that was diagnosed early by light-and electron-microscopic study of brain biopsy material. PMID:6158859

  19. Computer assisted biopsy of breast tumors.

    PubMed

    Arambula Cosio, Fernando; Lira Berra, Eric; Hevia Montiel, Nidiyare; Garcia Segundo, Cresencio; Garduno, Edgar; Alvarado Gonzalez, Montserrat; Quispe Siccha, Rosa Ma; Reyes Ramirez, Bartolome; Hazan Lasri, Eric

    2010-01-01

    In this paper we report our preliminary results of the development of a computer assisted system for breast biopsy. The system is based on tracked ultrasound images of the breast. A three dimensional ultrasound volume is constructed from a set of tracked B-scan images acquired with a calibrated probe. The system has been designed to assist a radiologist during breast biopsy, and also as a training system for radiology residents. A semiautomatic classification algorithm was implemented to assist the user with the annotation of the tumor on an ultrasound volume. We report the development of the system prototype, tested on a physical phantom of a breast with a tumor, made of polivinil alcohol. PMID:21097108

  20. Accessing Genetic Information with Liquid Biopsies.

    PubMed

    Cai, Xuyu; Janku, Filip; Zhan, Qimin; Fan, Jian-Bing

    2015-10-01

    Recent scientific advances in understanding circulating tumor cells, cell-free DNA/RNA, and exosomes in blood have laid a solid foundation for the development of routine molecular 'liquid biopsies'. This approach provides non-invasive access to genetic information--somatic mutations, epigenetic changes, and differential expression--about the physiological conditions of our body and diseases. It opens a valuable avenue for future genetic studies and human disease diagnosis, including prenatal and neurodegenerative disease diagnosis, as well as for cancer screening and monitoring. With the rapid development of highly sensitive and accurate technologies such as next-generation sequencing, molecular 'liquid biopsies' will quickly become a central piece in the future of precision medicine.

  1. Factors that can minimize bleeding complications after renal biopsy.

    PubMed

    Zhu, M S; Chen, J Z; Xu, A P

    2014-10-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding diatheses, amyloidosis, advanced age, gender and so on. Our primary purpose of this review is to summarize current measures in recent years literature aiming at minimizing the bleeding complication after the renal biopsy, including the drug application before and after renal biopsy, operation details in percutaneous renal biopsies, nursing and close monitoring after the biopsy and other kinds of biopsy methods.

  2. A Prospective Randomized Trial of Two Different Prostate Biopsy Schemes

    ClinicalTrials.gov

    2016-07-03

    Prostate Cancer; Local Anesthesia; Prostate-Specific Antigen/Blood; Biopsy/Methods; Image-guided Biopsy/Methods; Prostatic Neoplasms/Diagnosis; Prostate/Pathology; Prospective Studies; Humans; Male; Ultrasonography, Interventional/Methods

  3. Preliminary study of tendon biopsy in the horse.

    PubMed

    Webbon, P M

    1986-09-01

    A series of experimental tendon biopsies is described. Three biopsies were taken from the lateral digital extensor tendon (LDET) and three from the superficial flexor tendon (SFT). The LDET biopsies resulted in little discomfort whereas the SFT biopsies led to temporary lameness. The tendons were examined histologically up to 99 days after the biopsies were removed. In all of the tendons the defect filled with granulation tissue which subsequently became organised as a longitudinally orientated collagenous scar tissue. In this small series of biopsies the histological effects of the biopsy persisted longer in the SFT than in the LDET. It is concluded that tendon biopsy cannot be advocated for safe routine use in the horse.

  4. Correlation of HOXD3 promoter hypermethylation with clinical and pathologic features in screening prostate biopsies

    PubMed Central

    Chen, Leonard N; Rubin, Rachel S; Othepa, Eugide; Cer, Caroline; Yun, Elizabeth; Agarwal, Raghunath P; Collins, Brian T; McGeagh, Kevin; Pahira, John; Bandi, Guarav; Kowalczyk, Keith; Kumar, Deepak; Dritschilo, Anatoly; Collins, Sean P; Bostwick, David G; Lynch, John H; Suy, Simeng

    2014-01-01

    BACKGROUND Molecular markers that can discriminate indolent cancers from aggressive ones may improve the management of prostate cancer and minimize unnecessary treatment. Aberrant DNA methylation is a common epigenetic event in cancers and HOXD3 promoter hypermethylation (H3PH) has been found in prostate cancer. Our objective was to evaluate the relationship between H3PH and clinicopathologic features in screening prostate biopsies. METHODS Ninety-two patients who underwent a prostate biopsy at our institution between October 2011 and May 2012 were included in this study. The core with the greatest percentage of the highest grade disease was analyzed for H3PH by methylation-specific PCR. Correlational analysis was used to analyze the relationship between H3PH and various clinical parameters. Chi-square analysis was used to compare H3PH status between benign and malignant disease. RESULTS Of the 80 biopsies with HOXD3 methylation status assessable, 66 sets were confirmed to have cancer. In the 14 biopsies with benign disease there was minimal H3PH with the mean percentage of methylation reference (PMR) of 0.7%. In contrast, the HOXD3 promoter was hypermethylated in 16.7% of all cancers and in 50% of high risk tumors with an average PMR of 4.3% (P = 0.008). H3PH was significantly correlated with age (P = 0.013), Gleason score (P = 0.031) and the maximum involvement of the biopsy core (P = 0.035). CONCLUSIONS H3PH is associated with clinicopathologic features. The data indicate that H3PH is more common in older higher risk patients. More research is needed to determine the role of this marker in optimizing management strategies in men with newly diagnosed prostate cancer. Prostate 74:714–721, 2014. © 2014 The Authors. The Prostate published by Wiley Periodicals, Inc. PMID:24847526

  5. Conjunctival biopsy in adult form galactosialidosis.

    PubMed Central

    Usui, T; Sawaguchi, S; Abe, H; Iwata, K; Oyanagi, K

    1993-01-01

    Conjunctival biopsy was performed in two siblings with adult-form galactosialidosis. Electron microscopically, several types of intracytoplasmic inclusion were observed in the fibroblasts in conjunctival stroma, lymphatic capillary endothelial cells, Schwann cells, and epithelial cells. Membrane-bound vesicles with fibrillogranular content were frequently observed, and occasional lamellar structures were noted in these inclusions. Dense granular inclusions and oil droplets were also seen. Dense granular inclusions have not been reported in this disease previously. Images PMID:8384473

  6. [Is undirected liver biopsy a safe procedure?].

    PubMed

    Oliva, L; Hirt, M

    1993-09-01

    In the authors' group of 976 umaimed liver biopsies (ULB) 10 complications were recorded. The authors described them and compared them with reports from the world literature. Two patients from the group died after ULB. One as a result of biopsy from haemoperitoneum, the other patient died with delirium tremens after surgery called for by persisting peritoneal syndrome. In eight patients mild complications were involved. In five patients complications receded spontaneously, in three after administration of an analgetic. From the submitted paper ensues that ULB is not quite safe, even when used by an experienced physician and when all contraindications are respected. A smooth course is not ensured by a risk-free diagnosis, previous uncomplicated biopsies normal prebioptic haemocoagulation tests. It is essential to realize this with regard to every patient where we indicate ULB. It is better to omit it unless we are unequivocally convinced of its asset. The question thus is: What will be the benefit of ULB for the patient?

  7. Role of Transpedicular Percutaneous Vertebral Biopsy for Diagnosis of Pathology in Vertebral Compression Fractures

    PubMed Central

    Nadkarni, Sunil; Hardikar, Sharad Moreshwar; Hardikar, Madan Sharad

    2016-01-01

    Study Design Retrospective observational study. Purpose To identify the role of percutaneous vertebral biopsy in histopathological diagnosis of vertebral compression fractures and to identify the frequency of unexpected malignancy in vertebral compression fractures. Overview of Literature Vertebral compression fractures are common in the Indian population. Magnetic resonance imaging and nuclear imaging have some limitations in the diagnosis of definitive pathology of vertebral compression fractures. Therefore, histological confirmation is necessary for definitive diagnosis and to plan appropriate management for patient. Methods A retrospective observational study was conducted involving 84 patients who underwent percutaneous vertebral biopsy between 2010 and 2014. We performed C-arm guided percutaneous transpedicular core vertebral biopsy of vertebral compression fractures under combination of local anesthesia and intravenous conscious sedation. Results Sufficient biopsy material was obtained in 79 of the 84 cases. In the other five cases, biopsy material was not sufficient for reporting. Out of the 79 cases, osteoporotic pathology was detected in 69 patients, malignancy was detected in 8 patients and no pathology was found in 2 patients. Two patients with distant metastases to vertebra were identified. Primary spinal malignancy was detected in 6 patients (1 unsuspected plasmacytoma, 5 diagnosed malignancy preoperatively). So, the frequency of unsuspected malignancy of this study was 1.19% (1/84). None of the patients had any complications. Conclusions C-arm guided percutaneous transpedicular vertebral biopsy is useful in obtaining definitive histopathological diagnosis of vertebral compression fractures, especially in differentiating malignant and non-malignant vertebral compression fractures and helping plan appropriate management of patients. The rate of unexpected malignancy in vertebral compression fracture was 1.19%. PMID:27790322

  8. Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications

    PubMed Central

    Esen, Gül; Tutar, Burçin; Uras, Cihan; Calay, Zerrin; İnce, Ümit; Tutar, Onur

    2016-01-01

    PURPOSE We aimed to present our biopsy method and retrospectively evaluate the results, upgrade rate, and follow-up findings of stereotactic vacuum-assisted breast biopsy (VABB) procedures performed in our clinic. METHODS Two hundred thirty-four patients with mammographically detected nonpalpable breast lesions underwent VABB using a 9 gauge biopsy probe and prone biopsy table. A total of 195 patients (median age 53 years, range 32–80 years) with 198 microcalcification-only lesions with a follow-up of at least one year were included in the study. The location of the lesion relative to the needle was determined from the postfire images, and unlike the conventional technique, tissue retrieval was predominantly performed from that location, followed by a complete 360° rotation, if needed. RESULTS The median core number was 8.5. Biopsy results revealed 135 benign, 24 atypical, and 39 malignant lesions. The total upgrade rate at surgery was 7.7% (6.1% for ductal carcinomas in situ and 10.5% for atypical lesions). Patients with benign lesions were followed up for a median period of 27.5 months, with no interval change. At the follow-up, scar formation was seen in 23 patients (17%); three of the scars were remarkable for resembling a malignancy. CONCLUSION Our biposy method is fast and practical, and it is easily tolerated by patients without compromising accuracy. Patients with a diagnosis of atypia still need to undergo a diagnostic surgical procedure and those with a malignancy need to undergo curative surgery, even if the lesion is totally excised at biopsy. VABB may leave a scar in the breast tissue, which may resemble a malignancy, albeit rarely. PMID:27306660

  9. 21 CFR 878.4755 - Absorbable lung biopsy plug.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Absorbable lung biopsy plug. 878.4755 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4755 Absorbable lung biopsy plug. (a) Identification. A preformed (polymerized) absorbable lung biopsy plug is intended to...

  10. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  11. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  12. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  13. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  14. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  15. Electrical property-based biopsy for prostate cancer detection and assessment

    NASA Astrophysics Data System (ADS)

    Halter, Ryan J.; Mishra, Vaishali; Bouayad, Hamza; Manwaring, Preston; Heaney, John; Schned, Alan

    2011-03-01

    Prostate cancer diagnosis is based solely on biopsy-based findings. Unfortunately, routine biopsy protocols only sample ~0.95% of the entire gland limiting the technique's sensitivity to cancer detection. Previous studies have demonstrated significant electrical property differences between malignant and benign prostate tissues due to their dissimilar morphological architectures. We have taken the important step of translating these findings to the clinic by integrating an electrical property sensor into the tip of a standard biopsy needle. This novel device allows clinicians to simultaneously extract a tissue core and assess the electrical properties around the needle tip in real-time. The expected volume of tissue sensed with this device was estimated using finite-element method (FEM) based simulations to model the potential fields and current distributions. Prototype devices have been constructed and evaluated in a series of saline baths in order to validate the FEM-based findings. Simulations suggest that the electrical property sensor is able to interrogate a tissue volume of ~62.1 mm3 and experimental results demonstrated a volume of sensitivity of ~68.7 mm3. This coupled device is being used to assess the increased sensitivity and specificity to cancer detection when electrical properties are sensed in concert with tissue core extraction in a series of 50 ex vivo prostates. Typical 12-core prostate biopsy protocols extract a total tissue volume of 228 mm3 for histological assessment. Employing this electrical property sensor to gauge electrical properties at both the beginning and end of the needle trajectory will provide pathological assessment of an additional 1648 mm3 of tissue.

  16. Trends in breast biopsies for abnormalities detected at screening mammography: a population-based study in the Netherlands

    PubMed Central

    van Breest Smallenburg, V; Nederend, J; Voogd, A C; Coebergh, J W W; van Beek, M; Jansen, F H; Louwman, W J; Duijm, L E M

    2013-01-01

    Background: Diagnostic surgical breast biopsies have several disadvantages, therefore, they should be used with hesitation. We determined time trends in types of breast biopsies for the workup of abnormalities detected at screening mammography. We also examined diagnostic delays. Methods: In a Dutch breast cancer screening region 6230 women were referred for an abnormal screening mammogram between 1 January 1997 and 1 January 2011. During two year follow-up clinical data, breast imaging-, biopsy-, surgery- and pathology-reports were collected of these women. Furthermore, breast cancers diagnosed >3 months after referral (delays) were examined, this included review of mammograms and pathology specimens to determine the cause of the delays. Results: In 41.1% (1997–1998) and in 44.8% (2009–2010) of referred women imaging was sufficient for making the diagnosis (P<0.0001). Fine-needle aspiration cytology decreased from 12.7% (1997–1998) to 4.7% (2009–2010) (P<0.0001), percutaneous core-needle biopsies (CBs) increased from 8.0 to 49.1% (P<0.0001) and surgical biopsies decreased from 37.8 to 1.4% (P<0.0001). Delays in breast cancer diagnosis decreased from 6.7 to 1.8% (P=0.003). Conclusion: The use of diagnostic surgical breast biopsies has decreased substantially. They have mostly been replaced by percutaneous CBs and this replacement did not result in an increase of diagnostic delays. PMID:23695018

  17. High-resolution rapid diagnostic imaging of whole prostate biopsies using video-rate fluorescence structured illumination microscopy

    PubMed Central

    Wang, Mei; Kimbrell, Hillary Z.; Sholl, Andrew B.; Tulman, David B.; Elfer, Katherine N.; Schlichenmeyer, Tyler C.; Lee, Benjamin R.; Lacey, Michelle; Brown, J. Quincy

    2015-01-01

    Rapid assessment of prostate core biopsy pathology at the point-of-procedure could provide benefit in a variety of clinical situations. Even with advanced trans-rectal ultrasound guidance and saturation biopsy protocols, prostate cancer can be missed in up to half of all initial biopsy procedures. In addition, collection of tumor specimens for downstream histological, molecular, and genetic analysis is hindered by low tumor yield due to inability to identify prostate cancer grossly. However, current point-of-procedure pathology protocols such as frozen section analysis (FSA) are destructive, and too time- and labor-intensive to be practical or economical. Ex vivo microscopy of the excised specimens, stained with fast-acting fluorescent histology dyes, could be an attractive non-destructive alternative to FSA. In this work, we report the first demonstration of video-rate structured illumination microscopy (VR-SIM) for rapid high-resolution diagnostic imaging of prostate biopsies in realistic point-of-procedure timeframes. Large mosaic images of prostate biopsies stained with acridine orange are rendered in seconds, and contain excellent contrast and detail, exhibiting close correlation with corresponding H&E histology. A clinically-relevant review of VR-SIM images of 34 unfixed and uncut prostate core biopsies by two independent pathologists resulted in an area under the ROC curve (AUC) of 0.82–0.88, with a sensitivity ranging from 63–88% and a specificity ranging from 78–89%. When biopsies contained more than 5% tumor content, the sensitivity improved to 75–92%. The image quality, speed, minimal complexity, and ease of use of VR-SIM could prove to be features in favor of adoption as an alternative to destructive pathology at the point-of-procedure. PMID:26282168

  18. Fatal haemorrhage following liver biopsy in patients with HIV infection.

    PubMed Central

    Churchill, D R; Mann, D; Coker, R J; Miller, R F; Glazer, G; Goldin, R D; Lucas, S B; Weber, J N; De Cock, K M

    1996-01-01

    A retrospective review of all 248 liver biopsies performed in patients with HIV infection at two referral centres in London over a 12 year period revealed five cases of major bleeding following biopsy, with four deaths. The risk of major bleeding was 2.0%, and mortality was 1.6% following liver biopsy. The risk of bleeding as much higher than in published series of biopsies done in patients without HIV infection, owing in part to the high prevalence of thrombocytopaenia and clotting abnormalities in patients with HIV infection. HIV infection per se may also increase the risk of bleeding following liver biopsy. PMID:8655172

  19. Significant impact of transperineal template biopsy of the prostate at a single tertiary institution

    PubMed Central

    Huang, Sean; Reeves, Fairleigh; Preece, Jessica; Satasivam, Prassannah; Royce, Peter; Grummet, Jeremy P.

    2015-01-01

    Objective: The objective was to review the impact of transperineal biopsy (TPB) at our institution by assessing rates of cancer detection/grading, treatment outcomes and complications. Patients and Methods: A retrospective review of TPBs between 2009 and 2013 was performed. Variables included reason for TPB, age, prostate-specific antigen, previous histology, TPB histology, and management outcomes. Results: In total, 110 patients underwent 111 TPBs at our institution. On average, 22 cores were taken from each procedure. Disease-upgrade occurred in 37.5% of active surveillance patients, 35% of patients with previous negative transrectal ultrasound, and 58.8% in patients undergoing TPB for other reasons. Of these patients, anterior and/or transition zones were involved in 66%, 79%, and 80%, respectively. Involvement in anterior and/or transition zones only occurred in 40%, 37%, and 10%, respectively. About 77% of patients with disease-upgrading underwent treatment with curative intent. Complications included a 6.3% rate of acute urinary retention and 2.7% of clot retention, with no episodes of urosepsis. Conclusions: Transperineal biopsy at our institution showed a high rate of disease-upgrading, with a large proportion involving anterior and transition zones. A significant amount of patients went on to receive curative treatment. TPB is a valuable diagnostic procedure with minimal risk of developing urosepsis. We believe TBP should be offered as an option for all repeat prostate biopsies and considered as an option for initial prostate biopsy. PMID:26692659

  20. Increased Production of Clusterin in Biopsies of Repair Tissue following Autologous Chondrocyte Implantation

    PubMed Central

    Malda, Jos; Richardson, James B.; Roberts, Sally

    2013-01-01

    Objective. To characterize the immunolocalization of clusterin in the repair cartilage of patients having undergone autologous chondrocyte implantation (ACI) and evaluate correlation to clinical outcome. Design. Full-depth core biopsies of repair tissue were obtained from 38 patients who had undergone ACI at an average of 18 ± 13 months previously (range 8-67 months). The biopsies were snap frozen, cryosectioned, and clusterin production immunolocalized using a specific monoclonal clusterin antibody and compared with normal and osteoarthritic cartilage. Clinical outcome was assessed from patients preoperatively, at the time of biopsy, and annually postoperatively. Results. Intensity of immunostaining for clusterin decreased with age in healthy cartilage tissue. Clusterin was detected to a variable degree in 37 of the 38 ACI cartilage biopsies, in single and clustered chondrocytes, in the pericellular capsule and the cartilage extracellular matrix, as well as the osteocytes and osteoid within the bone. Chondrocytes in hyaline repair tissue were significantly more immunopositive than those in fibrocartilage repair tissue. Clinical outcome improved significantly post-ACI, but did not correlate with the presence of clusterin in the repair tissue. Conclusions. These results demonstrate the presence of clusterin in actively repairing human cartilage and indicate a different distribution of clusterin in this tissue compared to normal cartilage. Variability in clusterin staining in the repair tissue could indicate different states of chondrogenic differentiation. The clinical significance of clusterin within repair tissue is difficult to assess, although the ideal functioning repair tissue morphology should resemble that of healthy adult cartilage. PMID:26069669

  1. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    SciTech Connect

    Martin, Peter R.; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

    2014-07-15

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each

  2. Value of repeat biopsy in lupus nephritis flares

    PubMed Central

    Greloni, G; Scolnik, M; Marin, J; Lancioni, E; Quiroz, C; Zacariaz, J; De la Iglesia Niveyro, P; Christiansen, S; Pierangelo, M A; Varela, C F; Rosa-Diez, G J; Catoggio, L J; Soriano, E R

    2014-01-01

    Objectives Renal flares are common in lupus nephritis (LN), and class switch is thought to be characteristic. There is no agreement on indications for performing a repeat renal biopsy. Our objective was to retrospectively review patients who had more than one renal biopsy performed on clinical indications, and analyse clinical, pathological and treatment changes after successive biopsies. Methods Forty-five patients with LN and one or more repeat renal biopsies were included, with a total of 116 biopsies. Results Of the 71 repeat biopsies, pathological transition occurred in 39 (54.9%). When having a previous biopsy with a proliferative lesion, class switch occurred in 55.6%, with 24.4% evolving into non-proliferative classes. When previous biopsy was class V, transition to other classes occurred in 58.3% and changes were all into proliferative classes. Conversion from one pure proliferative form to another (class III to class IV or vice versa) happened in 11.3% of the rebiopsies, with 62 rebiopsies (87.3%) leading to a change in the treatment regimen. Conclusions Histological transformations were common, and they occurred when the previous biopsy had non-proliferative lesions as well as when lesions were proliferative. Treatments were modified after repeat renal biopsy in the majority of patients. In this experience, kidney repeat biopsies were useful in guiding treatment of LN flares. PMID:25396056

  3. Transthoracic needle biopsy of the lung

    PubMed Central

    DiBardino, David M.; Yarmus, Lonny B.

    2015-01-01

    Background Image guided transthoracic needle aspiration (TTNA) is a valuable tool used for the diagnosis of countless thoracic diseases. Computed tomography (CT) is the most common imaging modality used for guidance followed by ultrasound (US) for lesions abutting the pleural surface. Novel approaches using virtual CT guidance have recently been introduced. The objective of this review is to examine the current literature for TTNA biopsy of the lung focusing on diagnostic accuracy and safety. Methods MEDLINE was searched from inception to October 2015 for all case series examining image guided TTNA. Articles focusing on fluoroscopic guidance as well as influence of rapid on-site evaluation (ROSE) on yield were excluded. The diagnostic accuracy, defined as the number of true positives divided by the number of biopsies done, as well as the complication rate [pneumothorax (PTX), bleeding] was examined for CT guided TTNA, US guided TTNA as well as CT guided electromagnetic navigational-TTNA (E-TTNA). Of the 490 articles recovered 75 were included in our analysis. Results The overall pooled diagnostic accuracy for CT guided TTNA using 48 articles that met the inclusion and exclusion criteria was 92.1% (9,567/10,383). A similar yield was obtained examining ten articles using US guided TTNA of 88.7% (446/503). E-TTNA, being a new modality, only had one pilot study citing a diagnostic accuracy of 83% (19/23). Pooled PTX and hemorrhage rates were 20.5% and 2.8% respectively for CT guided TTNA. The PTX rate was lower in US guided TTNA at a pooled rate of 4.4%. E-TTNA showed a similar rate of PTX at 20% with no incidence of bleeding in a single pilot study available. Conclusions Image guided TTNA is a safe and accurate modality for the biopsy of lung pathology. This study found similar yield and safety profiles with the three imaging modalities examined. PMID:26807279

  4. Critical assessment of diagnostic value of endomyocardial biopsy. Assessment of cardiac biopsy.

    PubMed Central

    MacKay, E H; Littler, W A; Sleight, P

    1978-01-01

    Right or left ventricular endomyocardial biopsy with the Konno or the Olympus bioptome was attempted in 73 patients aged 5 months to 61 years, with 82 per cent success. Light and electron microscopy showed non-specific features in over half the biopsies with new or diagnostically useful information in only 10 per cent of cases, usually as a result of electron microscopy. The method is safe but is of strictly limited diagnostic value and is likely to be of most help as a research tool in the biochemical study of cardiomyopathies. Images PMID:626666

  5. Dermal vacuoles in two biopsies of psoriasis.

    PubMed

    Ayva, Sebnem; Erkek, Emel; Atasoy, Pinar

    2008-11-01

    Two patients presented with cutaneous lesions clinically typical of psoriasis. The first case was a 38-year-old man and the second was a 51-year-old woman. To confirm the diagnosis, 4-mm punch biopsy samples were obtained from both patients from the lesions on the knees. Histology in both cases was in favour of psoriasis and also revealed empty vacuoles in the papillary dermis, concentrated at sites of intense lymphocyte infiltration. The empty vacuoles resembled true fat cells or fat globules. They did not reveal positive immunostaining with CD34 antigen, suggesting that they were not lined by endothelial cells. Final histological diagnosis was psoriasis associated with dermal vacuolization.

  6. Endobronchial biopsies on aspirin and prasugrel.

    PubMed

    Harris, Kassem; Kebbe, Jad

    2015-06-01

    Patients are generally required to stop antiplatelet therapy prior to elective invasive procedures. Some patients receive dual antiplatelet therapy for recent vascular procedures such as drug-eluting coronary stenting, and early discontinuation of antiplatelet agents could lead to a significant risk of stent thrombosis. Most bronchoscopic procedures are performed on patients using Aspirin but not on those using Clopidogrel or Prasugrel. In this report, we describe a unique case of a patient with a recent placement of drug-eluting stents, who required endobronchial biopsies for evaluation of lung cancer recurrence. The procedure was performed successfully and safely with no complications. PMID:25697386

  7. 24. A CORE WORKER DISPLAYS THE CORE BOX AND CORES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. A CORE WORKER DISPLAYS THE CORE BOX AND CORES FOR A BRASS GATE VALVE BODY MADE ON A CORE BOX, CA. 1950. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

  8. The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

    PubMed Central

    Bayar, Göksel; Horasanlı, Kaya; Acinikli, Hüseyin; Tanrıverdi, Orhan; Dalkılıç, Ayhan; Arısan, Serdar

    2016-01-01

    Objective To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. Material and methods In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005–2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level <10 ng/mL, number of positive cores <3, maximum cancer involvement ratio <50% each core. Immediate re-biopsy (within 3 months) was performed to 65 patients who accepted AS. Finally, 43 patients who met re-biopsy criteria were included in the study. Prostate biopsy specimens were harvested from 12 cores under the guidance of transrectal ultrasound (TRUS). Re-biopsy was performed within 3 months (1–12 weeks). In re-biopsy, a total of 20 core biopsies were performed including the far lateral (6 cores) and transition zone (2 cores) in addition to standard 12 core biopsy. Our follow-up protocol is PSA measurement and digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens. Results Patients’ median age was 61 years and PSA level was 5 (2.7–9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active

  9. Sentinel lymph node biopsy in breast cancer

    PubMed Central

    Alsaif, Abdulaziz A.

    2015-01-01

    Objectives: To report our experience in sentinel lymph node biopsy (SLNB) in early breast cancer. Methods: This is a retrospective study conducted at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between January 2005 and December 2014. There were 120 patients who underwent SLNB with frozen section examination. Data collected included the characteristics of patients, index tumor, and sentinel node (SN), SLNB results, axillary recurrence rate and SLNB morbidity. Results: There were 120 patients who had 123 cancers. Sentinel node was identified in 117 patients having 120 tumors (97.6% success rate). No SN was found intraoperatively in 3 patients. Frozen section results showed that 95 patients were SN negative, those patients had no immediate axillary lymph node dissection (ALND), whereas 25 patients were SN positive and subsequently had immediate ALND. Upon further examination of the 95 negative SN’s by hematoxylin & eosin (H&E) and immunohistochemical staining for doubtful H&E cases, 10 turned out to have micrometastases (6 had delayed ALND and 4 had no further axillary surgery). Median follow up of patients was 35.5 months and the mean was 38.8 months. There was one axillary recurrence observed in the SN negative group. The morbidity of SLNB was minimal. Conclusion: The obtainable results from our local experience in SLNB in breast cancer, concur with that seen in published similar literature in particular the axillary failure rate. Sentinel lymph node biopsy resulted in minimal morbidity. PMID:26318461

  10. Prostate volume and biopsy tumor length are significant predictors for classical and redefined insignificant cancer on prostatectomy specimens in Japanese men with favorable pathologic features on biopsy

    PubMed Central

    2014-01-01

    Background Gleason pattern 3 less often has molecular abnormalities and often behaves indolent. It is controversial whether low grade small foci of prostate cancer (PCa) on biopsy could avoid immediate treatment or not, because substantial cases harbor unfavorable pathologic results on prostatectomy specimens. This study was designed to identify clinical predictors for classical and redefined insignificant cancer on prostatectomy specimens in Japanese men with favorable pathologic features on biopsy. Methods Retrospective review of 1040 PCa Japanese patients underwent radical prostatectomy between 2006 and 2013. Of those, 170 patients (16.3%) met the inclusion criteria of clinical stage ≤ cT2a, Gleason score (GS) ≤ 6, up to two positive biopsies, and no more than 50% of cancer involvement in any core. The associations between preoperative data and unfavorable pathologic results of prostatectomy specimens, and oncological outcome were analyzed. The definition of insignificant cancer consisted of pathologic stage ≤ pT2, GS ≤ 6, and an index tumor volume < 0.5 mL (classical) or 1.3 mL (redefined). Results Pathologic stage ≥ pT3, upgraded GS, index tumor volume ≥ 0.5 mL, and ≥ 1.3 mL were detected in 25 (14.7%), 77 (45.3%), 83 (48.8%), and 53 patients (31.2%), respectively. Less than half of cases had classical (41.2%) and redefined (47.6%) insignificant cancer. The 5-year recurrence-free survival was 86.8%, and the insignificant cancers essentially did not relapse regardless of the surgical margin status. MRI-estimated prostate volume, tumor length on biopsy, prostate-specific antigen density (PSAD), and findings of magnetic resonance imaging were associated with the presence of classical and redefined insignificant cancer. Large prostate volume and short tumor length on biopsy remained as independent predictors in multivariate analysis. Conclusions Favorable features of biopsy often are followed by adverse pathologic

  11. Optical biopsy of the prostate: can we TRUST (trans-rectal ultrasound-coupled spectral tomography)?

    NASA Astrophysics Data System (ADS)

    Piao, Daqing; Jiang, Zhen; Bartels, Kenneth E.; Holyoak, G. Reed; Ritchey, Jerry W.; Rock, Kendra; Ownby, Charlotte L.; Bunting, Charles F.; Slobodov, Gennady

    2011-03-01

    Needle-based core-biopsy to locate prostate cancer relies heavily upon trans-rectal ultrasound (TRUS) imaging guidance. Ultrasonographic findings of classic hypoechoic peripheral zone lesions have a low specificity of ~28%, a low positive predictive value of ~29%, and an overall accuracy of ~43%, in prostate cancer diagnosis. The prevalence of isoechoic or nearly invisible prostate cancers on ultrasonography ranges from 25 to 42%. As a result, TRUS is useful and convenient to direct the needle trajectory following a systematic biopsy sampling template rather than to target only the potentially malignant lesion for focal-biopsy. To address this deficiency in the first-line of prostate cancer imaging, a trans-rectal ultrasound-coupled spectral tomography (TRUST) approach is being developed to non-invasively resolve the likely optical signatures of prostate malignancy. The approach has evolved from using one NIR wavelength to two NIR bands, and recently to three bands of NIR spectrum information. The concept has been evaluated on one normal canine prostate and three dogs with implanted prostate tumor developed as a model. The initial results implementing TRUST on the canine prostate tumor model includes: (1) quantifying substantially increased total hemoglobin concentration over the time-course of imaging in a rapidly growing prostate tumor; (2) confirming hypoxia in a prostatic cystic lesion; and (3) imaging hypoxic changes of a necrotic prostate tumor. Despite these interesting results, intensive technologic development is necessary for translating the approach to benefiting clinical practice, wherein the ultimate utility is not possibly to eliminate needle-biopsy but to perform focal-biopsy that is only necessary to confirm the cancer, as well as to monitor and predict treatment responses.

  12. Temporal artery biopsy: is there any value in examining biopsies at multiple levels?

    PubMed Central

    Chakrabarty, A; Franks, A

    2000-01-01

    Aims—To analyse the cost-effectiveness of three strategies for examining temporal artery biopsies based on data from cases examined over the past 10 years. Methods—Of a total of 172 temporal artery biopsies, five were unsuitable for further analysis, 47 had already had levels cut, and 120 had levels cut as part of the study. All the biopsies were examined blind before and after levels. A tree with eventual diagnostic outcomes for different strategies was constructed and economic and sensitivity analyses performed. Welcan units were used to assess technical workload. Results—Only one of the 132 initially normal cases and two of 14 diagnosed with periarterial lymphocytic infiltration (PALI) revealed giant cell arteritis after examining the tissue at multiple levels. Fifteen cases (8.9%) showed PALI not previously observed. The marginal cost for each extra case of giant cell arteritis detected was 83.5 Welcan units for a strategy of routine levels on all sections, and 21 Welcan units for a strategy of only cutting levels if PALI was present on the initial section. These costs were sensitive to the frequency of giant cell arteritis in cases with PALI and to the relative extra cost of moving from cutting single section to routine levels. Conclusions—Routinely examining a temporal artery biopsy at multiple levels does not increase the diagnostic yield of the test, although selective further examination may be indicated in some cases. The significance of PALI is uncertain. The cost-benefit of the different strategies in terms of clinical decision making revolve around the perceived risk inherent in not making a diagnosis of giant cell arteritis. Key Words: temporal artery biopsy • economic analysis • decision analysis PMID:10767829

  13. Blood based cell biopsy for early detection of cancer

    NASA Astrophysics Data System (ADS)

    Tang, Cha-Mei; Adams, Daniel; Adams, Diane; Alpaugh, R. Katherine; Cristofanilli, Massimo; Martin, Stuart; Chumsri, Saranya; Marks, Jeffrey

    Early detection (ED) of cancer holds the promise for less aggressive treatments and better outcome. However, there are few accepted methods for ED. We report on a previously unknown blood cell found specifically in the peripheral blood of many solid tumors. They are defined as Cancer Associated Macrophage-Like cells (CAMLs) and are characterized by large size (25-300 μm) and expression of cancer markers. CAMLs were isolated on precision filters during blood filtration. We conducted prospective studies in breast cancer (BC) to ascertain CAML prevalence, specificity and sensitivity in relation to disease status at clinical presentation. We report on two related but separate studies: 1) the isolation of CAMLs from patients with known invasive BC, compared to healthy volunteers and, 2) a double blind study conducted on women undergoing core needle biopsy to evaluate suspicious breast masses. The studies show that CAMLs are found in all stages of BC and suggest that detection of CAMLs can differentiate patients with BC from those with benign breast conditions and healthy individuals. This non-invasive blood test can be potentially used for ED of BC and other malignancies after validation studies with the advantage of a minimally invasive procedure and longitudinal monitoring. This work was supported by Grants from Maryland TEDCO MTTCF, R01-CA154624 from NIH, KG100240 from Susan G. Komen Foundation, Era of Hope Scholar award from DoD (BC100675), and U01-CA084955 from NCI EDRN.

  14. Performing bone marrow biopsies with or without sedation: a comparison.

    PubMed

    Giannoutsos, I; Grech, H; Maboreke, T; Morgenstern, G

    2004-06-01

    Although intravenous sedation (ISED) in addition to a local anaesthetic (LA) is commonly used in the performance of a bone marrow aspirate and trephine (BMAT), it is not clear under what circumstances and in which way sedation may be most beneficial. In this study, information was gathered using a questionnaire, from 112 patients shortly after undergoing BMAT; the duration of the procedures and the length of the biopsy cores were measured and any complications noted. Most patients (68%) chose to receive LA only, and almost all (74/76) were happy with their decision. Patients who received sedation gave lower pain scores than patients receiving LA only (1 vs. 3) and were found to have lower levels of apprehension at the thought of having a repeat procedure. Patients having a repeat BMAT showed a slightly increased preference for having sedation compared with patients who were undergoing it for the first time. There is some concern that guidelines regarding the use of ISED for procedures other than BMAT are not always adhered to, and current practice may be best revealed by a large-scale audit of sedation practice for the performance of BMAT. Patients should be given the choice of having ISED if the appropriate resources are available, but in most cases the additional small risk of receiving sedation can be avoided.

  15. Magnetic Resonance Imaging-Guided Osseous Biopsy in Children With Chronic Recurrent Multifocal Osteomyelitis

    SciTech Connect

    Fritz, Jan; Tzaribachev, Nikolay; Thomas, Christoph; Wehrmann, Manfred; Horger, Marius S.; Carrino, John A.; Koenig, Claudius W.; Pereira, Philippe L.

    2012-02-15

    Purpose: To report the safety and diagnostic performance of magnetic resonance (MRI)-guided core biopsy of osseous lesions in children with chronic recurrent multifocal osteomyelitis (CRMO) that were visible on MRI but were occult on radiography and computed tomography (CT). Materials and Methods: A retrospective analysis of MRI-guided osseous biopsy performed in seven children (four girls and three boys; mean age 13 years (range 11 to 14) with CRMO was performed. Indication for using MRI guidance was visibility of lesions by MRI only. MRI-guided procedures were performed with 0.2-Tesla (Magnetom Concerto; Siemens, Erlangen, Germany; n = 5) or 1.5-T (Magnetom Espree; Siemens; n = 2) open MRI systems. Core needle biopsy was obtained using an MRI-compatible 4-mm drill system. Conscious sedation or general anesthesia was used. Parameters evaluated were lesion visibility, technical success, procedure time, complications and microbiology, cytology, and histopathology findings. Results: Seven of seven (100%) targeted lesions were successfully visualized and sampled. All obtained specimens were sufficient for histopathological analysis. Length of time of the procedures was 77 min (range 64 to 107). No complications occurred. Histopathology showed no evidence of malignancy, which was confirmed at mean follow-up of 50 months (range 28 to 78). Chronic nonspecific inflammation characteristic for CRMO was present in four of seven (58%) patients, and edema with no inflammatory cells was found in three of seven (42%) patients. There was no evidence of infection in any patient. Conclusion: MRI-guided osseous biopsy is a safe and accurate technique for the diagnosis of pediatric CRMO lesions that are visible on MRI only.

  16. Direct MRI-guided biopsy of the prostate: use of post-biopsy needle track imaging to confirm targeting

    PubMed Central

    Nicholson, Alexander J.; Pettersson, David R.; Korngold, Elena K.; Foster, Bryan R.; Hung, Arthur Y.; Amling, Christopher L.; Coakley, Fergus V.

    2015-01-01

    Purpose To report the observation that in-plane post-biopsy T2-weighted MRI often demonstrates the needle track as a transient visible linear tissue distortion during direct MRI-guided biopsy. Materials and methods We retrospectively identified 11 prostatic lesions in 9 men that underwent direct MRI-guided biopsy and in which post-biopsy images were obtained in the plane of the biopsy needle. Results In 9 of 11 targets, a post-biopsy needle track was visible as a linear tissue distortion on in-plane T2-weighted images obtained at a mean interval of 6 min (range 3–15). In these nine cases, the needle track traversed the intended target, and the biopsy was positive for malignancy in six. Biopsy was positive in one of two cases where the needle track was not visible. In five targets, one or more delayed series were obtained after a mean interval of 21 min (range 8–33), showing the track was no longer visible (n = 3) or was of progressively decreased conspicuity (n = 2). Conclusion Accurate targeting during direct MRI-guided biopsy of the prostate can be confirmed by obtaining post-biopsy in-plane images, since the needle track is usually visible as a transient linear tissue distortion. PMID:25687631

  17. Ultrasound: a new tool for precisely locating posterior iliac crests to obtain adequate bone marrow trephine biopsy specimen.

    PubMed

    Islam, Anwarul

    2013-08-01

    Ultrasound imaging has evolved as a very useful tool in medical science. However, the technique of ultrasound-guided bone marrow trephine biopsy (BMTB) has not been routinely used by haematologists and oncologists to help locate the posterior iliac crest during the BMTB procedure. We have used the technique of ultrasound-guided BMTB in 20 patients diagnosed with various haematological and non-haematological malignant conditions. We found the technique simple and useful in precisely locating the posterior iliac crest. As a result, it facilitates the extraction of a satisfactory core sample or aspiration biopsy and is more surgically precise than when access to the target bone is based only on external landmarks and blind biopsy.

  18. Accuracy validation for MRI-guided robotic prostate biopsy

    NASA Astrophysics Data System (ADS)

    Xu, Helen; Lasso, Andras; Vikal, Siddharth; Guion, Peter; Krieger, Axel; Kaushal, Aradhana; Whitcomb, Louis L.; Fichtinger, Gabor

    2010-02-01

    We report a quantitative evaluation of the clinical accuracy of a MRI-guided robotic prostate biopsy system that has been in use for over five years at the U.S. National Cancer Institute. A two-step rigid volume registration using mutual information between the pre and post needle insertion images was performed. Contour overlays of the prostate before and after registration were used to validate the registration. A total of 20 biopsies from 5 patients were evaluated. The maximum registration error was 2 mm. The mean biopsy target displacement, needle placement error, and biopsy error was 5.4 mm, 2.2 mm, and 5.1 mm respectively. The results show that the pre-planned biopsy target did dislocate during the procedure and therefore causing biopsy errors.

  19. Stratification of the aggressiveness of prostate cancer using pre-biopsy multiparametric MRI (mpMRI).

    PubMed

    Dwivedi, Durgesh Kumar; Kumar, Rajeev; Bora, Girdhar S; Thulkar, Sanjay; Sharma, Sanjay; Gupta, Siddhartha Datta; Jagannathan, Naranamangalam R

    2016-03-01

    Risk stratification, based on the Gleason score (GS) of a prostate biopsy, is an important decision-making tool in prostate cancer management. As low-grade disease may not need active intervention, the ability to identify aggressive cancers on imaging could limit the need for prostate biopsies. We assessed the ability of multiparametric MRI (mpMRI) in pre-biopsy risk stratification of men with prostate cancer. One hundred and twenty men suspected to have prostate cancer underwent mpMRI (diffusion MRI and MR spectroscopic imaging) prior to biopsy. Twenty-six had cancer and were stratified into three groups based on GS: low grade (GS ≤ 6), intermediate grade (GS = 7) and high grade (GS ≥ 8). A total of 910 regions of interest (ROIs) from the peripheral zone (PZ, range 25-45) were analyzed from these 26 patients. The metabolite ratio [citrate/(choline + creatine)] and apparent diffusion coefficient (ADC) of voxels were calculated for the PZ regions corresponding to the biopsy cores and compared with histology. The median metabolite ratios for low-grade, intermediate-grade and high-grade cancer were 0.29 (range: 0.16, 0.61), 0.17 (range: 0.13, 0.32) and 0.13 (range: 0.05, 0.23), respectively (p = 0.004). The corresponding mean ADCs (×10(-3) mm(2) /s) for low-grade, intermediate-grade and high-grade cancer were 0.99 ± 0.08, 0.86 ± 0.11 and 0.69 ± 0.12, respectively (p < 0.0001). The combined ADC and metabolite ratio model showed strong discriminatory ability to differentiate subjects with GS ≤ 6 from subjects with GS ≥ 7 with an area under the curve of 94%. These data indicate that pre-biopsy mpMRI may stratify PCa aggressiveness noninvasively. As the recent literature data suggest that men with GS ≤ 6 cancer may not need radical therapy, our data may help limit the need for biopsy and allow informed decision making for clinical intervention. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Patient Outcomes in Canceled MRI-Guided Breast Biopsies

    PubMed Central

    Niell, Bethany L.; Lee, Janie M.; Johansen, Christopher; Halpern, Elkan F.; Rafferty, Elizabeth A.

    2013-01-01

    OBJECTIVE. The reported frequency of aborted MRI-guided breast biopsies ranges from 8% to 17%, usually secondary to nonvisualization at attempted biopsy. Our study examines the frequency of MRI-guided breast biopsies aborted because of lesion nonvisualization and the subsequent risk of malignancy. MATERIALS AND METHODS. We identified 350 patients and 445 lesions scheduled for MRI-guided biopsy between January 1, 2007, and December 31, 2009. Medical records and imaging studies were reviewed to ascertain patient demographics, lesion and imaging characteristics, and subsequent pathology results. Chi-square statistics were calculated for patient level analyses. RESULTS. MRI-guided biopsies were aborted in 13% (56/445) of lesions and 15% (53/350; 95% CI, 11.6–19.3%) of patients because of nonvisualization of the biopsy target at the time of attempted biopsy. Of these 53 patients, 50 patients had follow-up data available. Malignancy was subsequently diagnosed in five of those 50 patients (10%; 95% CI, 3.3–21.8%) patients, three with invasive ductal carcinomas and two with ductal carcinoma in situ. The mean time to malignant diagnosis from the date of aborted biopsy was 2.6 months (range, 1.1–6.9 months). CONCLUSION. Informed consent for MRI-guided breast biopsies should include discussion of biopsy cancellation because of nonvisualization of the target lesion. The low yet significant risk of malignancy in patients subsequent to an aborted MRI-guided breast biopsy warrants short-term follow-up MRI after a canceled biopsy. PMID:24370148

  1. Diagnostic yield of brain biopsies in children presenting to neurology.

    PubMed

    Venkateswaran, Sunita; Hawkins, Cynthia; Wassmer, Evangeline

    2008-03-01

    The role of brain biopsy is well established in patients with neoplastic lesions, with a diagnostic yield approaching 95%. The diagnostic yield of brain biopsy in adults with neurological decline varies from 20% to 43%. Only a few studies have examined the diagnostic yield of brain biopsy in children with idiopathic neurological decline. A retrospective analysis was conducted on all open and closed pediatric brain biopsies performed between January 1988 and May 2003. Biopsies were performed for diagnostic purposes in patients showing a progressively deteriorating neurologic course in whom less-invasive modalities such as neuroimaging, electroencephalography (EEG), and molecular genetic studies were either negative or inconclusive. Immunocompromised patients were included. Patients were excluded if the preoperative diagnosis was a neoplasm or if the patient was undergoing a resection as part of a work-up for intractable epilepsy. Each patient underwent numerous investigations before brain biopsy. The utility of each biopsy was analyzed. Sixty-six children had brain biopsies performed for diagnostic purposes during the study period. Patient ages ranged from 2 months to 16 years and 9 months at the time of biopsy. The diagnostic yield was 48.5% overall, with a yield of 68.8% between 1996 and 2003. Of the total, 26 (39.4%) biopsies were both diagnostic and useful. Patients most frequently presented with seizures (56.1%) and encephalopathy (33%). The most frequently diagnosed disease was vasculitis (18.2%). A total of 71.9% of patients with diagnostic biopsies improved with appropriate treatment. Brain biopsy in children had a diagnostic yield of 48.5% in our series. A specific diagnosis may help in management and outcome, especially with a diagnosis of vasculitis. PMID:18192645

  2. Microfabricated instrument for tissue biopsy and analysis

    DOEpatents

    Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

    2001-01-01

    A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate.

  3. Intrinsic Frequency and the Single Wave Biopsy

    PubMed Central

    Petrasek, Danny; Pahlevan, Niema M.; Tavallali, Peyman; Rinderknecht, Derek G.; Gharib, Morteza

    2015-01-01

    Insulin resistance is the hallmark of classical type II diabetes. In addition, insulin resistance plays a central role in metabolic syndrome, which astonishingly affects 1 out of 3 adults in North America. The insulin resistance state can precede the manifestation of diabetes and hypertension by years. Insulin resistance is correlated with a low-grade inflammatory condition, thought to be induced by obesity as well as other conditions. Currently, the methods to measure and monitor insulin resistance, such as the homeostatic model assessment and the euglycemic insulin clamp, can be impractical, expensive, and invasive. Abundant evidence exists that relates increased pulse pressure, pulse wave velocity (PWV), and vascular dysfunction with insulin resistance. We introduce a potential method of assessing insulin resistance that relies on a novel signal-processing algorithm, the intrinsic frequency method (IFM). The method requires a single pulse pressure wave, thus the term “ wave biopsy.” PMID:26183600

  4. Automated quantitative muscle biopsy analysis system

    NASA Technical Reports Server (NTRS)

    Castleman, Kenneth R. (Inventor)

    1980-01-01

    An automated system to aid the diagnosis of neuromuscular diseases by producing fiber size histograms utilizing histochemically stained muscle biopsy tissue. Televised images of the microscopic fibers are processed electronically by a multi-microprocessor computer, which isolates, measures, and classifies the fibers and displays the fiber size distribution. The architecture of the multi-microprocessor computer, which is iterated to any required degree of complexity, features a series of individual microprocessors P.sub.n each receiving data from a shared memory M.sub.n-1 and outputing processed data to a separate shared memory M.sub.n+1 under control of a program stored in dedicated memory M.sub.n.

  5. [Conjunctival rhinosporidiois diagnosed in a biopsy specimen].

    PubMed

    Zoroquiain, Pablo; Moreno, Alberto; Oddó, David

    2014-04-01

    11 years old girl, from south region of Chile, without history of travels outside Chile nor the province, complaints of red eye with blepharitis and blood-tingued epiphora. Eye exam revealed a pseudomembrane. Clinical diagnosis was folicular conjunctivitis. A surgical removal was performed and the lesion sent to biopsy analysis. On microscopic examination numerous 50-150 microm cysts with keratinous wall and numerous endospores were found. Rinosporidiosis is an infection caused by Rhinosporidium seeberi that frecuently affects nasal cavity but could infect eye, urogenital tract and airways. This infections is considered endemic in Asia and Africa, but it is very important to have the suspicious among polyps in these areas because travel to endemic areas is become more frecuently. PMID:24878912

  6. Percutaneous renal biopsy as an outpatient procedure.

    PubMed Central

    Alebiosu, Christopher O.; Kadiri, Solomon

    2004-01-01

    Percutaneous renal biopsy (PRB) is a safe and effective tool in the diagnosis and management of renal disease. It is the gold standard for evaluating renal parenchymal disease. It is both useful for diagnosis and monitoring progress of renal diseases. Where facilities and personnel are available to carry out the procedure in developing countries, it has become increasingly difficult for patients to pay for hospital admission fees, the procedure, and processing of the samples obtained. Information on the success rate and safety of the procedure is of interest to nephrologists for cost-benefit considerations and medicolegal purposes. This paper reports the outcome of outpatient PRB done among patients of the University College Hospital, Ibadan, Nigeria. With the use of ultrasound guidance, PRB remains a safe procedure and can be done on an outpatient basis. PMID:15481751

  7. The Practicality of Targeted Prostate Biopsy Procedures on the Dominant Side of the Tumor Determined by Magnetic Resonance Imaging in Elderly Patients with High Serum Levels of Prostate-Specific Antigen

    PubMed Central

    Huh, Jung Sik; Kim, Bong Soo; Kim, Young Joo; Kim, Sung Dae

    2015-01-01

    Purpose To examine the possibility of reducing the number of cores per prostate biopsy in elderly patients with high levels of prostate-specific antigen (PSA) without significantly lowering the detection rate of prostate cancer. Materials and Methods Two hundreds sixteen men with PSA levels >20 ng/mL who underwent prostate biopsies from May 2009 to April 2013 were retrospectively reviewed. With the help of magnetic resonance imaging (MRI), the laterality of the dominant tumor burden in patients was determined. The results of targeted biopsies were compared with those of conventional biopsy procedures. Results The mean age and PSA level were 79.5 years and 81.3 ng/mL, respectively, and the overall diagnostic rate of sextant biopsies was 81.9% (177/216). MRI was able to show the tumor burden in 189 of the 216 patients. The detection rate of transrectal ultrasonography (TRUS)-guided targeted biopsies was 87.3% (165/189). Detection rates were comparable with conventional biopsies (81.9% [177/216]) (p=0.23). Of the 177 men in whom the results of the sextant biopsy were positive, 12 men (6.8%) with PSA levels <29 ng/mL did not have any cancer cells according to targeted biopsies. However, all other patients were diagnosed with prostate cancer using the abovementioned techniques. Conclusions We believe that TRUS-guided targeted biopsies of the prostate in elderly men with high PSA levels could reduce the number of unnecessary cores per biopsy. However, a risk of detection loss remains. Therefore, we recommend that at least a sextant biopsy should be performed, even in elderly patients, in order to detect prostate cancer. PMID:26770939

  8. Needle aspiration biopsy in salivary gland lesions.

    PubMed

    Shaha, A R; Webber, C; DiMaio, T; Jaffe, B M

    1990-10-01

    The value of needle aspiration biopsy in the evaluation and management of salivary gland pathology is controversial. The major reasons for this controversy are the difficulty in cytologic evaluation and the fact that the extent of surgery can be easily defined based on clinical judgement. However, a preoperative diagnosis is helpful in discussions with patients regarding the extent and type of surgery. Apart from the fact that needle biopsy can distinguish benign from malignant conditions, it is also very useful in distinguishing between salivary and other nonsalivary pathology. Over the past 7 1/2 years, we have performed 160 needle aspirations of parotid, submandibular, and submucosal lesions. Adequate specimens for cytologic evaluation were obtained in 155 patients (97%). A total of 84 parotid lesions, 70 submandibular lumps, and 6 submucosal abnormalities were detected. A cytologic diagnosis of benign pathology was made in 120 patients. Twelve patients had lymphoma and the diagnosis was suspected based on needle aspiration. There were 10 patients with tuberculosis and 30 patients with hyperplastic lymph nodes or benign lymphoepithelial disease of the parotid. There were three false-positive and two false-negative reports. No complications such as hematoma, nerve injury, or infection developed. The major difficulty was in distinguishing between malignancy and obstructive sialadenitis in the submandibular region. Needle aspiration was helpful in evaluating lesions in the tail of the parotid and submandibular area. The cytologic distinction between salivary and nonsalivary pathology was useful in planning the appropriate surgery and the extent of surgical resection. From a clinical standpoint, the distinction between benign and malignant salivary and nonsalivary pathology was very helpful. Preoperative diagnosis of Warthin's tumor, lymphoma, or benign lymphoepithelial disease was essential to the correct management of these patients.

  9. Preservative solution for skeletal muscle biopsy samples

    PubMed Central

    Kurt, Yasemin Gulcan; Kurt, Bulent; Ozcan, Omer; Topal, Turgut; Kilic, Abdullah; Muftuoglu, Tuba; Acikel, Cengizhan; Sener, Kenan; Sahiner, Fatih; Yigit, Nuri; Aydin, Ibrahim; Alay, Semih; Ekinci, Safak

    2015-01-01

    Context: Muscle biopsy samples must be frozen with liquid nitrogen immediately after excision and maintained at -80°C until analysis. Because of this requirement for tissue processing, patients with neuromuscular diseases often have to travel to centers with on-site muscle pathology laboratories for muscle biopsy sample excision to ensure that samples are properly preserved. Aim: Here, we developed a preservative solution and examined its protectiveness on striated muscle tissues for a minimum of the length of time that would be required to reach a specific muscle pathology laboratory. Materials and Methods: A preservative solution called Kurt-Ozcan (KO) solution was prepared. Eight healthy Sprague-Dawley rats were sacrificed; striated muscle tissue samples were collected and divided into six different groups. Muscle tissue samples were separated into groups for morphological, enzyme histochemical, molecular, and biochemical analysis. Statistical method used: Chi-square and Kruskal Wallis tests. Results: Samples kept in the KO and University of Wisconsin (UW) solutions exhibited very good morphological scores at 3, 6, and 18 hours, but artificial changes were observed at 24 hours. Similar findings were observed for the evaluated enzyme activities. There were no differences between the control group and the samples kept in the KO or UW solution at 3, 6, and 18 hours for morphological, enzyme histochemical, and biochemical features. The messenger ribonucleic acid (mRNA) of β-actin gene was protected up to 6 hours in the KO and UW solutions. Conclusion: The KO solution protects the morphological, enzyme histochemical, and biochemical features of striated muscle tissue of healthy rats for 18 hours and preserves the mRNA for 6 hours. PMID:26019417

  10. Core layering

    NASA Astrophysics Data System (ADS)

    Jacobson, S. A.; Rubie, D. C.; Hernlund, J. W.; Morbidelli, A.

    2015-12-01

    We have created a planetary accretion and differentiation model that self-consistently builds and evolves Earth's core. From this model, we show that the core grows stably stratified as the result of rising metal-silicate equilibration temperatures and pressures, which increases the concentrations of light element impurities into each newer core addition. This stable stratification would naturally resist convection and frustrate the onset of a geodynamo, however, late giant impacts could mechanically mix the distinct accreted core layers creating large homogenous regions. Within these regions, a geodynamo may operate. From this model, we interpret the difference between the planetary magnetic fields of Earth and Venus as a difference in giant impact histories. Our planetary accretion model is a numerical N-body integration of the Grand Tack scenario [1]—the most successful terrestrial planet formation model to date [2,3]. Then, we take the accretion histories of Earth-like and Venus-like planets from this model and post-process the growth of each terrestrial planet according to a well-tested planetary differentiation model [4,5]. This model fits Earth's mantle by modifying the oxygen content of the pre-cursor planetesimals and embryos as well as the conditions of metal-silicate equilibration. Other non-volatile major, minor and trace elements included in the model are assumed to be in CI chondrite proportions. The results from this model across many simulated terrestrial planet growth histories are robust. If the kinetic energy delivered by larger impacts is neglected, the core of each planet grows with a strong stable stratification that would significantly impede convection. However, if giant impact mixing is very efficient or if the impact history delivers large impacts late, than the stable stratification can be removed. [1] Walsh et al. Nature 475 (2011) [2] O'Brien et al. Icarus 223 (2014) [3] Jacobson & Morbidelli PTRSA 372 (2014) [4] Rubie et al. EPSL 301

  11. Discontinuation of Anticoagulant or Antiplatelet Therapy for Transrectal Ultrasound-Guided Prostate Biopsies: A Single-Center Experience

    PubMed Central

    Casey, Rowan G; Galvin, David J; Manecksha, Rustom P; Varadaraj, Haradikar; McDermott, TED; Grainger, Ronald; Lynch, Thomas H

    2012-01-01

    Purpose Historically, it was thought that hemorrhagic complications were increased with transrectal ultrasound-guided prostate biopsies (TRUS biopsy) of patients receiving anticoagulation/antiplatelet therapy. However, the current literature supports the continuation of anticoagulation/antiplatelet therapy without additional morbidity. We assessed our experience regarding the continuation of anticoagulation/antiplatelet therapy during TRUS biopsy. Materials and Methods A total of 91 and 98 patients were included in the anticoagulation/antiplatelet (group I) and control (group II) groups, respectively. Group I subgroups consisted of patients on monotherapy or dual therapy of aspirin, warfarin, clopidogrel, or low molecular weight heparin. The TRUS biopsy technique was standardized to 12 cores from the peripheral zones. Patients completed a questionnaire over the 7 days following TRUS biopsy. The questionnaire was designed to assess the presence of hematuria, rectal bleeding, and hematospermia. Development of rectal pain, fever, and emergency hospital admissions following TRUS biopsy were also recorded. Results The patients' mean age was 65 years (range, 52 to 74 years) and 63.5 years (range, 54 to 74 years) in groups I and II, respectively. The overall incidence of hematuria was 46% in group I compared with 63% in group II (p=0.018). The incidence of hematospermia was 6% and 10% in groups I and II, respectively. The incidence of rectal bleeding was similar in group I (40%) and group II (39%). Statistical analysis was conducted by using Fisher exact test. Conclusions There were fewer hematuria episodes in anticoagulation/antiplatelet patients. This study suggests that it is not necessary to discontinue anticoagulation/antiplatelet treatment before TRUS biopsy. PMID:22536465

  12. Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

    PubMed Central

    Prasad, Narayan; Kumar, Shashi; Manjunath, Revanasiddappa; Bhadauria, Dharmendra; Kaul, Anupama; Sharma, Raj K; Gupta, Amit; Lal, Hira; Jain, Manoj; Agrawal, Vinita

    2015-01-01

    Background Percutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods. Methods We compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004–December 2010 and 628 biopsies during second period from January 2011–March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period. Results Of all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h. Conclusions Real-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications. PMID:25815170

  13. Automatic biopsy instruments used through a coaxial bone biopsy system with an eccentric drill tip.

    PubMed

    Aström, K G; Sundström, J C; Lindgren, P G; Ahlström, K H

    1995-05-01

    Twenty-eight consecutive CT (n = 23) or ultrasonographically (n = 5) guided biopsy procedures were performed on musculoskeletal lytic lesions covered (n = 13) or not covered (n = 15) with intact bone. Specimens were obtained by means of Biopty techniques (n = 27), i.e. Biopty and Monopty instruments, through different cannulas with normal or shortened needle-throws. Four out of 5 bone penetrations were successful with an Ostycut needle, and all 8 bone penetrations by a coaxial bone biopsy system with an eccentric drill. The eccentric drill makes a hole in the cortical bone larger than the diameter of the outer cannula of this system, making it easy to anchor the cannula and then coaxially insert a Biopty-Gun needle for example. The overall histopathological diagnostic accuracy of the Biopty techniques was 25/27 (92.6%).

  14. Renal biopsy in the management of lupus nephritis during pregnancy.

    PubMed

    Chen, T K; Gelber, A C; Witter, F R; Petri, M; Fine, D M

    2015-02-01

    The differential diagnosis of proteinuria and hematuria in pregnancy is broad and includes active lupus nephritis. Identification of the correct diagnosis often has a profound therapeutic impact on not only the mother but also the fetus. To date, relatively few reports exist on the role of renal biopsy during pregnancy among women with systemic lupus erythematosus (SLE). We present a case series of 11 pregnant women with SLE who underwent a renal biopsy to evaluate a presumptive flare of lupus nephritis. The electronic medical record was retrospectively analyzed for pre-biopsy serum creatinine, proteinuria, hematuria, antinuclear antibodies (ANA), and antibodies to double-stranded DNA (anti-dsDNA); histologic findings on renal biopsy; and the clinical course of each mother and fetus. From 2001 to 2012, 11 pregnant women with SLE flares during pregnancy underwent a renal biopsy at an academic tertiary medical center. At the time of biopsy, median gestational age was 16 weeks (range 9 to 27), median serum creatinine was 0.6 mg/dl (interquartile range 0.5 to 0.9), six (55%) had hematuria, and all had proteinuria >500 mg/24 hours. Proliferative lupus nephritis was found in 10 (91%) of 11 biopsies (five with ISN/RPS Class III; five with ISN/RPS Class IV). All but one individual underwent a change in management guided by information gleaned from renal biopsy. No apparent biopsy-related complications occurred to mother or fetus. Three women elected to terminate their pregnancy; although many factors were involved, the findings on renal biopsy informed the decision-making process. Among the remaining cases, there were three pre-term deliveries, one fetus with complete heart block, one in utero demise, and one maternal death. Renal biopsy is helpful at informing the management of patients with lupus nephritis during pregnancy.

  15. Limitations of stereotactic biopsy in the initial management of gliomas.

    PubMed Central

    Jackson, R. J.; Fuller, G. N.; Abi-Said, D.; Lang, F. F.; Gokaslan, Z. L.; Shi, W. M.; Wildrick, D. M.; Sawaya, R.

    2001-01-01

    Stereotactic biopsy is often performed for diagnostic purposes before treating patients whose imaging studies highly suggest glioma. Indications cited for biopsy include diagnosis and/or the "inoperability" of the tumor. This study questions the routine use of stereotactic biopsy in the initial management of gliomas. At The University of Texas M. D. Anderson Cancer Center, we retrospectively reviewed a consecutive series of 81 patients whose imaging studies suggested glioma and who underwent stereotactic biopsy followed by craniotomy/resection (within 60 days) between 1993 and 1998. All relevant clinical and imaging information was reviewed, including computerized volumetric analysis of the tumors based on pre- and postoperative MRI. Stereotactic biopsy was performed at institutions other than M. D. Anderson in 78 (96%) of 81 patients. The majority of tumors were located either in eloquent brain (36 of 81 = 44%) or near-eloquent brain (41 of 81 = 51%), and this frequently was the rationale cited for performing stereotactic biopsy. Gross total resection (>95%) was achieved in 46 (57%) of 81 patients, with a median extent of resection of 96% for this series. Diagnoses based on biopsy or resection in the same patient differed in 40 (49%) of 82 cases. This discrepancy was reduced to 30 (38%) of 80 cases when the biopsy slides were reviewed preoperatively by each of three neuropathologists at M. D. Anderson. Major neurologic complications occurred in 10 (12.3%) of 81 surgical patients and 3 (3.7%) of 81 patients undergoing biopsy. Surgical morbidity was probably higher in our series than it would be for glioma patients in general because our patients represent a highly selected subset of glioma patients whose tumors present a technical challenge to remove. Stereotactic biopsy is frequently inaccurate in providing a correct diagnosis and is associated with additional risk and cost. If stereotactic biopsy is performed, expert neuropathology consultation should be sought

  16. PET-directed, 3D Ultrasound-guided prostate biopsy

    PubMed Central

    Fei, Baowei; Nieh, Peter T; Schuster, David M; Master, Viraj A

    2013-01-01

    Multimodatity imaging is a promising approach for improving prostate cancer detection and diagnosis. This article describes various concepts in PET-directed, ultrasound-guided biopsies and highlights a new PET/ultrasound fusion targeted biopsy system for prostate cancer detection. PMID:25392702

  17. Diagnosis of sarcoidosis by lip biopsy of minor salivary glands

    PubMed Central

    Tannenbaum, Hyman; Anderson, Larry G.; Rosenberg, Earle H.; Sheffer, Albert L.

    1974-01-01

    In two patients with bilateral parotid gland swelling of unknown etiology the diagnosis of sarcoidosis was established by lip biopsy of the minor salivary glands. This simple, innocuous biopsy procedure may prove useful in tissue documentation of sarcoidosis. ImagesFIG. 1 PMID:4442017

  18. Diffuse reflectance imaging: a tool for guided biopsy

    NASA Astrophysics Data System (ADS)

    Jayanthi, Jayaraj L.; Subhash, Narayanan; Manju, Stephen; Nisha, Unni G.; Beena, Valappil T.

    2012-01-01

    Accurate diagnosis of premalignant or malignant oral lesions depends on the quality of the biopsy, adequate clinical information and correct interpretation of the biopsy results. The major clinical challenge is to precisely locate the biopsy site in a clinically suspicious lesion. Dips due to oxygenated hemoglobin absorption have been noticed at 545 and 575 nm in the diffusely reflected white light spectra of oral mucosa and the intensity ratio R545/R575 has been found suited for early detection of oral pre-cancers. A multi-spectral diffuse reflectance (DR) imaging system has been developed consisting of an electron multiplying charge coupled device (EMCCD) camera and a liquid crystal tunable filter for guiding the clinician to an optimal biopsy site. Towards this DR images were recorded from 27 patients with potentially malignant lesions on their tongue (dorsal, lateral and ventral sides) and from 44 healthy controls at 545 and 575 nm with the DR imaging system. False colored ratio image R545/R575 of the lesion provides a visual discerning capability that helps in locating the most malignant site for biopsy. Histopathological report of guided biopsy showed that out of the 27 patients 16 were cancers, 9 pre-cancers and 2 lichen planus. In this clinical trial DR imaging has correctly guided 25 biopsy sites, yielding a sensitivity of 93% and a specificity of 98%, thereby establishing the potential of DR imaging as a tool for guided biopsy.

  19. Biopsy of the right adrenal gland by the transhepatic approach

    SciTech Connect

    Price, R.B.; Bernardino, M.E.; Berkman, W.A.; Sones, P.J. Jr.; Torres, W.E.

    1983-08-01

    A transhepatic computed-tomographic-guided biopsy of a right adrenal mass is described. This method is simpler to perform than the usual posterior biopsy carried out with the patient prone and is less likely to cause a complicating pneumothorax. In seven of eight patients with right adrenal masses, adrenal tissue was obtained and an accurate diagnosis was possible. No complications resulted.

  20. My approach to the interpretation of endometrial biopsies and curettings

    PubMed Central

    McCluggage, W G

    2006-01-01

    A major proportion of the workload in many histopathology laboratories is accounted for by endometrial biopsies, either curettage specimens or outpatient biopsy specimens. The increasing use of pipelle and other methods of biopsy not necessitating general anaesthesia has resulted in greater numbers of specimens with scant tissue, resulting in problems in assessing adequacy and in interpreting artefactual changes, some of which appear more common with outpatient biopsies. In this review, the criteria for adequacy and common artefacts in endometrial biopsies, as well as the interpretation of endometrial biopsies in general, are discussed, concentrating on areas that cause problems for pathologists. An adequate clinical history, including knowledge of the age, menstrual history and menopausal status, and information on the use of exogenous hormones and tamoxifen, is necessary for the pathologist to critically evaluate endometrial biopsies. Topics such as endometritis, endometrial polyps, changes that are induced by hormones and tamoxifen within the endometrium, endometrial metaplasias and hyperplasias, atypical polypoid adenomyoma, adenofibroma, adenosarcoma, histological types of endometrial carcinoma and grading of endometrial carcinomas are discussed with regard to endometrial biopsy specimens rather than hysterectomy specimens. The value of ancillary techniques, especially immunohistochemistry, is discussed where appropriate. PMID:16873562

  1. Percutaneous lung biopsy in the horse: comparison of two instruments and repeated biopsy in horses with induced acute interstitial pneumopathy.

    PubMed

    Venner, M; Schmidbauer, S; Drommer, W; Deegen, E

    2006-01-01

    The aim of the study reported here was to compare complications of lung biopsy in horses and the quality of the lung specimens after biopsy using the manual Tru-Cut biopsy needle (TC) and an automated biopsy needle (ABN). For experiment 1, lung biopsy was performed in 50 horses with one instrument on one side of the thorax, and then with the other instrument on the other side. Postmortem examination was performed in 20 of the 50 horses. Coughing was detected in 10 of 50 horses and epistaxis was observed in 6 of the 50 horses. Endoscopy revealed bleeding into the airways in 16 of 49 horses and in 5 of 49 horses after biopsy with the TC or the ABN, respectively. Use of the ABN induced a significantly smaller amount of bleeding. Pneumothorax was detected by radiography in 1 of 50 horses. Hematoma diameter determined in 7 of 20 horses at postmortem examination, was significantly larger after biopsy with the TC than with the ABN. The quality of the lung specimen was good. In experiment 2, complications after repeated and multiple lung biopsies in 6 horses were evaluated. Moderate epistaxis was observed on 13 of 104 occasions. Bleeding into the airways was detected at endoscopy on 41 of 104 occasions, and pneumothorax was detected during 4 of 104 occasions. Complications such as hematoma at the biopsy site and bleeding into the airways were greater after biopsy with the TC than after use of the ABN. Lung biopsy specimens obtained with the ABN were fairly safe for the animal.

  2. Recent advances in image-guided targeted prostate biopsy.

    PubMed

    Brown, Anna M; Elbuluk, Osama; Mertan, Francesca; Sankineni, Sandeep; Margolis, Daniel J; Wood, Bradford J; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-08-01

    Prostate cancer is a common malignancy in the United States that results in over 30,000 deaths per year. The current state of prostate cancer diagnosis, based on PSA screening and sextant biopsy, has been criticized for both overdiagnosis of low-grade tumors and underdiagnosis of clinically significant prostate cancers (Gleason score ≥7). Recently, image guidance has been added to perform targeted biopsies of lesions detected on multi-parametric magnetic resonance imaging (mpMRI) scans. These methods have improved the ability to detect clinically significant cancer, while reducing the diagnosis of low-grade tumors. Several approaches have been explored to improve the accuracy of image-guided targeted prostate biopsy, including in-bore MRI-guided, cognitive fusion, and MRI/transrectal ultrasound fusion-guided biopsy. This review will examine recent advances in these image-guided targeted prostate biopsy techniques. PMID:25596716

  3. The global burden of major infectious complications following prostate biopsy.

    PubMed

    Bennett, H Y; Roberts, M J; Doi, S A R; Gardiner, R A

    2016-06-01

    We present a systematic review providing estimates of the overall and regional burden of infectious complications following prostate biopsy. A directly standardized prevalence estimate was used because it reflects the burden of disease more explicitly. Complications included sepsis, hospitalization, bacteraemia, bacteriuria, and acute urinary retention after biopsy. There were 165 articles, comprising 162 577 patients, included in the final analysis. Our findings demonstrate that transrectal biopsy was associated with a higher burden of hospitalization (1·1% vs. 0·9%) and sepsis (0·8% vs. 0·1%) compared to transperineal biopsy, while acute urinary retention was more prevalent after transperineal than transrectal biopsy (4·2% vs. 0·9%). The differences were statistically non-significant because of large heterogeneity across countries. We also demonstrate and discuss regional variations in complication rates, with Asian studies reporting higher rates of sepsis and hospitalization.

  4. Aspiration biopsy of testis: another method for histologic examination

    SciTech Connect

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-08-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective.

  5. CT-directed robotic biopsy testbed: motivation and concept

    NASA Astrophysics Data System (ADS)

    Cleary, Kevin R.; Stoianovici, Dan S.; Glossop, Neil D.; Gary, Kevin A.; Onda, Sumiyo; Cody, Richard; Lindisch, David; Stanimir, Alexandru; Mazilu, Dumitru; Patriciu, Alexandru; Watson, Vance; Levy, Elliot

    2001-05-01

    As a demonstration platform, we are developing a robotic biopsy testbed incorporating a mobile CT scanner, a small needle driver robot, and an optical localizer. This testbed will be used to compare robotically assisted biopsy to the current manual technique, and allow us to investigate software architectures for integrating multiple medical devices. This is a collaboration between engineers and physicians from three universities and a commercial vendor. In this paper we describe the CT-directed biopsy technique, review some other biopsy systems including passive and semi- autonomous devices, describe our testbed components, and present our software architecture. This testbed is a first step in developing the image-guided, robotically assisted, physician directed, biopsy systems of the future.

  6. Patient information preferences and behaviour in relation to oral biopsies.

    PubMed

    López-Jornet, P; Camacho-Alonso, F; Sanchez-Siles, M

    2012-12-01

    Our aim was to study the impact of information on the behaviour of patients who were to have an oral biopsy specimen taken. Patients were randomly assigned either to be given the basic information about oral biopsy or a more extensive amount of information. The Krantz Health Opinion Survey was used as a measure of preferences in decisions made about oral biopsy, and we used a questionnaire to assess anxiety. A total of 260 patients were studied. The participants were satisfied with the information provided (both form and content), but significantly more of those given basic information would have liked to know more (p=0.02). We conclude that information exerts a clear effect on patients' attitude to oral biopsy. Provision of preoperative information leads to significantly less anxiety in all patients having a procedure under local anaesthesia. The results emphasise that patients need to be adequately informed about oral biopsy.

  7. The global burden of major infectious complications following prostate biopsy.

    PubMed

    Bennett, H Y; Roberts, M J; Doi, S A R; Gardiner, R A

    2016-06-01

    We present a systematic review providing estimates of the overall and regional burden of infectious complications following prostate biopsy. A directly standardized prevalence estimate was used because it reflects the burden of disease more explicitly. Complications included sepsis, hospitalization, bacteraemia, bacteriuria, and acute urinary retention after biopsy. There were 165 articles, comprising 162 577 patients, included in the final analysis. Our findings demonstrate that transrectal biopsy was associated with a higher burden of hospitalization (1·1% vs. 0·9%) and sepsis (0·8% vs. 0·1%) compared to transperineal biopsy, while acute urinary retention was more prevalent after transperineal than transrectal biopsy (4·2% vs. 0·9%). The differences were statistically non-significant because of large heterogeneity across countries. We also demonstrate and discuss regional variations in complication rates, with Asian studies reporting higher rates of sepsis and hospitalization. PMID:26645476

  8. NOTE: Adaptation of a 3D prostate cancer atlas for transrectal ultrasound guided target-specific biopsy

    NASA Astrophysics Data System (ADS)

    Narayanan, R.; Werahera, P. N.; Barqawi, A.; Crawford, E. D.; Shinohara, K.; Simoneau, A. R.; Suri, J. S.

    2008-10-01

    Due to lack of imaging modalities to identify prostate cancer in vivo, current TRUS guided prostate biopsies are taken randomly. Consequently, many important cancers are missed during initial biopsies. The purpose of this study was to determine the potential clinical utility of a high-speed registration algorithm for a 3D prostate cancer atlas. This 3D prostate cancer atlas provides voxel-level likelihood of cancer and optimized biopsy locations on a template space (Zhan et al 2007). The atlas was constructed from 158 expert annotated, 3D reconstructed radical prostatectomy specimens outlined for cancers (Shen et al 2004). For successful clinical implementation, the prostate atlas needs to be registered to each patient's TRUS image with high registration accuracy in a time-efficient manner. This is implemented in a two-step procedure, the segmentation of the prostate gland from a patient's TRUS image followed by the registration of the prostate atlas. We have developed a fast registration algorithm suitable for clinical applications of this prostate cancer atlas. The registration algorithm was implemented on a graphical processing unit (GPU) to meet the critical processing speed requirements for atlas guided biopsy. A color overlay of the atlas superposed on the TRUS image was presented to help pick statistically likely regions known to harbor cancer. We validated our fast registration algorithm using computer simulations of two optimized 7- and 12-core biopsy protocols to maximize the overall detection rate. Using a GPU, patient's TRUS image segmentation and atlas registration took less than 12 s. The prostate cancer atlas guided 7- and 12-core biopsy protocols had cancer detection rates of 84.81% and 89.87% respectively when validated on the same set of data. Whereas the sextant biopsy approach without the utility of 3D cancer atlas detected only 70.5% of the cancers using the same histology data. We estimate 10-20% increase in prostate cancer detection rates

  9. Microfabricated instrument for tissue biopsy and analysis

    SciTech Connect

    Krulevitch, P.A.; Lee, A.P.; Northrup, M.A.; Benett, W.J.

    1999-11-16

    This invention relates to a microfabricated biopsy/histology instrument which has several advantages over the conventional procedures. The advantages include: minimal specimen handling; smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 {mu}m or greater); micro-liter volumes of chemicals for treating the specimens; low cost; disposable; fabrication process which renders sterile parts; and ease of use. The cutter is a cheese-grater style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate. For automation purposes, microvalves and micropumps may be incorporated. Also, specimens in parallel may be cut and treated with identical or varied chemicals. The instrument is disposable due to its low cost and thus could replace current expensive microtome and histology equipment.

  10. Uncompacted myelin lamellae in peripheral nerve biopsy.

    PubMed

    Vital, Claude; Vital, Anne; Bouillot, Sandrine; Favereaux, Alexandre; Lagueny, Alain; Ferrer, Xavier; Brechenmacher, Christiane; Petry, Klaus G

    2003-01-01

    Since 1979, the authors have studied 49 peripheral nerve biopsies presenting uncompacted myelin lamellae (UML). Based on the ultrastructural pattern of UML they propose a 3-category classification. The first category includes cases displaying regular UML, which was observed in 43 cases; it was more frequent in 9 cases with polyneuropathy organomegaly endocrinopathy m-protein skin changes (POEMS) syndrome as well as in 1 case of Charcot-Marie-Tooth 1B with a novel point mutation in the P0 gene. The second category consists of cases showing irregular UML, observed in 4 cases with IgM monoclonal gammopathy and anti-myelin-associated glycoprotein (MAG) activity. This group included 1 benign case and 3 B-cell malignant lymphomas. The third category is complex UML, which was present in 2 unrelated patients with an Arg 98 His missense mutation in the P0 protein gene. Irregular and complex UML are respectively related to MAG and P0, which play a crucial role in myelin lamellae compaction and adhesion.

  11. Fine needle aspiration biopsy of thyroid nodules

    PubMed Central

    Arda, I; Yildirim, S; Demirhan, B; Firat, S

    2001-01-01

    BACKGROUND—Fine needle aspiration biopsy (FNA) is a routine diagnostic technique for evaluating thyroid nodules. Many reports in adults consider that FNA is superior to thyroid ultrasonography (USG) and radionuclide scanning (RS). Only five studies have been published on FNA of childhood thyroid nodules.
AIMS—To investigate the reliability of FNA in the evaluation and management of thyroid nodules, and compare the results of FNA, USG, and RS with regard to final histopathological diagnosis.
METHODS—FNA was performed in 46 children with thyroid nodules after USG and RS examination. We investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of USG, RS, and FNA in their management.
RESULTS—Six patients who had malignant or suspicious cells on FNA examination underwent immediate surgery. The other 40 patients received medical treatment according to their hormonal status. Fifteen of these nodules either disappeared or decreased in number and/or size. Surgery was performed in 25 patients who did not respond to therapy. Statistical analysis revealed sensitivity, specificity, accuracy, and positive and negative predictive values respectively as follows: 60%, 59%, 59%, 15%, and 92% for USG; 30%, 42%, 39%, 12%, and 68% for SC; 100%, 95%, 95%, 67%, and 100% for FNAB.
CONCLUSION—FNAB is as reliable in children as in adults for definitive diagnosis of thyroid nodules. Using this technique avoids unnecessary thyroid surgery in children.

 PMID:11567941

  12. Microfabricated instrument for tissue biopsy and analysis

    DOEpatents

    Krulevitch, Peter A.; Lee, Abraham P.; Northrup, M. Allen; Benett, William J.

    1999-01-01

    A microfabricated biopsy/histology instrument which has several advantages over the conventional procedures, including minimal specimen handling, smooth cutting edges with atomic sharpness capable of slicing very thin specimens (approximately 2 .mu.m or greater), micro-liter volumes of chemicals for treating the specimens, low cost, disposable, fabrication process which renders sterile parts, and ease of use. The cutter is a "cheese-grater" style design comprising a block or substrate of silicon and which uses anisotropic etching of the silicon to form extremely sharp and precise cutting edges. As a specimen is cut, it passes through the silicon cutter and lies flat on a piece of glass which is bonded to the cutter. Microchannels are etched into the glass or silicon substrates for delivering small volumes of chemicals for treating the specimen. After treatment, the specimens can be examined through the glass substrate. For automation purposes, microvalves and micropumps may be incorporated. Also, specimens in parallel may be cut and treated with identical or varied chemicals. The instrument is disposable due to its low cost and thus could replace current expensive microtome and histology equipment.

  13. The role of biopsy in incidental renal tumours☆

    PubMed Central

    Al-Marhoon, Mohammed S.

    2011-01-01

    Purpose Historically, the biopsy of renal masses was not advocated, and to date there remains some controversy on the role of biopsy for renal masses in making treatment decisions. With the widespread use of imaging methods, the incidental diagnosis of renal masses has increased, necessitating renal biopsies to better plan the management of these tumours. Here I review previous reports to define the role of biopsy in incidental renal tumours. Methods Data were obtained from English-language studies listed in PubMed on the use of renal biopsy for evaluating incidental solid small renal tumours. Results The biopsy of small renal tumours is increasingly accepted due to: the increase in the incidence of small renal tumours; the finding that a significant number of these tumours are benign; the availability of new management options, such as ablative therapy and surveillance strategies; that imaging alone is unable to predict the biological behaviour of these tumours; and advances in the pathological evaluation of the biopsies. The biopsy procedure has an acceptable complication rate but is not free of limitations. The current recommendations for the use of renal biopsy in small renal tumours are: to help in differentiating benign from malignant renal tumours; before or during ablative therapies and during the follow-up after ablative therapies, for defining treatment success or failure; and to exclude nonrenal cell primary tumours (metastasis and lymphoma) or benign conditions (abscess), which may not require surgery. Conclusions The biopsy of small renal tumours is a safe and accurate procedure, and can help in the planning of definitive patient management. PMID:26579260

  14. Transrectal-ultrasound prostatic biopsy preparation: rectal enema vs. mechanical bowel preparation

    PubMed Central

    Lombardo, Riccardo; Presicce, Fabrizio; Bellangino, Mariangela; Agro, Enrico Finazzi; Gambrosier, Matteo Bonetto; Trucchi, Alberto; Petta, Stefano; Tubaro, Andrea

    2015-01-01

    Introduction Transrectal prostate biopsy (TRUSbx) is the standard for the diagnosis of prostate cancer. Different bowel preparations are used for patients undergoing TRUSbx. The aim of our study was to compare two different bowel preparations for TRUSbx. Material and methods From May 2012 and onwards, a selected group of men undergoing TRUS 12-core prostate biopsy were enrolled into a prospective database. Patients were randomized 1:1 to receive a rectal enema (Group A) the night before the procedure or polyethylene glycol 34.8 grams/4 liters of water the day before the procedure (Group B). A VAS scale to evaluate the patients’ discomfort according to the two preparations was collected. The same antibiotic prophylaxis was performed in both groups. All complications were prospectively recorded and graded according to the Clavien Classification System (CCS). Results A total of 198 patients were consecutively enrolled. Mean age was 67.5 ±7.9 years, mean body mass index (BMI) was 27.1 ±4.2 Kg/m2, mean PSA value was 9.3 ±12.6 ng/ml and the mean prostatic volume was 60.6 ±29 ml. 97 patients were enrolled in Group A and 101 in Group B. Overall post-biopsy morbidity rate was 60%. No significant differences for low-grade and high-grade complications was observed between the two groups. Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02). Conclusions Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort. PMID:26251750

  15. [The repeated biopsy in patients with lupus nephritis].

    PubMed

    Subils, Gisella; Alba, Paula; Gobbi, Carla; Astesana, Pablo; Babini, Alejandra; Albiero, Eduardo

    2014-01-01

    We retrospectively studied patients with SLE according to ACR criteria, with NL who underwent a repeat renal biopsy from 2005 to 2012. We analyzed the main indications of renal biopsies, the histopathological Class and activity and chronicity changes. RESULTS The total number of patients with NL was 120, of which 18 (15%) patients underwent repeat renal biopsy, 18 had 2 renal biopsies and 6 had 3 biopsies. 3 (16.7%) patients were smokers; 1 (5.6%) had a history of previous DBT, 2 (11.1%) had a history of hypertension; and 3 (16.7%) patients had previous obesity. The duration of SLE was 15 ± 96 months; the time between the 1st and the 2nd biopsy was 45 ± 11 months and the time between the 2nd and 3rd biopsy was 56 ± 12 months. Indications for repeat biopsy were proteinuria in 10 biopsies (41.6%); proteinuria with impaired renal function in 2 biopsies (8.3%); proteinuria with pathological urine sediment in 8 (33.3%); . and pathological proteinuria with pathological urine sediment and impaired renal function in 4 biopsies (16.6%) The most frequent histological changes found between first and repeat biopsies were class IV to class III: 2 (8.2%) ; Class IV to Class IV: 8 (33.3%), class IV to class III + V: 2 (8.2%); class IV to class IV + V 3 (12.5%); class IV to class V: 2 (8.2%). Changes in NL biopsies with proliferative activity and chronicity indices (A / C) were: A to A / C: 7 (29.1%), A / C to A / C: 7 (29.1%). The immunosuppressive therapy was increased in 79.1% and 16.6% remained without changes. 20% patients received cyclophosphamide 1 g every 30 days, 26% Cyclophosphamide 500 mg every 15 days, 23% induction therapy with mycophenolate mofetil; 23% with Rituximab; 8% Cyclosporin A. Maintenance therapy with mycophenolate mofetil was performed in 87.5%; azathioprine in 1 case. Hydroxychloroquine was used in all cases.

  16. Microbiological diagnosis of vertebral osteomyelitis: relevance of second percutaneous biopsy following initial negative biopsy and limited yield of post-biopsy blood cultures.

    PubMed

    Gras, G; Buzele, R; Parienti, J J; Debiais, F; Dinh, A; Dupon, M; Roblot, F; Mulleman, D; Marcelli, C; Michon, J; Bernard, L

    2014-03-01

    The purpose of this investigation was to evaluate the microbiological diagnosis yield of post-biopsy blood cultures (PBBCs) and second percutaneous needle biopsy (PNB) following an initial negative biopsy in vertebral osteomyelitis (VO) without bacteremia. A retrospective multicenter study was performed. Patients with VO, pre-biopsy negative blood culture(s), ≥1 PNB, and ≥1 PBBC (0-4 h) were included. One hundred and sixty-nine PNBs (136 first and 33 following initial negative biopsy) were performed for 136 patients (median age = 58 years, sex ratio M/F = 1.9). First and second PNBs had a similar yield: 43.4 % (59/136) versus 39.4 % (13/33), respectively. Only two PBBCs (1.1 %) led to a microbiological diagnosis. The strategy with positive first PNB and second PNB following an initial negative result led to microbiological diagnosis in 79.6 % (74/93) of cases versus 44.1 % (60/136) for the strategy with only one biopsy. In the multivariate analysis, young age (odds ratio, OR [95 % confidence interval (CI)] = 0.98 [0.97; 0.99] per 1 year increase, p = 0.02) and >1 sample (OR = 2.4 ([1.3; 4.4], p = 0.007)) were independently associated with positive PNB. To optimize microbiological diagnosis in vertebral osteomyelitis, performing a second PNB (after an initial negative biopsy) could lead to a microbiological diagnosis in nearly 80 % of patients. PBBC appears to be limited in microbiological diagnosis.

  17. Renal biopsy practice: What is the gold standard?

    PubMed

    Brachemi, Soumeya; Bollée, Guillaume

    2014-11-01

    Renal biopsy (RB) is useful for diagnosis and therapy guidance of renal diseases but incurs a risk of bleeding complications of variable severity, from transitory haematuria or asymptomatic hematoma to life-threatening hemorrhage. Several risk factors for complications after RB have been identified, including high blood pressure, age, decreased renal function, obesity, anemia, low platelet count and hemostasis disorders. These should be carefully assessed and, whenever possible, corrected before the procedure. The incidence of serious complications has become low with the use of automated biopsy devices and ultrasound guidance, which is currently the "gold standard" procedure for percutaneous RB. An outpatient biopsy may be considered in a carefully selected population with no risk factor for bleeding. However, controversies persist on the duration of observation after biopsy, especially for native kidney biopsy. Transjugular RB and laparoscopic RB represent reliable alternatives to conventional percutaneous biopsy in patients at high risk of bleeding, although some factors limit their use. This aim of this review is to summarize the issues of complications after RB, assessment of hemorrhagic risk factors, optimal biopsy procedure and strategies aimed to minimize the risk of bleeding.

  18. Brain biopsy in neurologic decline of unknown etiology.

    PubMed

    Magaki, Shino; Gardner, Tracie; Khanlou, Negar; Yong, William H; Salamon, Noriko; Vinters, Harry V

    2015-04-01

    Brain biopsies have an uncertain role in the diagnosis of patients with dementia or neurologic decline of unknown etiology. They are often performed only after an exhaustive panel of less invasive tests and procedures have failed to provide a definitive diagnosis. The objective of this study was to evaluate the sensitivity of brain biopsies in this patient group through the retrospective analysis of 53 brain biopsies performed for neurologic disease of unknown etiology at a single tertiary care institution between December 2001 and December 2011. Patients with known nonlymphomatous neoplasms thought to be associated with the neurologic symptoms or with immunodeficiency were excluded from the study. Furthermore, the clinical presentation, imaging and laboratory tests were compared between diagnostic groups to identify factors more likely to yield a diagnosis. Sixty percent of the biopsies were diagnostic (32 of 53), with the most common histologic diagnosis of central nervous system lymphoma in 14 of 53 patients (26% of total) followed by infarct in four subjects (7.5%). A few patients were found to have rare and unsuspected diseases such as lymphomatosis cerebri, neurosarcoidosis and neuroaxonal leukodystrophy. Complications from biopsy were uncommon and included hemorrhage and infection with abscess formation at the biopsy site. These results suggest that brain biopsies may be useful in difficult cases in which less invasive measures have been unable to yield a definitive diagnosis.

  19. Neuropathological alterations in diabetic truncal neuropathy: evaluation by skin biopsy

    PubMed Central

    Lauria, G.; McArthur, J.; Hauer, P.; Griffin, J.; Cornblath, D.

    1998-01-01

    OBJECTIVES—To describe the neuropathological features in skin biopsies from patients with diabetic truncal neuropathy.
METHODS—Three patients with diabetic truncal neuropathy underwent skin biopsies from both symptomatic and asymptomatic regions of the chest and trunk. After local anaesthesia, biopsies were performed using a 3 mm diameter punch device (Acupunch). Intraepidermal nerve fibres (IENFs), the most distal processes of small myelinated and unmyelinated nerve fibres, were identified after staining with PGP 9.5 as previously described.
RESULTS—Diabetes was diagnosed at the time of the neurological presentation in two, and one was a known diabetic patient. All three had associated sensory-motor polyneuropathy. In all, skin biopsies showed a marked reduction of both epidermal and dermal nerve fibres in the symptomatic dermatomes, compared with skin from asymptomatic truncal areas. In one patient, a follow up skin biopsy when symptoms had improved showed a return of IENFs.
CONCLUSIONS—In diabetic truncal neuropathy, skin biopsies from symptomatic regions show a loss of IENFs. After clinical recovery, there is a return of the IENF population, suggesting that improvement occurs by nerve regeneration. These findings suggest that sensory nerve fibre injury in diabetic truncal neuropathy is distal to or within the sensory ganglia. Skin biopsy provides a possible tool for understanding the pathophysiology of the disease.

 PMID:9810952

  20. Sentinel Lymph Node Biopsy in Colon Cancer

    PubMed Central

    Bembenek, Andreas E.; Rosenberg, Robert; Wagler, Elke; Gretschel, Stephan; Sendler, Andreas; Siewert, Joerg-Ruediger; Nährig, Jörg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Gröne, Jörn; Buhr, Heinz-Johannes; Haier, Jörg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, Olaf; Grützmann, Robert; Imdahl, Andreas; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus-Dieter; Schlag, Peter M.

    2007-01-01

    Introduction: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. Methods: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. Results: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P < 0.0001), the number of tumor-involved lymph nodes was inversely associated. If only slim patients (BMI ≤24) were investigated in experienced centers (>22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. Conclusions: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy. PMID:17522509

  1. Towards the mid-infrared optical biopsy

    NASA Astrophysics Data System (ADS)

    Seddon, Angela B.; Benson, Trevor M.; Sujecki, Slawomir; Abdel-Moneim, Nabil; Tang, Zhuoqi; Furniss, David; Sojka, Lukasz; Stone, Nick; Jayakrupakar, Nallala; Lloyd, Gavin R.; Lindsay, Ian; Ward, Jon; Farries, Mark; Moselund, Peter M.; Napier, Bruce; Lamrini, Samir; Møller, Uffe; Kubat, Irnis; Petersen, Christian R.; Bang, Ole

    2016-03-01

    We are establishing a new paradigm in mid-infrared molecular sensing, mapping and imaging to open up the midinfrared spectral region for in vivo (i.e. in person) medical diagnostics and surgery. Thus, we are working towards the mid-infrared optical biopsy (`opsy' look at, bio the biology) in situ in the body for real-time diagnosis. This new paradigm will be enabled through focused development of devices and systems which are robust, functionally designed, safe, compact and cost effective and are based on active and passive mid-infrared optical fibers. In particular, this will enable early diagnosis of external cancers, mid-infrared detection of cancer-margins during external surgery for precise removal of diseased tissue, in one go during the surgery, and mid-infrared endoscopy for early diagnosis of internal cancers and their precision removal. The mid-infrared spectral region has previously lacked portable, bright sources. We set a record in demonstrating extreme broad-band supercontinuum generated light 1.4 to 13.3 microns in a specially engineered, high numerical aperture mid-infrared optical fiber. The active mid-infrared fiber broadband supercontinuum for the first time offers the possibility of a bright mid-infrared wideband source in a portable package as a first step for medical fiber-based systems operating in the mid-infrared. Moreover, mid-infrared molecular mapping and imaging is potentially a disruptive technology to give improved monitoring of the environment, energy efficiency, security, agriculture and in manufacturing and chemical processing. This work is in part supported by the European Commission: Framework Seven (FP7) Large-Scale Integrated Project MINERVA: MId-to-NEaR- infrared spectroscopy for improVed medical diAgnostics (317803; www.minerva-project.eu).

  2. Are complications of transrectal ultrasound-guided biopsies of the prostate gland increasing?

    PubMed

    Dodds, Peter R; Boucher, Jonathan D; Shield, Dennis E; Bernie, Jonathan E; Batter, Stephen J; Serels, Scott R; Dodds, Jon H

    2011-09-01

    Although transrectal ultrasound-guided biopsies (TRUSB) of the prostate gland are generally considered to be low-risk procedures, a study from Canada reported that there had been a significant increase in the percentage of hospital admissions following TRUSBs between 1996 and 2005 (1.0% to 4.1%). The authors speculated that the increase may be secondary to the emergence of antibiotic-resistant enteric bacteria or the result of an increasing number of cores taken with each TRUSB. In a chart review, we retrospectively evaluated complications from 2,080 consecutive TRUSBs performed by one urology group in Connecticut between January 2003 and August 2010. We identified seven patients (0.34%) who were admitted to an acute-care hospital for infectious complications and three patients (0.14%) who were admitted for bleeding. The risk of serious infections and bleeding did not significantly rise during the study period despite a significant increase in the mean number of biopsy cores taken.

  3. Does Prebiopsy, Nonsterile Ultrasonography Gel Affect Biopsy-Site Asepsis?

    SciTech Connect

    Gurel, Kamil Karabay, Oguz; Gurel, Safiye; Hildebolt, Charles

    2008-01-15

    Purpose. The purpose of this study was to determine the extent to which the use of nonsterile gel, prior to antiseptic procedures in ultrasonography (US)-guided percutaneous biopsies, results in contamination of the biopsy site. Materials and Methods. Patients referred for US-guided percutaneous biopsies were included in this study. Transmission material used for US evaluation before biopsy-site antiseptic procedures were performed was either nonsterile gel or sterile saline. Patients were randomly assigned to two groups: nonsterile gel (n = 30) and sterile saline (n = 30). Before the transmission material was used and after antiseptic procedures were performed, microbial swabs of a 10-cm{sup 2}-diameter area were obtained at the biopsy site. Swabs were also obtained from the gel, saline, and povidine-iodine. Inoculated specimen plates were incubated at 37{sup o}C under aerobic conditions, and the numbers of colony-forming units recorded. Nominal logistic regression analysis was used to calculate the odds of postantisepsis bacterial growth (after antiseptic procedures were performed) based on group, gender, coincidental disease (diabetes, chronic renal failure, and malignancy), biopsy-site location (head and neck or breast and abdomen), and local factors (skin fold, skin tag, and hair). Results. The following odds ratios (adjusted for the other variables) and their 95% confidence intervals were calculated: (1) group (2.9 [0.8-11.1]; p = 0.10); (2) gender (1.2 [0.3-5.2]; p = 0.78); (3) coincidental disease (7.6 [0.9-166.7]; p = 0.09); (4) biopsy site location (6.2 [1.4-31.3]; p = 0.02); and (5) local factors (7.0 [1.6-36.0]; p = 0.01). No bacterial growth occurred with swabs obtained from gel, povidine-iodine, or saline. Conclusion. We conclude that nonsterile gel used prior to percutaneous biopsy does not affect biopsy-site asepsis.

  4. Current indications for renal biopsy: a questionnaire-based survey.

    PubMed

    Fuiano, G; Mazza, G; Comi, N; Caglioti, A; De Nicola, L; Iodice, C; Andreucci, M; Andreucci, V E

    2000-03-01

    Indications for renal biopsy are still ill defined. We recently sent a detailed questionnaire to 360 nephrologists in different areas of the world with the aim of providing information on this critical issue by evaluating the replies. The questionnaire was organized in four sections that included questions on renal biopsy indications in patients with normal renal function, renal insufficiency, and a transplanted kidney. In addition, the questions included methods applied to each renal biopsy procedure and to specimen processing. We received 166 replies; North Europe (50 replies), South Europe (47 replies), North America (31 replies), Australia and New Zealand (24 replies), and other countries (14 replies). In patients with normal renal function, primary indications for renal biopsy were microhematuria associated with proteinuria, particularly greater than 1 g/d of protein. In chronic renal insufficiency, kidney dimension was the major parameter considered before renal biopsy, whereas the presence of diabetes or serological abnormalities was not considered critical. In the course of acute renal failure (ARF) of unknown origin, 20% of the respondents would perform renal biopsy in the early stages, 26% after 1 week of nonrecovery, and 40% after 4 weeks. In a transplanted kidney, the majority of nephrologists would perform a renal biopsy in the case of graft failure after surgery, ARF after initial good function, slow progressive deterioration of renal function, and onset of nephrotic proteinuria. The last section provided comprehensive information on the technical aspects of renal biopsy. This survey represents the first attempt to provide a reliable consensus that can be used in developing guidelines on the use of kidney biopsy. PMID:10692270

  5. Mercury's Core

    NASA Astrophysics Data System (ADS)

    Peale, S. J.

    2005-05-01

    In determining Mercury's core structure from its rotational properties, the location of Cassini state 1 is crucial. Convincing radar evidence indicates that the mantle rests on a liquid layer (Margot et al. 2005), but there are no empirical constraints on the moment of inertia C/MR2, which constraints must wait for the determination of the gravitational coefficients J2 and C22 from the MESSENGER orbiting spacecraft, and an accurate determination of the obliquity of the Cassini state. Tidal and core-mantle dissipation drive the spin to the Cassini state with a time scale O(105) years, so the spin should occupy the Cassini state and thereby define its obliquity---unless there has been a recent excitation of a free precession of the spin. Another way the spin might be displaced from the Cassini state is if the variations in the orbital elements, which change the position of the Cassini state, cause the spin axis to lag behind as it attempts to follow the state. Fortunately, the solid angle the spin axis encloses as it precesses around the Cassini state is an adiabatic invariant, and it is conserved if the orbital element variations are slow compared to the precession rate. As the precession period is O(1000) years, and the time scales of orbital parameter variations are O(105) years, the spin axis should remain very close to the Cassini state if it were ever close. But how close is close? The increasing precision of the radar and eventual spacecraft measurements warrants a check on the likely proximity of the spin axis to the Cassini state. By numerically following the positions of the spin axis and Cassini state with orbital parameters varying with time scales and amplitudes comparable to the real variations, we show that the spin should remain within 1″ of the Cassini state once dissipative torques bring it there. The current spin axis position should thus define the Cassini state sufficiently to put reasonably tight constraints on the core structure

  6. ALK positivity on pleuroscopic pleural biopsy in lung adenocarcinoma.

    PubMed

    Vaidya, Preyas J; Kate, Arvind H; Mehta, Deval; Dhabar, Boman N; Chhajed, Prashant N

    2016-01-01

    Lung cancer is the leading cause of cancer deaths worldwide, and around 75% to 80% of lung cancers are detected in advanced stage. Multiple genetic mutations are identified and reported in adenocarcinoma of the lung. Various pulmonary samples can be tested for molecular mutations in lung cancer. However, feasibility of molecular profiling of pleuroscopic pleural biopsies in lung adenocarcinoma is not reported. We describe a case of advanced adenocarcinoma of lung with positive anaplastic lymphoma tyrosine kinase mutation on pleuroscopic pleural biopsy and improved with oral crizotinib. The current case highlights the feasibility of pleuroscopy.-guided pleural biopsies in molecular profiling of lung adenocarcinoma. PMID:27461706

  7. The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

    PubMed

    Stanek-Widera, A; Biskup-Frużyńska, M; Zembala-Nożyńska, E; Śnietura, M; Lange, D

    2016-03-01

    Fine needle aspiration biopsy (FNA) is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE). We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO) there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100%) cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100%) provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100%) specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment) indicates that repeat FNA in order to confirm the diagnosis is unnecessary. PMID:27179270

  8. Biopsy Quantitative Patohistology and Seral Values of Prostate Specific Antigen-Alpha (1) Antichymotrypsine Complex in Prediction of Adverse Pathology Findings after Radical Prostatectomy.

    PubMed

    Tomasković, Igor; Milicić, Valerija; Tomić, Miroslav; Ruzić, Boris; Ulamec, Monika

    2015-09-01

    In this prospective study we examined the utility of parameters obtained on prostate needle biopsy and prostate specific antigen-alpha(1)-antichymotripsine complex (PSA-ACT) to predict adverse pathologic findings after radical prostatectomy. 45 consecutive patients assigned for radical prostatectomy due to clinically localized prostate cancer were included in the study. Prostate biopsy parameters such as number of positive cores, the greatest percentage of tumor in the positive cores, Gleason score, perineural invasion, unilaterality or bilaterality of the tumor were recorded. PSA-ACT was determined using sandwich immunoassay chemiluminiscent method (Bayer, Tarrytown, New York). We analyzed relationship of preoperative PSA, PSA-ACTand quantitative biopsy parameters with final pathology after prostatectomy. Adverse findings were considered when extracapsular extension of cancer (pT3) was noted. Postoperatively, 29 (64.4%) patients were diagnosed with pT2 disease and 16 (35.6%) with pT3 disease. There was a significant difference in localized vs. locally advanced disease in number of positive biopsy cores (p<0.001), greatest percentage of tumor in the core (p=0.008), localization of the tumor (p=0.003) and perineural invasion (p=0.004). Logistic regression was used to develop a model on the multivariate level. It included number of positive cores and PSA-ACT and was significant on our cohort with the reliability of 82.22%. The combination of PSA-ACT and a large scale of biopsy parameters could be used in prediction of adverse pathologic findings after radical prostatectomy. Clinical decisions and patients counselling could be influenced by these predictors but further confirmation on a larger population is necessary. PMID:26898067

  9. EVALUATING THE PROSTATE CANCER PREVENTION TRIAL HIGH GRADE PROSTATE CANCER RISK CALCULATOR IN TEN INTERNATIONAL BIOSY COHORTS: RESULTS FROM THE PROSTATE BIOPSY COLLABORATIVE GROUP

    PubMed Central

    Ankerst, Donna P.; Boeck, Andreas; Freedland, Stephen J.; Jones, J. Stephen; Cronin, Angel M.; Roobol, Monique J.; Hugosson, Jonas; Kattan, Michael W.; Klein, Eric A.; Hamdy, Freddie; Neal, David; Donovan, Jenny; Parekh, Dipen J.; Klocker, Helmut; Horninger, Wolfgang; Benchikh, Amine; Salama, Gilles; Villers, Arnauld; Moreira, Daniel M.; Schröder, Fritz H.; Lilja, Hans; Vickers, Andrew J.; Thompson, Ian M.

    2013-01-01

    OBJECTIVES To assess the applicability of the Prostate Cancer Prevention Trial High Grade (Gleason grade ≥ 7) Risk Calculator (PCPTHG) in ten international cohorts, representing a range of populations. METHODS 25,512 biopsies from 10 cohorts (6 European, 1 UK, and 3 US) were included; 4 implemented 6-core biopsies and the remaining had 10- or higher schemes; 8 were screening cohorts and 2 were clinical. PCPTHG risks were calculated using prostate-specific antigen (PSA), digital rectal examination, age, African origin and history of prior biopsy and evaluated in terms of calibration plots, areas underneath the receiver operating characteristic curve (AUC), and net benefit curves. RESULTS The median AUC of the PCPTHG for high grade disease detection in the 10- and higher-core cohorts was 73.5% (range 63.9% to 76.7%) compared to a median of 78.1 (range = 72.0 to 87.6) among the four 6-core cohorts. Only the 10-core Cleveland Clinic cohort showed clear evidence of under-prediction by the PCPTHG, and this was restricted to risk ranges less than 15%. The PCPTHG demonstrated higher clinical net benefit in higher- compared to six-core biopsy cohorts, and among the former, there were no notable differences observed between clinical and screening cohorts, nor between European and US cohorts. CONCLUSIONS The PCPTHG requires minimal patient information and can be applied across a range of populations. PCPTHG risk thresholds ranging from 5 to 20%, depending on patient risk averseness, are recommended for clinical prostate biopsy decision-making. PMID:22527674

  10. Breast Biopsy: The Effects of Hypnosis and Music.

    PubMed

    Téllez, Arnoldo; Sánchez-Jáuregui, Teresa; Juárez-García, Dehisy M; García-Solís, Manuel

    2016-01-01

    The authors evaluated the efficacies of audio-recorded hypnosis with background music and music without hypnosis in the reduction of emotional and physical disturbances in patients scheduled for breast biopsy in comparison with a control group. A total of 75 patients were randomly assigned to 3 different groups and evaluated at baseline and before and after breast biopsy using visual analog scales of stress, pain, depression, anxiety, fatigue, optimism, and general well-being. The results showed that, before breast biopsy, the music group presented less stress and anxiety, whereas the hypnosis with music group presented reduced stress, anxiety, and depression and increased optimism and general well-being. After the biopsy, the music group presented less anxiety and pain, whereas the hypnosis group showed less anxiety and increased optimism. PMID:27585728

  11. [Stereotaxic brain biopsy in AIDS patients with neurological manifestations].

    PubMed

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    Prospective series showing the importance of computerized stereotactic brain biopsy in the management of AIDS patients neurologically symptomatic and confirmed by images. Patients undergone an algorithm step by step done by their own doctors and referred to us for stereotactic biopsy. Our protocol was opened in August 1995 and closed in December 1996. Twenty patients were biopsied. This protocol is similar to the Levy's one (Chicago IL, USA). We have got diagnosis in all cases. Lymphoma was predominant and followed by toxoplasmosis, progressive multifocal leukoencephalopathy and HIV encephalopathy. We included one patient with diploic giant cells lymphoma. Our mortality and morbidity was zero. By these results we conclude that stereotactic biopsy in AIDS patients is safe and effective.

  12. [Stereotaxic brain biopsy in AIDS patients with neurological manifestations].

    PubMed

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    Prospective series showing the importance of computerized stereotactic brain biopsy in the management of AIDS patients neurologically symptomatic and confirmed by images. Patients undergone an algorithm step by step done by their own doctors and referred to us for stereotactic biopsy. Our protocol was opened in August 1995 and closed in December 1996. Twenty patients were biopsied. This protocol is similar to the Levy's one (Chicago IL, USA). We have got diagnosis in all cases. Lymphoma was predominant and followed by toxoplasmosis, progressive multifocal leukoencephalopathy and HIV encephalopathy. We included one patient with diploic giant cells lymphoma. Our mortality and morbidity was zero. By these results we conclude that stereotactic biopsy in AIDS patients is safe and effective. PMID:9698730

  13. The disappearing clip: an unusual complication in MRI biopsy

    PubMed Central

    Bourke, Anita Geraldine; Peter, Prasant; Jose, Chaitra Lesli

    2014-01-01

    MRI-guided biopsies are being increasingly used for otherwise occult breast lesions. Clip migration has been reported however, to the best of our knowledge, there have been no documented cases of entire disappearance of a marker clip. Absence of the postbiopsy marker clip was noted when our patient returned for preoperative hook-wire localisation even though accurate clip placement had been confirmed on the post-MRI biopsy mammogram. PMID:25139917

  14. Pericardial Tamponade Following CT-Guided Lung Biopsy

    SciTech Connect

    Mitchell, Michael J.; Montgomery, Mark; Reiter, Charles G.; Culp, William C.

    2008-07-15

    While not free from hazards, CT-guided biopsy of the lung is a safe procedure, with few major complications. Despite its safety record, however, potentially fatal complications do rarely occur. We report a case of pericardial tamponade following CT-guided lung biopsy. Rapid diagnosis and therapy allowed for complete patient recovery. Physicians who perform this procedure should be aware of the known complications and be prepared to treat them appropriately.

  15. Low coherence interferometry approach for aiding fine needle aspiration biopsies

    NASA Astrophysics Data System (ADS)

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor

    2014-11-01

    We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively.

  16. Advanced Imaging for Biopsy Guidance in Primary Brain Tumors

    PubMed Central

    Tsiouris, Apostolos J; Ramakrishna, Rohan

    2016-01-01

    Accurate glioma sampling is required for diagnosis and establishing eligibility for relevant clinical trials. MR-based perfusion and spectroscopy sequences supplement conventional MR in noninvasively predicting the areas of highest tumor grade for biopsy. We report the case of a patient with gliomatosis cerebri and multifocal patchy enhancement in whom the combination of advanced and conventional imaging attributes successfully guided a diagnostic biopsy. PMID:27014538

  17. Emergency right hepatectomy after laparoscopic tru-cut liver biopsy

    PubMed Central

    Quezada, Nicolás; León, Felipe; Martínez, Jorge; Jarufe, Nicolás; Guerra, Juan Francisco

    2015-01-01

    Background Liver biopsy is a common procedure usually required for final pathologic diagnosis of different liver diseases. Morbidity following tru-cut biopsy is uncommon, with bleeding complications generally self-limited. Few cases of major hemorrhage after liver biopsies have been reported, but to our knowledge, no cases of emergency hepatectomy following a tru-cut liver biopsy have been reported previously. Presentation of case We report the case of a 38 years-old woman who presented with an intrahepatic arterial bleeding after a tru-cut liver biopsy under direct laparoscopic visualization, initially controlled by ligation of the right hepatic artery and temporary liver packing. On tenth postoperative day, she developed a pseudo-aneurysm of the anterior branch of the right hepatic artery, evolving with massive bleeding that was not amenable to control by endovascular therapy. Therefore, an emergency right hepatectomy had to be performed in order to stop the bleeding. The patient achieved hemodynamic stabilization, but developed a biliary fistula from the liver surface, refractory to non-operative treatment. In consequence, a Roux-Y hepatico-jejunostomy was performed at third month, with no further complications. Discussion Bleeding following tru-cut biopsy is a rare event. To our knowledge, this is the first report of an emergency hepatectomy due to hemorrhage following liver biopsy. Risks and complications of liver biopsy are revised. Conclusion Care must be taken when performing this kind of procedures and a high level of suspicion regarding this complication should be taken in count when clinical/hemodynamic deterioration occurs after these procedures. PMID:25618399

  18. Low coherence interferometry approach for aiding fine needle aspiration biopsies

    PubMed Central

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor

    2014-01-01

    Abstract. We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively. PMID:25375634

  19. A Comparison of Four- Versus Three-Pass Transjugular Biopsy Using a 19-G Tru-Cut Needle and a Randomized Study Using a Cassette to Prevent Biopsy Fragmentation

    SciTech Connect

    Vibhakorn, Shusang; Cholongitas, Evangelos; Kalambokis, George; Manousou, Pinelopi; Quaglia, Alberto; Marelli, Laura; Senzolo, Marco; Patch, David; Dhillon, Amar; Burroughs, Andrew K.

    2009-05-15

    Recently, it has been shown that transjugular liver biopsy (TJLB) with three passes gives comparable specimens to percutaneous liver biopsy (PLB). The aim of this study was to evaluate the adequacy of TJLB using four passes in a consecutive series of patients, and whether using a supportive cassette can prevent fragmentation. One hundred consecutive TJLBs in 92 patients (48 transplanted), always using four passes (19-G Tru-Cut), were compared to three-pass TJLBs. The four-pass TJLB specimens were randomized at a 1:1 ratio of liver cores placed in a cassette versus not. The four-pass TJLBs, compared to three-pass TJLBs, resulted in better specimens for length ({>=}25 mm: 50% vs. 35%; p = 0.026) and number of complete portal tracts (CPTs) ({>=}11: 40% vs. 26%; p = 0.027), without a higher complication rate. The four-pass TJLB with {>=}11 CPTs had a median length of 27 mm, and 57% of them longer than 28 mm contained {>=}11 CPTs. Putting the liver biopsy cores into a cassette did not improve the fragmentation rate or adequacy of the specimen (length and number of CPTs) of TJLB. We conclude that at least four passes with TJLB should be performed when liver specimens are needed for grading and staging. Using a supportive cassette did not reduce fragmentation.

  20. Evaluation of electronic biopsy for clinical diagnosis in virtual colonoscopy

    NASA Astrophysics Data System (ADS)

    Marino, Joseph; Du, Wei; Barish, Matthew; Li, Ellen; Zhu, Wei; Kaufman, Arie

    2011-03-01

    Virtual colonoscopy provides techniques not available in optical colonoscopy, an exciting one being the ability to perform an electronic biopsy. An electronic biopsy image is created using ray-casting volume rendering of the CT data with a translucent transfer function mapping higher densities to red and lower densities to blue. The resulting image allows the physician to gain insight into the internal structure of polyps. Benign tissue and adenomas can be differentiated; the former will appear as homogeneously blue and the latter as irregular red structures. Although this technique is now common, is included with clinical systems, and has been used successfully for computer aided detection, there has so far been no study to evaluate the effectiveness of a physician using electronic biopsy in determining the pathological state of a polyp. We present here such a study, wherein an experienced radiologist ranked polyps based on electronic biopsy alone per scan (supine and prone), as well as both combined. Our results show a correct identification 77% of the time using prone or supine images alone, and 80% accuracy using both. Using ROC analysis based on this study with one reader and a modest sample size, the combined score is not significantly higher than using a single electronic biopsy image alone. However, our analysis indicates a trend of superiority for the combined ranking that deserves a follow-up confirmatory study with a larger sample and more readers. This study yields hope that an improved electronic biopsy technique could become a primary clinical diagnosis method.

  1. CT Fluoroscopy-Guided Lung Biopsy with Novel Steerable Biopsy Canula: Ex-Vivo Evaluation in Ventilated Porcine Lung Explants

    SciTech Connect

    Schaefer, Philipp J. Fabel, Michael; Bolte, Hendrik; Schaefer, Fritz K. W.; Jahnke, Thomas; Heller, Martin; Lammer, Johannes; Biederer, Juergen

    2010-08-15

    The purpose was to evaluate ex-vivo a prototype of a novel biopsy canula under CT fluoroscopy-guidance in ventilated porcine lung explants in respiratory motion simulations. Using an established chest phantom for porcine lung explants, n = 24 artificial lesions consisting of a fat-wax-Lipiodol mixture (approx. 70HU) were placed adjacent to sensible structures such as aorta, pericardium, diaphragm, bronchus and pulmonary artery. A piston pump connected to a reservoir beneath a flexible silicone reconstruction of a diaphragm simulated respiratory motion by rhythmic inflation and deflation of 1.5 L water. As biopsy device an 18-gauge prototype biopsy canula with a lancet-like, helically bended cutting edge was used. The artificial lesions were punctured under CT fluoroscopy-guidance (SOMATOM Sensation 64, Siemens, Erlangen, Germany; 30mAs/120 kV/5 mm slice thickness) implementing a dedicated protocol for CT fluoroscopy-guided lung biopsy. The mean-diameter of the artificial lesions was 8.3 {+-} 2.6 mm, and the mean-distance of the phantom wall to the lesions was 54.1 {+-} 13.5 mm. The mean-displacement of the lesions by respiratory motion was 14.1 {+-} 4.0 mm. The mean-duration of CT fluoroscopy was 9.6 {+-} 5.1 s. On a 4-point scale (1 = central; 2 = peripheral; 3 = marginal; 4 = off target), the mean-targeted precision was 1.9 {+-} 0.9. No misplacement of the biopsy canula affecting adjacent structures could be detected. The novel steerable biopsy canula proved to be efficient in the ex-vivo set-up. The chest phantom enabling respiratory motion and the steerable biopsy canula offer a feasible ex-vivo system for evaluating and training CT fluoroscopy-guided lung biopsy adapted to respiratory motion.

  2. Wall or machine suction rectal biopsy for Hirschsprung's disease: a simple modified technique can improve the adequacy of biopsy.

    PubMed

    Ali, A E; Morecroft, J A; Bowen, J C; Bruce, J; Morabito, A

    2006-08-01

    Suction rectal biopsy (SRB) may not include sufficient submucosa for histological diagnosis of Hirschsprung's disease (HD) and a repeat biopsy is required. Substitution of the conventional syringe for sustained suction from a machine or wall suction unit could provide a more consistently adequate tissue biopsy. This study was conducted to compare the adequacy of SRB specimens using a conventional method of syringe suction (SSRB) with those taken by wall or machine suction (WSRB). Hospital records of patients who had a SRB between 2002 and 2004 were studied retrospectively. The biopsy was considered inadequate if there was insufficient submucosa and a repeat specimen was requested. SSRB were taken using the conventional SSRB technique. WSRB were taken with the same Noblett forceps but with suction from wall suction or from a portable suction machine. Ninety-five infants had 103 SRB, 24 had WSRB and all (100%) were adequate for histopathological diagnosis or exclusion of HD. Seventy nine conventional SSRB were undertaken in 71 infants of which 64 (81.02%) were adequate. The difference in adequacy between WSRB and SSRB was statistically significant (P = 0.02). There were no instances of haemorrhage or bowel perforation in either subgroup. WSRB with the Noblett biopsy forceps is more likely to produce an adequate specimen and to reduce the incidence of repeat biopsies.

  3. Percutaneous ultrasound-guided renal biopsy: A Libyan experience

    PubMed Central

    Mishra, A.; Tarsin, R.; ElHabbash, B.; Zagan, N.; Markus, R.; Drebeka, S.; AbdElmola, K.; Shawish, T.; Shebani, A.; AbdElmola, T.; ElUsta, A.; Ehtuish, E. F.

    2010-01-01

    This study was done to assess the safety and efficacy of ultrasound-guided percutaneous renal biopsy (PRB), to ascertain the risk factors for complications and determine the optimal period of observation. The radiologist (A.M.) at the National Organ Transplant Centre, Central Hospital, Tripoli, Libya, performed 86 PRBs between February 1, 2006, and January 31, 2008, using an automated biopsy gun with 16-gauge needle. Coagulation profile was done in all the patients. All patients were kept on strict bed rest for six hours post-procedure. Eighty six renal biopsies were performed on 78 patients referred from rheumatology department and eight post-kidney transplant recipients; 23 were males with age range 15 – 56 years and 63 females with age range 16 – 66 years. A mean of 17.5 glomeruli were present in each specimen. A glomerular yield of less than five glomeruli was seen in four biopsies. Class I lupus nephritis (LN) was seen in 1 patient, class II lupus nephritis in 7 patients, class III LN in 13 patients and class IV LN in 29 patients. All the eight renal allografts were diagnosed as acute tubular necrosis or acute interstitial rejection. The risk of post-biopsy bleeding was higher in women, older patients and higher PTT. The overall complication rate was 5.8%. Three complications were observed within six hours of biopsy. No late complication was seen. PRB under real-time ultrasound-guidance is a safe and efficacious procedure to establish the histological diagnosis and should be done as out-patient procedure. Observation time of six hours post-biopsy is optimal. PMID:20835320

  4. Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

    PubMed Central

    Kakushima, Naomi; Kanemoto, Hideyuki; Sasaki, Keiko; Kawata, Noboru; Tanaka, Masaki; Takizawa, Kohei; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki; Ono, Hiroyuki

    2015-01-01

    AIM: To investigate the accuracy of endoscopic or biopsy diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs). METHODS: Clinicopathological data were reviewed for 84 superficial NADETs from 74 patients who underwent surgery or endoscopic resection between September 2002 and August 2014 at a single prefectural cancer center. Superficial NADETs were defined as lesions confined to the mucosa or submucosa. Demographic and clinicopathological data were retrieved from charts, endoscopic and pathologic reports. Endoscopic reports included endoscopic diagnosis, location, gross type, diameter, color, and presence or absence of biopsy. Endoscopic diagnoses were made by an endoscopist in charge of the examination before biopsy specimens were obtained. Endoscopic images were obtained using routine, front-view, high-resolution video endoscopy, and chromoendoscopy with indigocarmine was performed for all lesions. Endoscopic images were reviewed by at least two endoscopists to assess endoscopic findings indicative of carcinoma. Preoperative diagnoses based on endoscopy and biopsy findings were compared with histological diagnoses of resected specimens. Sensitivity, specificity, and accuracy were assessed for endoscopic diagnosis and biopsy diagnosis. RESULTS: The majority (81%) of the lesions were located in the second portion of the duodenum. The median lesion diameter was 14.5 mm according to final histology. Surgery was performed for 49 lesions from 39 patients, and 35 lesions from 35 patients were endoscopically resected. Final histology confirmed 65 carcinomas, 15 adenomas, and 3 hyperplasias. A final diagnosis of duodenal carcinoma was made for 91% (52/57) of the lesions diagnosed as carcinoma by endoscopy and 93% (42/45) of the lesions diagnosed as carcinoma by biopsy. The sensitivity, specificity, and accuracy of endoscopic diagnoses were 80%, 72%, and 78%, respectively, whereas those of biopsy diagnoses were 72%, 80%, and 74%, respectively

  5. Dual-core antiresonant hollow core fibers.

    PubMed

    Liu, Xuesong; Fan, Zhongwei; Shi, Zhaohui; Ma, Yunfeng; Yu, Jin; Zhang, Jing

    2016-07-25

    In this work, dual-core antiresonant hollow core fibers (AR-HCFs) are numerically demonstrated, based on our knowledge, for the first time. Two fiber structures are proposed. One is a composite of two single-core nested nodeless AR-HCFs, exhibiting low confinement loss and a circular mode profile in each core. The other has a relatively simple structure, with a whole elliptical outer jacket, presenting a uniform and wide transmission band. The modal couplings of the dual-core AR-HCFs rely on a unique mechanism that transfers power through the air. The core separation and the gap between the two cores influence the modal coupling strength. With proper designs, both of the dual-core fibers can have low phase birefringence and short modal coupling lengths of several centimeters.

  6. Nose biopsy: a comparison between two sampling techniques.

    PubMed

    Segal, Nili; Osyntsov, Lidia; Olchowski, Judith; Kordeluk, Sofia; Plakht, Ygal

    2016-06-01

    Pre operative biopsy is important in obtaining preliminary information that may help in tailoring the optimal treatment. The aim of this study was to compare two sampling techniques of obtaining nasal biopsy-nasal forceps and nasal scissors in terms of pathological results. Biopsies of nasal lesions were taken from patients undergoing nasal surgery by two techniques- with nasal forceps and with nasal scissors. Each sample was examined by a senior pathologist that was blinded to the sampling method. A grading system was used to rate the crush artifact in every sample (none, mild, moderate, severe). A comparison was made between the severity of the crush artifact and the pathological results of the two techniques. One hundred and forty-four samples were taken from 46 patients. Thirty-one were males and the mean age was 49.6 years. Samples taken by forceps had significantly higher grades of crush artifacts compared to those taken by scissors. The degree of crush artifacts had a significant influence on the accuracy of the pre operative biopsy. Forceps cause significant amount of crush artifacts compared to scissors. The degree of crush artifact in the tissue sample influences the accuracy of the biopsy.

  7. Renal biopsy: Still a landmark for the nephrologist.

    PubMed

    Visconti, Luca; Cernaro, Valeria; Ricciardi, Carlo Alberto; Lacava, Viviana; Pellicanò, Vincenzo; Lacquaniti, Antonio; Buemi, Michele; Santoro, Domenico

    2016-07-01

    Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefits must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists.

  8. Liquid Biopsy of Hepatocellular Carcinoma: Circulating Tumor-Derived Biomarkers.

    PubMed

    Yin, Chang-Qing; Yuan, Chun-Hui; Qu, Zhen; Guan, Qing; Chen, Hao; Wang, Fu-Bing

    2016-01-01

    Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide due to latent liver disease, late diagnosis, and nonresponse to systemic treatments. Till now, surgical and/or biopsy specimens are still generally used as a gold standard by the clinicians for clinical decision-making. However, apart from their invasive characteristics, tumor biopsy only mirrors a single spot of the tumor, failing to reflect current cancer dynamics and progression. Therefore, it is imperative to develop new diagnostic strategies with significant effectiveness and reliability to monitor high-risk populations and detect HCC at an early stage. In the past decade, the potent utilities of "liquid biopsy" have attracted intense concern and were developed to evaluate cancer progression in several clinical trials. "Liquid biopsies" represent a series of noninvasive tests that detect cancer byproducts easily accessible in peripheral blood, mainly including circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) that are shed into the blood from the tumor sites. In this review, we focus on the recent developments in the field of "liquid biopsy" as well as the diagnostic and prognostic significance of CTCs and cfNAs in HCC patients. PMID:27403030

  9. Renal biopsy and pathologic evaluation of glomerular disease.

    PubMed

    Lees, George E; Cianciolo, Rachel E; Clubb, Fred J

    2011-08-01

    Presence of suspected primary glomerular disease is the most common and compelling reason to consider renal biopsy. Pathologic findings in samples from animals with nephritic or nephrotic glomerulopathies, as well as from animals with persistent subclinical glomerular proteinuria that is not associated with advanced chronic kidney disease, frequently guide treatment decisions and inform prognosis when suitable specimens are obtained and examined appropriately. Ultrasound-guided needle biopsy techniques generally are satisfactory; however, other methods of locating or approaching the kidney, such as manual palpation (e.g., in cats), laparoscopy, or open surgery, also can be used. Visual assessment of the tissue content of needle biopsy samples to verify that they are renal cortex (i.e., contain glomeruli) as they are obtained is a key step that minimizes the submission of uninformative samples for examination. Adequate planning for a renal biopsy also requires prior procurement of the fixatives and preservatives needed to process and submit samples that will be suitable for electron microscopic examination and immunostaining, as well as for light microscopic evaluation. Finally, to be optimally informative, renal biopsy specimens must be processed by laboratories that routinely perform the required specialized examinations and then be evaluated by experienced veterinary nephropathologists. The pathologic findings must be carefully integrated with one another and with information derived from the clinical investigation of the patient's illness to formulate the correct diagnosis and most informative guidance for therapeutic management of the animal's glomerular disease. PMID:21782145

  10. Surveillance biopsies after paediatric kidney transplantation: A review.

    PubMed

    Rose, Edward M; Kennedy, Sean E; Mackie, Fiona E

    2016-09-01

    Kidney transplantation is the most effective means of treating children with end-stage kidney disease, and yet, there continues to be a limited "life span" of transplanted kidneys in paediatric recipients. Early graft monitoring, using the surveillance biopsy, has the potential to extend renal allograft survival in paediatric recipients. The surveillance biopsy provides important and timely information about acute and chronic graft pathology, particularly SCR and calcineurin inhibitor-induced nephrotoxicity, which can subsequently guide management decisions and improve long-term graft survival. The ostensible value of the surveillance biopsy is furthered by the limitations of conventional renal functional studies. However, there is still much debate surrounding the surveillance biopsy in paediatric recipients, particularly in regard to its overall utility, safety and timing. This review discusses the current literature regarding the utility, safety, and potential predictive value of surveillance biopsies for guiding post-transplant management in paediatric renal allograft recipients, as well as the viability of other potentially newer non-invasive strategies for renal allograft monitoring. PMID:27306873

  11. Remote biopsy darting and marking of polar bears

    USGS Publications Warehouse

    Pagano, Anthony M.; Peacock, Elizabeth; McKinney, Melissa A.

    2014-01-01

    Remote biopsy darting of polar bears (Ursus maritimus) is less invasive and time intensive than physical capture and is therefore useful when capture is challenging or unsafe. We worked with two manufacturers to develop a combination biopsy and marking dart for use on polar bears. We had an 80% success rate of collecting a tissue sample with a single biopsy dart and collected tissue samples from 143 polar bears on land, in water, and on sea ice. Dye marks ensured that 96% of the bears were not resampled during the same sampling period, and we recovered 96% of the darts fired. Biopsy heads with 5 mm diameters collected an average of 0.12 g of fur, tissue, and subcutaneous adipose tissue, while biopsy heads with 7 mm diameters collected an average of 0.32 g. Tissue samples were 99.3% successful (142 of 143 samples) in providing a genetic and sex identification of individuals. We had a 64% success rate collecting adipose tissue and we successfully examined fatty acid signatures in all adipose samples. Adipose lipid content values were lower compared to values from immobilized or harvested polar bears, indicating that our method was not suitable for quantifying adipose lipid content.

  12. CT Guided Bone Biopsy Using a Battery Powered Intraosseous Device

    SciTech Connect

    Schnapauff, Dirk Marnitz, Tim Freyhardt, Patrick Collettini, Federico; Hartwig, Kerstin; Joehrens, Korinna; Hamm, Bernd Kroencke, Thomas Gebauer, Bernhard

    2013-10-15

    Purpose: To evaluate the feasibility of a battery powered intraosseous device to perform CT-fluoroscopy guided bone biopsy. Methods: Retrospective analysis of 12 patients in whom bone specimen were acquired from different locations under CT-fluoroscopy guidance using the OnControl bone marrow biopsy system (OBM, Vidacare, Shavano Park, TX, USA). Data of the 12 were compared to a historic cohort in whom the specimen were acquired using the classic Jamshidi Needle, as reference needle using manual force for biopsy. Results: Technical success was reached in 11 of 12 cases, indicated by central localisation of the needle within the target lesion. All specimen sampled were sufficient for histopathological workup. Compared to the historical cohort the time needed for biopsy decreased significantly from 13 {+-} 6 to 6 {+-} 4 min (P = 0.0001). Due to the shortened intervention time the radiation dose (CTDI) during CT-fluoroscopy was lowered significantly from 169 {+-} 87 to 111 {+-} 54 mGy Multiplication-Sign cm (P = 0.0001). Interventional radiologists were confident with the performance of the needle especially when using in sclerotic or osteoblastic lesions. Conclusion: The OBM is an attractive support for CT-fluoroscopy guided bone biopsy which is safe tool and compared to the classical approach using the Jamshidi needle leading to significantly reduced intervention time and radiation exposure.

  13. Renal biopsy: Still a landmark for the nephrologist.

    PubMed

    Visconti, Luca; Cernaro, Valeria; Ricciardi, Carlo Alberto; Lacava, Viviana; Pellicanò, Vincenzo; Lacquaniti, Antonio; Buemi, Michele; Santoro, Domenico

    2016-07-01

    Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefits must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists. PMID:27458561

  14. Renal biopsy: Still a landmark for the nephrologist

    PubMed Central

    Visconti, Luca; Cernaro, Valeria; Ricciardi, Carlo Alberto; Lacava, Viviana; Pellicanò, Vincenzo; Lacquaniti, Antonio; Buemi, Michele; Santoro, Domenico

    2016-01-01

    Renal biopsy was performed for the first time more than one century ago, but its clinical use was routinely introduced in the 1950s. It is still an essential tool for diagnosis and choice of treatment of several primary or secondary kidney diseases. Moreover, it may help to know the expected time of end stage renal disease. The indications are represented by nephritic and/or nephrotic syndrome and rapidly progressive acute renal failure of unknown origin. Nowadays, it is performed mainly by nephrologists and radiologists using a 14-18 gauges needle with automated spring-loaded biopsy device, under real-time ultrasound guidance. Bleeding is the major primary complication that in rare cases may lead to retroperitoneal haemorrhage and need for surgical intervention and/or death. For this reason, careful evaluation of risks and benefits must be taken into account, and all procedures to minimize the risk of complications must be observed. After biopsy, an observation time of 12-24 h is necessary, whilst a prolonged observation may be needed rarely. In some cases it could be safer to use different techniques to reduce the risk of complications, such as laparoscopic or transjugular renal biopsy in patients with coagulopathy or alternative approaches in obese patients. Despite progress in medicine over the years with the introduction of more advanced molecular biology techniques, renal biopsy is still an irreplaceable tool for nephrologists. PMID:27458561

  15. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures.

    PubMed

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C; Leblond, Frédéric

    2015-11-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue.

  16. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures.

    PubMed

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C; Leblond, Frédéric

    2015-11-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  17. High-Frequency Ultrasound Array Designed for Ultrasound-Guided Breast Biopsy.

    PubMed

    Cummins, Thomas; Eliahoo, Payam; Kirk Shung, K

    2016-06-01

    This paper describes the development of a miniaturized high-frequency linear array that can be integrated within a core biopsy needle to improve tissue sampling accuracy during breast cancer biopsy procedures. The 64-element linear array has an element width of [Formula: see text], kerf width of [Formula: see text], element length of 1 mm, and element thickness of [Formula: see text]. The 2-2 array composite was fabricated using deep reactive ion etching of lead magnesium niobate-lead titanate (PMN-PT) single crystal material. The array composite fabrication process as well as a novel high-density electrical interconnect solution are presented and discussed. Array performance measurements show that the array had a center frequency and fractional bandwidth ([Formula: see text]) of 59.1 MHz and 29.4%, respectively. Insertion loss and adjacent element crosstalk at the center frequency were -41.0 and [Formula: see text], respectively. A B-mode image of a tungsten wire target phantom was captured using a synthetic aperture imaging system and the imaging test results demonstrate axial and lateral resolutions of 33.2 and [Formula: see text], respectively. PMID:27046895

  18. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures

    PubMed Central

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C.; Leblond, Frédéric

    2015-01-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  19. Myocarditis confirmed by biopsy presenting as acute myocardial infarction.

    PubMed Central

    Costanzo-Nordin, M R; O'Connell, J B; Subramanian, R; Robinson, J A; Scanlon, P J

    1985-01-01

    Two cases of acute myocardial infarction occurred in association with myocarditis, which was confirmed by biopsy. The first patient suffered an anteroseptal and the second patient an inferior wall myocardial infarction shortly after an acute viral illness. In both patients, coronary angiography showed normal coronary arteries, and right ventricular endomyocardial biopsy confirmed myocarditis. Histological abnormalities attributable to ischaemic heart disease were absent. The first patient's condition became stable after immunosuppressive treatment. Myocarditis resolved spontaneously within three months in the second patient. Coronary artery spasm and myocardial involvement with a systemic disease were unlikely. Endomyocardial biopsy in patients with acute myocardial infarction and normal coronary arteries may be useful in identifying myocarditis associated with myocardial necrosis. Myocarditis in acute myocardial infarction in the absence of coronary artery obstruction has not previously been documented during life. Images PMID:3966948

  20. The role of renal biopsy in small renal masses.

    PubMed

    Burruni, Rodolfo; Lhermitte, Benoit; Cerantola, Yannick; Tawadros, Thomas; Meuwly, Jean-Yves; Berthold, Dominik; Jichlinski, Patrice; Valerio, Massimo

    2016-01-01

    Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered. In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives.

  1. Percutaneous needle biopsy of the transplanted kidney: technique and complications.

    PubMed

    Huraib, S; Goldberg, H; Katz, A; Cardella, C J; deVeber, G A; Cook, G T; Uldall, P R

    1989-07-01

    Over 11 1/2 years, 420 percutaneous needle biopsies were obtained from the transplanted kidneys of 205 patients at one institution. The procedure was performed by one nephrologist and 55 nephrology trainees. No limit was placed on the number of biopsies performed on one kidney, and the highest number was seven. The complications were macroscopic hematuria in 28 biopsies, prolonged hematuria (greater than 24 hours) in eight, transient anuria in five, and prolonged anuria requiring surgical intervention in one. Perinephric hematoma occurred in three patients; retroperitoneal hematoma led to compression of the iliac vein in one. None of these complications led to loss of the transplant. It is suggested that the freedom from serious complication is related to the safety of the technique and the precautions applied to preparation of the patient. These are described in detail.

  2. Smooth muscle pseudotumours: a potentially confusing artefact of rectal biopsy.

    PubMed Central

    Dankwa, E K; Davies, J D

    1988-01-01

    An artefactual smooth muscle lesion was found in seven of 500 consecutive rectal biopsy specimens. The lesions had the deceptive appearance of a genuine tumour although none of the patients with the lesion had presented with a rectal mucosal swelling. The morphology of the lesion and its poor reproducibility under experimental conditions suggested that it was an artefact of the biopsy procedure: it was easily reproduced in resected specimens of large bowel using punch or basket forceps but not when using flat forceps. The presence of the lesion seems to depend on the type of forceps used rather than on differences in deployment and seems to be caused by avulsion of the superficial part of the muscularis propria and its incorporation into the tissues included in rectal biopsy specimens. Images Fig 2 Fig 3 Fig 1 Fig 4 PMID:3045159

  3. Pericardial Tamponade: a Rare Complication of Sternal Bone Marrow Biopsy

    PubMed Central

    Santavy, Petr; Troubil, Martin; Lonsky, Vladimir

    2013-01-01

    Injury of the heart with concomitant pericardial tamponade as a result of sternal bone marrow biopsy is rare. An 80-year-old man was admitted with dehydration and non-specified abdominal pain to the regional hospital. Sternal aspiration biopsy was performed because of anemia and thrombocytopenia. Later on, because of the back pain, general weakness and blood pressure drop, an echocardiography examination was indicated. Pericardial fluid collection was found. Anticipated ascending aortic dissection was excluded on computed tomography scan, but pericardial fluid collection was confirmed. Transfer to our cardiac surgical facility ensued. Limited heart tamponade was affirmed on echocardiography and surgery was immediately indicated. Blood effusion was found in upper mediastinal fat tissue and 300 mL of blood were evacuated from opened pericardial space. Stab wound by sternal biopsy needle at the upper part of ascending aorta was repaired by pledgeted suture. Postoperative course was uneventful. PMID:24179668

  4. Sequential muscle biopsy changes in a case of congenital myopathy.

    SciTech Connect

    Danon, M. J.; Giometti, C. S.; Manaligod, J. R.; Swisher, C.; Center for Mechanistic Biology and Biotechnology; New York Medical Coll.; Univ. of Illinois at Chicago; Children's Memorial Hospital

    1997-05-01

    Muscle biopsies at age 7 months in a set of dizygotic male twins born floppy showed typical features of congenital fiber-type disproportion (CFTD). One of the twins died at age 1 year due to respiratory complications. The second one subsequently developed facial diplegia and external ophthalmoplegia. He never walked, remained wheelchair bound, and required continuous ventilatory support. He underwent repeat biopsies at ages 2 and 4, which showed many atrophic type 1 muscle fibers containing central nuclei and severe type 2 fiber deficiency compatible with centronuclear myopathy (CNM). Two-dimensional gel electrophoresis of muscle showed decreases of type II myosin light chains 2 and 3, suggestive of histochemical type I fiber deficiency. The progressive nature of morphological changes in one of our patients cannot be explained by maturational arrest. Repeat biopsies in cases of CFTD with rapid clinical deterioration may very well show CNM.

  5. Splitting and biopsy for bovine embryo sexing under field conditions.

    PubMed

    Lopes, R F; Forell, F; Oliveira, A T; Rodrigues, J L

    2001-12-01

    Improvements on embryo micromanipulation techniques led to the use of embryo bisection technology in commercial embryo transfer programs, and made possible the direct genetic analysis of preimplantation bovine embryos by biopsy. For example, aspiration and microsection, allow bovine embryos sexing by detection of male-specific Y-chromosome in a sample of embryonic cells. We report on the application of the methodologies of splitting and biopsy of bovine embryos in field conditions, and on the results of embryo sex determination by the polymerase chain reaction (PCR). Pregnancy rates achieved with fresh bisected or biopsied embryos (50 to 60%) were similar to the fresh intact embryos (55 to 61%). The PCR protocol used for embryo sexing showed 92% to 94% of efficiency and 90 to 100% of accuracy. These results demonstrate these procedures are suitable for use in field conditions.

  6. The role of renal biopsy in small renal masses

    PubMed Central

    Burruni, Rodolfo; Lhermitte, Benoit; Cerantola, Yannick; Tawadros, Thomas; Meuwly, Jean-Yves; Berthold, Dominik; Jichlinski, Patrice; Valerio, Massimo

    2016-01-01

    Renal biopsy is being increasingly proposed as a diagnostic tool to characterize small renal masses (SRM). Indeed, the wide adoption of imaging in the diagnostic workup of many diseases had led to a substantial increased incidence of SRM (diameter ≤4 cm). While modern ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) techniques have high sensitivity for detecting SRM, none is able to accurately and reliably characterize them in terms of histological features. This is currently of key importance in guiding clinical decision-making in some situations, and in these cases renal biopsy should be considered. In this review, we aim to summarize the technique, diagnostic performance, and predicting factors of nondiagnostic biopsy, as well as the future perspectives. PMID:26858784

  7. Fine needle aspiration biopsy in salivary gland tumours.

    PubMed

    Lau, T; Balle, V H; Bretlau, P

    1986-04-01

    Of 105 tumours of the major salivary glands, 90 were benign and 15 malignant. In benign tumours a correct preoperative diagnosis was made by fine needle aspiration biopsy in 84%, and none were falsely classed as malignant. In the malignant tumours, only 8 out of 15 (53%) were correctly diagnosed as malignant while 7 were misdiagnosed as benign. It is concluded that in benign salivary gland tumours there is good accordance between fine needle aspiration biopsy and the final histological report, in contrast to the malignant tumours where this is less convincing. Fine needle aspiration biopsy is a valuable diagnostic tool, but the result should be carefully evaluated, regarded as only part of the clinical picture and not solely relied on.

  8. IgG Subclass Staining in Routine Renal Biopsy Material.

    PubMed

    Hemminger, Jessica; Nadasdy, Gyongyi; Satoskar, Anjali; Brodsky, Sergey V; Nadasdy, Tibor

    2016-05-01

    Immunofluorescence staining plays a vital role in nephropathology, but the panel of antibodies used has not changed for decades. Further classification of immunoglobulin (Ig)G-containing immune-type deposits with IgG subclass staining (IgG1, IgG2, IgG3, and IgG4) has been shown to be of diagnostic utility in glomerular diseases, but their value in the evaluation of renal biopsies has not been addressed systematically in large renal biopsy material. Between January 2007 and June 2014, using direct immunofluorescence, we stained every renal biopsy for the IgG subclasses if there was moderate to prominent glomerular IgG staining and/or IgG-predominant or IgG-codominant glomerular staining. The total number of biopsies stained was 1084, which included 367 cases of membranous glomerulonephritis, 307 cases of lupus nephritis, 74 cases of fibrillary glomerulonephritis, 53 cases of proliferative glomerulonephritis with monoclonal IgG deposits, and 25 cases of antiglomerular basement membrane disease, among others. We found that monoclonality of IgG deposits cannot always be reliably determined on the basis of kappa and lambda light chain staining alone, particularly if concomitant (frequently nonspecific) IgM staining is present. In IgG heavy and heavy and light chain deposition disease (3 cases), subclass staining is very helpful, and in proliferative glomerulonephritis with monoclonal IgG deposits subclass staining is necessary. IgG subclass staining is useful in differentiating primary from secondary membranous glomerulonephritis. In proliferative glomerulonephritis with polyclonal IgG deposition, IgG1 dominance/codominance with concomitant IgG3 and IgG2 but weak or absent IgG4 staining favors an underlying autoimmune disease. IgG subclass staining is a very useful diagnostic method in a selected cohort of renal biopsies, particularly in biopsies with glomerulonephritis with monoclonal IgG deposits.

  9. [Hepatic puncture biopsy in ambulatory care. Advantages and disadvantages].

    PubMed

    Nouel, O

    1997-03-01

    There is a clear trend towards favoring outpatient care in an attempt to control health care costs. Despite widespread acceptance in some countries, many teams in France still prefer to hospitalize patients requiring percutaneous liver biopsy because the outpatient setting has not been encouraged in French text books on hepatology, many gastroenterologists do not have access to outpatient facilities, and the lack of French references which has raised questions as to the legal responsibilities involved. The series of 231 outpatient percutaneous liver biopsies reported by Bourgaux in this issue of La Presse Médicale will remove the doubt in many minds. There are many advantages for the generally young population with early stage liver disease, frequently hepatitis C, requiring percutaneous liver biopsy. Lower cost is probably the primary advantage, but improved patient comfort, especially if repeated procedures are needed, is also greatly appreciated. The outpatient procedure is safe when all the selection criteria are met including: normal coagulation, ultrasonographically homogeneous liver, patient compliance and availability of a structured outpatient clinic, and absence of a severe concomitent disease. These apparently restrictive criteria actually include the majority of the indications for liver biopsy. There is another debate on whether echo-guided biopsy would be even safer but as emphasized by Bourgaux et al. this would require a reorganization of most of the hepatogastroenterology departments. One other point cannot be overlooked. Some operators (and patients) may also feel that the impressive nature of the procedure merits a more impressive setting, i.e. full hospitalization. Consequently, while it is quite reasonable to propose outpatient liver biopsy as a classical procedure, there are situations when personal preference may still dictate hospitalization.

  10. Renal biopsy findings in Belgium: a retrospective single center analysis.

    PubMed

    Mesquita, M; Fosso, C; Bakoto Sol, E; Libertalis, M; Corazza, F; Vanden Houte, K; Dratwa, M

    2011-01-01

    Renal biopsy is the definitive diagnostic test in patients with renal parenchymal disease. Renal biopsy registry is an important tool which can provide valuable data concerning early and correct epidemiological description and clinical correlations of renal diseases. Records of 326 adult renal biopsies performed at our hospital from January 1991 till the end of December 2006 were retrospectively examined. Overall, secondary glomerular diseases (SGD) were predominant (39.9%), followed by primary glomerular diseases (PGD) (30.4%), vascular diseases (13.2%) and TIN (6.7%). Total sclerosis of the kidney did not allow histopathological diagnosis in 5.8% of all biopsied kidneys. Focal and Segmental Glomerular Sclerosis (FSGS), IgA Nephropathy (IgAGN) and Minimal Change Disease (MCD) and Membranous Glomerulopathy (MGN) were the most common PGD, altogether representing 75.7% of all PGD. FSGS was the most frequent (30.3%), followed by IgAGN (21.2%), MCD (19.1%) and MGN in 15.1%. Vasculitis, HIVAN, diabetic nephropathy and amyloidosis were the most common SGD, altogether representing 90% of all SGD. Immune Mediated Glomerulonephritis (IMGN) were the most frequent (32.3%), followed by HIVAN (16.9%), diabetic nephropathy (14.6%) and amyloidosis (10%). Nephroangiosclerosis (benign and malignant nephroangiosclerosis) was the most frequent vascular nephropathy responsible for 79% of all vascular diseases. Thrombotic microangiopathy was seen in 9.3% and atherothrombotic disease in 7% of all vascular diseases. Concerning tubular diseases, chronic TIN accounted for 63.6% of all tubular diseases, followed by light chain-cast nephropathy (22.7%) and acute TIN (13.6%). Because of lack of material, 3.4% of all biopsies could not be analyzed. These data demonstrate that the distribution of biopsy-proved renal diseases in a Belgian population of the Brussels area is strongly influenced by the indications of renal biopsy. Harmonization of these indications might reflect with more accuracy

  11. Do we still need renal biopsy in lupus nephritis?

    PubMed

    Haładyj, Ewa; Cervera, Ricard

    2016-01-01

    The natural course of systemic lupus erythematosus (SLE) is characterized by periods of disease activity and remissions. Prolonged disease activity results in cumulative organ damage. Lupus nephritis is one of the most common and devastating manifestations of SLE. In the era of changing therapy to less toxic regimens, some authors have stated that if mycophenolate mofetil can be used for the induction and maintenance treatment in all histological classes of lupus nephritis, renal biopsy can be omitted. This article aims to answer the question of what brings the bigger risk: renal biopsy or its abandonment.

  12. Two cases of uterine malignant lymphoma diagnosed by needle biopsy

    PubMed Central

    Ichimura, Tomoyuki; Murakami, Makoto; Matsuda, Makiko; Kawamura, Naoki; Sumi, Toshiyuki

    2015-01-01

    Abstract The incidence of primary malignant lymphoma arising in the female genital tract is extremely rare and constitutes approximately 0.05% of malignant tumors. Uterine malignant lymphoma develops in the endometrial stroma, causing minimal necrosis. It is therefore difficult to diagnose malignant lymphoma, as it does not involve genital bleeding or epithelial defects. We have performed transcervical needle biopsies from deep in the myometrium, with the purpose of diagnosing uterine muscle layer lesions, such as leiomyosarcoma, but this is an unusual method. In this report, we suggest that transcervical needle biopsy is useful in the diagnosis of uterine malignant lymphoma. PMID:26370331

  13. Altered coagulability: an aid to selective breast biopsy.

    PubMed Central

    Spillert, C. R.; Passannante, M. R.; Salzer-Pagan, J. E.; Lazaro, E. J.

    1993-01-01

    Difficulty in discriminating nonadvanced breast cancer from benign breast disease results in many cancer negative biopsies. Development of a test to better differentiate between these two entities to reduce the number of cancer negative biopsies was the purpose of this blind study. The clue that prompted the development of this test resides in the state of hypercoagulability in cancer. Hypercoagulability can be measured by assessing tissue factor-mediated altered coagulability. The amount of tissue factor release is contingent on prior activation of the monocyte (the only blood cell that generates tissue factor) in vivo. PMID:8478968

  14. MR guided breast interventions: role in biopsy targeting and lumpectomies

    PubMed Central

    Jagadeesan, Jayender; Richman, Danielle M; Kacher, Daniel F

    2015-01-01

    Synopsis Contrast enhanced breast MRI is increasingly being used to diagnose breast cancer and to perform biopsy procedures. The American Cancer Society has advised women at high risk for breast cancer to have breast MRI screening as an adjunct to screening mammography. This article places special emphasis on biopsy and operative planning involving MRI and reviews utility of breast MRI in monitoring response to neoadjuvant chemotherapy. We describe peer-reviewed data on currently accepted MR-guided therapeutic methods for addressing benign and malignant breast diseases, including intraoperative imaging. PMID:26499274

  15. Ileal Pouch Biopsy Triggers Investigation and Diagnosis of Systemic Mastocytosis

    PubMed Central

    Mannan, Abul Ala Syed Rifat; Shen, Bo; Hsieh, Fred; Patil, Deepa T.

    2016-01-01

    We report a unique case of systemic mastocytosis (SM) diagnosed in an ileal pouch biopsy obtained from a 44-year-old woman with ulcerative colitis. She presented with intermittent abdominal pain and watery diarrhea that did not respond to antibiotic therapy. The pouch biopsy showed expansion of the lamina propria by aggregates of CD117 and CD25-positive abnormal mast cells. A subsequent bone marrow analysis showed an increase in abnormal mast cells. Based on World Health Organization criteria, she was diagnosed with SM and responded to cromolyn sodium therapy. Systemic mastocytosis can mimic pouchitis, and thus recognition of this condition is important for appropriate clinical management. PMID:27807556

  16. A survey of oral biopsies in Brazilian pediatric patients.

    PubMed

    Maia, D M; Merly, F; Castro, W H; Gomez, R S

    2000-01-01

    This paper presents a review of 1018 oral biopsies in pediatric patients from the Oral Pathology Service, Minas Gerais Federal University, Brazil. The lesions were divided into ten main categories. The most common oral lesions in this study were follicular cyst in the maxillary anterior region, followed by inflammatory fibrous hyperplasia in the same region, and mucocele in the lower lip. Cysts of the jaws and oral soft tissues comprised 26.1 percent of total oral biopsies. The importance of these findings in oral diagnosis is discussed. PMID:10826049

  17. Do we still need renal biopsy in lupus nephritis?

    PubMed Central

    Cervera, Ricard

    2016-01-01

    The natural course of systemic lupus erythematosus (SLE) is characterized by periods of disease activity and remissions. Prolonged disease activity results in cumulative organ damage. Lupus nephritis is one of the most common and devastating manifestations of SLE. In the era of changing therapy to less toxic regimens, some authors have stated that if mycophenolate mofetil can be used for the induction and maintenance treatment in all histological classes of lupus nephritis, renal biopsy can be omitted. This article aims to answer the question of what brings the bigger risk: renal biopsy or its abandonment. PMID:27407281

  18. Internal mammary lymph node biopsy guided by computed tomography

    PubMed Central

    Irving, Henry C.; Hardy, Graham J.

    1982-01-01

    Internal mammary lymph node enlargement may be demonstrated using computed tomography (CT), and a confirmatory tissue diagnosis of metastatic involvement may be obtained using fine needle aspiration biopsy with needle tip placement guided by the CT scanner. A case history is described to illustrate how a patient presented 9 years after mastectomy with an internal mammary lymph node metastasis and how cytopathological diagnosis of this metastasis was achieved by CT guided biopsy. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:7145793

  19. Diagnosis of salivary gland tumors by fine needle aspiration biopsy.

    PubMed

    Sismanis, A; Merriam, J M; Kline, T S; Davis, R K; Shapshay, S M; Strong, M S

    1981-01-01

    The cytologic findings of 51 smears obtained by fine needle aspiration biopsy from salivary gland masses were compared with the histologic findings of permanent sections. The overall concurrence rate between cytologic and histologic findings for being and malignant lesions was 91%. The diagnostic accuracy (exact histologic diagnosis) for the benign lesions was 87% and for the malignant tumors 60%. One case showed false-positive results and 1 case false-negative results. Fine needle aspiration biopsy has been found to be safe, free of complications, and helpful in the planning of treatment.

  20. [Biopsy of suspicious lesions in patients with breast cancer].

    PubMed

    Colin, P-E; Schroeder, H; Gonne, E; Hanocq, F; André, C; Rorive, A; Jerusalem, G; Collignon, J

    2015-11-01

    Discordances between hormone receptors and HER2 status in primary and metastatic breast cancer have been reported by several studies. In this context, systematic biopsies could be clinically relevant in breast cancer to confirm the biological characteristics of a suspicious lesion. In this article, illustrated by 2 case reports and based on a recent review on this topic, we discuss the clinical significance of receptor discordances and possible diagnosis of a secondary primary tumor. The role of these biopsies for the identification of new therapeutic targets is also envisaged as well as underlying mechanisms for receptors' modification like tumoral heterogeneity, clonal selection and technical artifacts. PMID:26738268

  1. The pros and cons of outpatient breast biopsy.

    PubMed

    Lou, M A; Mandal, A K; Alexander, J L

    1976-06-01

    A review of the 130 breast biopsies performed on women during the past three years at the Martin Luther King, Jr, General Hospital showed that 90 were performed on outpatients and 40 on inpatients. Of the 90 outpatient procedures, 61 were under local anesthesia and 29 under general. Only three outpatient biopsy specimens were malignant and required subsequent patient admission to the hospital for mastectomy at an interval of 9 to 14 days. In all three, the axillary nodes were uninvolved. In two, no residual tumor was found in the mastectomy specimen.

  2. Evaluation of neutrophil-to-lymphocyte ratio prior to prostate biopsy to predict biopsy histology: Results of 1836 patients

    PubMed Central

    Gokce, Mehmet Ilker; Hamidi, Nurullah; Suer, Evren; Tangal, Semih; Huseynov, Adil; Ibiş, Arif

    2015-01-01

    Introduction: We evaluate the role of NLR prior to prostate biopsy to predict biopsy histology and Gleason score in patients with prostate cancer. Methods: In this retrospective study, we evaluated data of patients underwent prostate biopsy between May 2005 and March 2015. We collected the following data: age, prostate-specific antigen (PSA), biopsy histology, Gleason score (GS) in prostate cancer patients, neutrophil counts, and lymphocyte counts. Patients were grouped as benign prostatic hyperplasia (BPH), prostate cancer, and prostatitis. The Chi square test was used to compare categorical variables and analysis of variance (ANOVA) was applied for continuous variables. Results: Data of 1836 patients were investigated. The mean age, total PSA and neutrophil-lymphocyte ratio (NLR) of the population were 66.8 ± 8.17 years, 9.38 ± 4.7 ng/dL, and 3.11 ± 1.71, respectively. Patients were divided as follows: 625 in the group with BPH history, 600 in the prostatitis group, and 611 in the prostate cancer histology group. The mean NLR of the prostatitis group was higher compared to the prostate cancer and BPH groups (p = 0.0001). The mean NLR of the prostate cancer group was significantly higher compared to the BPH group (p = 0.002). The GS 8–10 group had a significantly higher mean NLR compared to GS 5–6 (3.64 vs. 2.54, p = 0.0001) and GS 7 (3.64 vs. 2.58, p = 0.0001) patients. Conclusions: NLR was found to differ with regard to histology of prostate biopsy and higher GS was associated with higher NLR in patients with prostate cancer. However prostatitis prevents the use of NLR in predicting prostate cancer before a prostate biopsy. Also, the retrospective nature and lack of multivariate analysis in this study somewhat limits the relevance of these results. PMID:26600880

  3. Evaluating The PCPT Risk Calculator in Ten International Biopsy Cohorts: Results from the Prostate Biopsy Collaborative Group

    PubMed Central

    Ankerst, Donna P.; Boeck, Andreas; Freedland, Stephen J.; Thompson, Ian M.; Cronin, Angel M.; Roobol, Monique J.; Hugosson, Jonas; Jones, J. Stephen; Kattan, Michael W.; Klein, Eric A.; Hamdy, Freddie; Neal, David; Donovan, Jenny; Parekh, Dipen J.; Klocker, Helmut; Horninger, Wolfgang; Benchikh, Amine; Salama, Gilles; Villers, Arnauld; Moreira, Daniel M.; Schröder, Fritz H.; Lilja, Hans; Vickers, Andrew J.

    2013-01-01

    Objectives To evaluate the discrimination, calibration and net benefit performance of the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) across five European Randomized study of Screening for Prostate Cancer (ERSPC), 1 United Kingdom, 1 Austrian and 3 US biopsy cohorts. Methods PCPTRC risks were calculated for 25,733 biopsies using prostate-specific antigen (PSA), digital rectal examination, family history and history of prior biopsy, and single imputation for missing covariates. Predictions were evaluated using the areas underneath the receiver operating characteristic curves (AUC), discrimination slopes, chi-square tests of goodness of fit, and net benefit decision curves. Results AUCs of the PCPTRC ranged from a low of 56% in the ERSPC Goeteborg Rounds 2-6 cohort to a high of 72% in the ERSPC Goeteborg Round 1 cohort, and were statistically significantly higher than that of PSA in 6 out of the 10 cohorts. The PCPTRC was well-calibrated in the SABOR, Tyrol and Durham cohorts. There was limited to no net benefit to using the PCPTRC for biopsy referral compared to biopsying all or no men in all five ERSPC cohorts and benefit within a limited range of risk thresholds in all other cohorts. Conclusions External validation of the PCPTRC across ten cohorts revealed varying degree of success highly dependent on the cohort, most likely due to different criteria for and work-up before biopsy. Future validation studies of new calculators for prostate cancer should acknowledge the potential impact of the specific cohort studied when reporting successful versus failed validation. PMID:22210512

  4. Nomograms for predicting Gleason upgrading in a contemporary Chinese cohort receiving radical prostatectomy after extended prostate biopsy: development and internal validation.

    PubMed

    He, Biming; Chen, Rui; Gao, Xu; Ren, Shancheng; Yang, Bo; Hou, Jianguo; Wang, Linhui; Yang, Qing; Zhou, Tie; Zhao, Lin; Xu, Chuanliang; Sun, Yinghao

    2016-03-29

    The current strategy for the histological assessment of prostate cancer (PCa) is mainly based on the Gleason score (GS). However, 30-40% of patients who undergo radical prostatectomy (RP) are misclassified at biopsy pathologically. Thus, we developed and validated nomograms for the prediction of Gleason score upgrading (GSU) in patients who underwent radical prostatectomy after extended prostate biopsy in a Chinese population. This retrospective study included a total of 411 patients who underwent radical prostatectomy at our institute after having prostate biopsies between 2011 and 2015. The final pathologic GS was upgraded in 151 (36.74%) of the cases in all patients and 92 (60.13%) cases in men with GS=6. In multivariate analyses, the primary biopsy GS, secondary biopsy GS and obesity were predictive of GSU in the patient cohort assessed. In patients with GS=6, the significant predictors of GSU included the body mass index (BMI), prostate-specific antigen density(PSAD) and percentage of positive cores. The area under the curve (AUC) of the prediction models was 0.753 for the entire patient population and 0.727 for the patients with GS=6. Both nomograms were well calibrated, and decision curve analysis demonstrated a high net benefit across a wide range of threshold probabilities. This study may be relevant for improved risk assessment and clinical decision-making in PCa patients. PMID:26943768

  5. Core-core and core-valence correlation

    NASA Technical Reports Server (NTRS)

    Bauschlicher, Charles W., Jr.; Langhoff, Stephen R.; Taylor, Peter R.

    1988-01-01

    The effect of (1s) core correlation on properties and energy separations was analyzed using full configuration-interaction (FCI) calculations. The Be 1 S - 1 P, the C 3 P - 5 S and CH+ 1 Sigma + or - 1 Pi separations, and CH+ spectroscopic constants, dipole moment and 1 Sigma + - 1 Pi transition dipole moment were studied. The results of the FCI calculations are compared to those obtained using approximate methods. In addition, the generation of atomic natural orbital (ANO) basis sets, as a method for contracting a primitive basis set for both valence and core correlation, is discussed. When both core-core and core-valence correlation are included in the calculation, no suitable truncated CI approach consistently reproduces the FCI, and contraction of the basis set is very difficult. If the (nearly constant) core-core correlation is eliminated, and only the core-valence correlation is included, CASSCF/MRCI approached reproduce the FCI results and basis set contraction is significantly easier.

  6. Percutaneous biopsy for risk stratification of renal masses.

    PubMed

    Blute, Michael L; Drewry, Anna; Abel, Edwin Jason

    2015-10-01

    The increased use of abdominal imaging has led to identification of more patients with incidental renal masses, and renal mass biopsy (RMB) has become a popular method to evaluate unknown renal masses prior to definitive treatment. Pathologic data obtained from biopsy may be used to guide decisions for treatment and may include the presence or absence of malignant tumor, renal cell cancer subtype, tumor grade and the presence of other aggressive pathologic features. However, prior to using RMB for risk stratification, it is important to understand whether RMB findings are equivalent to pathologic analysis of surgical specimens and to identify any potential limitations of this approach. This review outlines the advantages and limitations of the current studies that evaluate RMB as a guide for treatment decision in patients with unknown renal masses. In multiple series, RMB has demonstrated low morbidity and a theoretical reduction in cost, if patients with benign tumors are identified from biopsy and can avoid subsequent treatment. However, when considering the routine use of RMB for risk stratification, it is important to note that biopsy may underestimate risk in some patients by undergrading, understaging or failing to identify aggressive tumor features. Future studies should focus on developing treatment algorithms that integrate RMB to identify the optimal use in risk stratification of patients with unknown renal masses.

  7. Optical spectroscopy for stereotactic biopsy of brain tumors

    NASA Astrophysics Data System (ADS)

    Markwardt, Niklas; von Berg, Anna; Fiedler, Sebastian; Goetz, Marcus; Haj-Hosseini, Neda; Polzer, Christoph; Stepp, Herbert; Zelenkov, Petr; Rühm, Adrian

    2015-07-01

    Stereotactic biopsy procedure is performed to obtain a tissue sample for diagnosis purposes. Currently, a fiber-based mechano-optical device for stereotactic biopsies of brain tumors is developed. Two different fluorophores are employed to improve the safety and reliability of this procedure: The fluorescence of intravenously applied indocyanine green (ICG) facilitates the recognition of blood vessels and thus helps minimize the risk of cerebral hemorrhages. 5- aminolevulinic-acid-induced protoporphyrin IX (PpIX) fluorescence is used to localize vital tumor tissue. ICG fluorescence detection using a 2-fiber probe turned out to be an applicable method to recognize blood vessels about 1.5 mm ahead of the fiber tip during a brain tumor biopsy. Moreover, the suitability of two different PpIX excitation wavelengths regarding practical aspects was investigated: While PpIX excitation in the violet region (at 405 nm) allows for higher sensitivity, red excitation (at 633 nm) is noticeably superior with regard to blood layers obscuring the fluorescence signal. Contact measurements on brain simulating agar phantoms demonstrated that a typical blood coverage of the tumor reduces the PpIX signal to about 75% and nearly 0% for 633 nm and 405 nm excitation, respectively. As a result, 633 nm seems to be the wavelength of choice for PpIX-assisted detection of high-grade gliomas in stereotactic biopsy.

  8. [Sentinel lymph node biopsy in pregnancy-associated breast cancer].

    PubMed

    Mátrai, Zoltán; Bánhidy, Ferenc; Téglás, Melinda; Kovács, Eszter; Sávolt, Akos; Udvarhelyi, Nóra; Bartal, Alexandra; Kásler, Miklós

    2013-12-01

    The incidence of pregnancy-associated breast cancer is rising. Sentinel lymph node biopsy is the method of choice in clinically node negative cases as the indicated minimally invasive regional staging procedure. Some reports have linked radioisotope and blue dye required for lymphatic mapping to teratogenic effects, the idea of which has become a generalized statement and, until recently, contraindication for these agents was considered during pregnancy. Today, there are many published reports of successful interventions with low-dose 99mTc-labeled human albumin nanocolloid, based on dosimetric modeling demonstrating a negligible radiation exposure of the fetus. These results contributed to the seemingly safe and successful use of sentinel lymph node biopsy during pregnancy, though generally it can not replace axillary lymphadenectomy in the absence of high-quality evidence. The possibility of sentinel lymph node biopsy should be offered to pregnancy-associated early breast cancer patients with clinically negative axilla, and patients should be involved in the decision making following extensive counselling. This paper presents the successful use of sentinel lymph node biopsy with low-dose tracer during two pregnancies (in the first and third trimesters) and, for the first time in Hungarian language, it offers a comprehensive literature review on this topic. Orv. Hetil., 154(50), 1991-1997. PMID:24317358

  9. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  10. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  11. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  12. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  13. 21 CFR 870.4075 - Endomyocardial biopsy device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endomyocardial biopsy device. 870.4075 Section 870.4075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... procedure to remove samples of tissue from the inner wall of the heart. (b) Classification. Class...

  14. Radial Scar at Image-guided Needle Biopsy

    PubMed Central

    Conlon, Niamh; D’Arcy, Clare; Kaplan, Jennifer B.; Bowser, Zenica L.; Cordero, Anibal; Brogi, Edi; Corben, Adriana D.

    2016-01-01

    Optimal management of a lesion yielding radial scar (RS) without epithelial atypia on breast biopsy is controversial. In this single-institution study spanning 17 years, 53 patients with this biopsy diagnosis were evaluated in terms of clinical, radiologic, and pathologic features and outcomes. RSs were categorized as either “incidental” or as the “targeted” lesion according to defined criteria. Of 48 patients who underwent surgical excision after a diagnosis of RS on biopsy, only 1 had an “upgrade” diagnosis of malignancy (2%). No “incidental” RS was associated with the presence of malignancy on surgical excision. Meta-analysis of 20 RS excision studies demonstrated an overall upgrade rate of 10.4%, with a higher rate in patients with a diagnosis of RS with atypia (26%). The upgrade rate for RS without atypia was 7.5% overall. The lower rate of upgrade to malignancy in this study (2%) is likely related to the thorough radiologic-pathologic review undertaken. In the setting of multidisciplinary agreement and careful radiologic-pathologic correlation, it may be appropriate for patients with a biopsy diagnosis of RS without atypia to forego surgical excision in favor of imaging follow-up. PMID:25634748

  15. [Experience in teaching a biopsy-section course in Belarus].

    PubMed

    Krylov, Yu V; Malashenko, S V; Lesnichaya, O V; Krylov, A Yu

    2015-01-01

    The paper deals with the improvement of teaching a biopsy-section course (BSC). The authors have analyzed the most frequent errors in the interaction of clinicians with a pathology service and summed up the experience of the Pathological Anatomy Department in practical work and teaching the BSC. The differentiated approach to teaching the BSC to resident students of different specialties is proposed.

  16. [Recurrent breast haematoma after fine needle aspiration biopsy of angiosarcoma].

    PubMed

    Ortiz Mendoza, Carlos Manuel

    2007-03-01

    It is reported a rare complication after a fine needle aspiration biopsy of a breast angiosarcoma. A 30-years-old female presented with a right breast lump. An ovoid, hypoecoic lesion of 39 x 13 mm was detect by ultrasonography. A fine needle aspiration biopsy was carried out for diagnosis, but only blood was report. After the biopsy the skin showed a violaceous color, the lump was tender, reappeared in three instances and increased its size (15 cm). In spite of conservative management the pain and the mass did not disappear, then surgical management was decided. A soft, violaceous mass of 13 x 6 x 4 cm, with well demarcated boundaries was removed. A capillary and cavernous breast hemangioma was diagnosed. Four months later a recurrence presented, and a new excision was carried out with a resulting moderately differentiated angiosarcoma, then a simple mastectomy was performed for definitive treatment. On a literature search only one similar case was found. A recurrent haematoma after a fine needle aspiration biopsy of a breast tumor mandates to rule out an angiosarcoma.

  17. A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice

    SciTech Connect

    Atar, Eli; Ben Ari, Ziv; Bachar, Gil N.; Amlinski, Yelena; Neyman, Chaim; Knizhnik, Michael; Litvin, Sergey; Schmilovitz-Weiss, Hemda; Shapiro, Riki; Bruckhaimer, Elchanan; Tur-Kaspa, Ran; Belenky, Alexander

    2010-06-15

    The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.

  18. Visually Estimated MRI Targeted Prostate Biopsy Could Improve the Detection of Significant Prostate Cancer in Patients with a PSA Level <10 ng/mL

    PubMed Central

    Lee, Dong Hoon; Nam, Jong Kil; Park, Sung Woo; Lee, Seung Soo; Han, Ji-Yeon; Lee, Sang Don; Lee, Joon Woo

    2016-01-01

    Purpose To compare prostate cancer detection rates between 12 cores transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and visually estimated multiparametric magnetic resonance imaging (mp-MRI)-targeted prostate biopsy (MRI-visual-Bx) for patients with prostate specific antigen (PSA) level less than 10 ng/mL. Materials and Methods In total, 76 patients with PSA levels below 10 ng/mL underwent 3.0 Tesla mp-MRI and TRUS-Bx prospectively in 2014. In patients with abnormal lesions on mp-MRI, we performed additional MRI-visual-Bx. We compared pathologic results, including the rate of clinically significant prostate cancer cores (cancer length greater than 5 mm and/or any Gleason grade greater than 3 in the biopsy core). Results The mean PSA was 6.43 ng/mL. In total, 48 of 76 (63.2%) patients had abnormal lesions on mp-MRI, and 116 targeted biopsy cores, an average of 2.42 per patient, were taken. The overall detection rates of prostate cancer using TRUS-Bx and MRI-visual-Bx were 26/76 (34.2%) and 23/48 (47.9%), respectively. In comparing the pathologic results of TRUS-Bx and MRI-visual-Bx cores, the positive rates were 8.4% (77 of 912 cores) and 46.6% (54 of 116 cores), respectively (p<0.001). Mean cancer core lengths and mean cancer core percentages were 3.2 mm and 24.5%, respectively, in TRUS-Bx and 6.3 mm and 45.4% in MRI-visual-Bx (p<0.001). In addition, Gleason score ≥7 was noted more frequently using MRI-visual-Bx (p=0.028). The detection rate of clinically significant prostate cancer was 27/77 (35.1%) and 40/54 (74.1%) for TRUS-Bx and MRI-visual-Bx, respectively (p<0.001). Conclusion MRI-visual-Bx showed better performance in the detection of clinically significant prostate cancer, compared to TRUS-Bx among patients with a PSA level less than 10 ng/mL. PMID:26996553

  19. Single-Institution Results of Image-Guided Nonplugged Percutaneous Versus Transjugular Liver Biopsy

    SciTech Connect

    Hardman, Rulon L.; Perrich, Kiley D.; Silas, Anne M.

    2011-04-15

    Purpose: To retrospectively review patients who underwent transjugular and image-guided percutaneous biopsy and compare the relative risk of ascites, thrombocytopenia, and coagulopathy. Materials and Methods: From August 2001 through February 2006, a total of 238 liver biopsies were performed. The radiologist reviewed all patient referrals for transjugular biopsy. These patients either underwent transjugular biopsy or were reassigned to percutaneous biopsy (crossover group). Patients referred to percutaneous image-guided liver biopsy underwent this same procedure. Biopsies were considered successful if a tissue diagnosis could be made from the samples obtained. Results: A total of 36 transjugular biopsies were performed with 3 total (8.3%) and 1 major (2.8%) complications. A total of 171 percutaneous biopsies were performed with 10 (5.8%) total and 3 (1.8%) major complications. The crossover group showed a total of 4 (12.9%) complications with 1 (3.2%) major complication. Sample adequacy was 91.9% for transjugular and 99.5% for percutaneous biopsy. Conclusion: Both transjugular and percutaneous liver biopsy techniques are efficacious and safe. Contraindications such as thrombocytopenia, coagulopathy, and ascites are indicators of greater complications but are not necessarily prevented by transjugular biopsy. Percutaneous biopsy more frequently yields a diagnostic specimen than transjugular biopsy.

  20. Diabetic nephropathy: Is it time yet for routine kidney biopsy?

    PubMed Central

    Gonzalez Suarez, Maria L; Thomas, David B; Barisoni, Laura; Fornoni, Alessia

    2013-01-01

    Diabetic nephropathy (DN) is one of the most important long-term complications of diabetes. Patients with diabetes and chronic kidney disease have an increased risk of all-cause mortality, cardiovascular mortality, and kidney failure. The clinical diagnosis of DN depends on the detection of microalbuminuria. This usually occurs after the first five years from the onset of diabetes, and predictors of DN development and progression are being studied but are not yet implemented into clinical practice. Diagnostic tests are useful tools to recognize onset, progression and response to therapeutic interventions. Microalbuminuria is an indicator of DN, and it is considered the only noninvasive marker of early onset. However, up to now there is no diagnostic tool that can predict which patients will develop DN before any damage is present. Pathological renal injury is hard to predict only with clinical and laboratory findings. An accurate estimate of damage in DN can only be achieved by the histological analysis of tissue samples. At the present time, renal biopsy is indicated on patients with diabetes under the suspicion of the presence of nephropathies other than DN. Results from renal biopsies in patients with diabetes had made possible the classification of renal biopsies in three major groups associated with different prognostic features: diabetic nephropathy, non-diabetic renal disease (NDRD), and a superimposed non-diabetic condition on underlying diabetic nephropathy. In patients with type 2 diabetes with a higher degree of suspicion for NDRD, it is granted the need of a renal biopsy. It is important to identify and differentiate these pathologies at an early stage in order to prevent progression and potential complications. Therefore, a more extensive use of biopsy is advisable. PMID:24379914

  1. Kidney biopsy in west of Iran: Complications and histopathological findings

    PubMed Central

    Rahbar, M.

    2009-01-01

    In this retrospective study, we reviewed the medical records and histopathology findings of 135 patients who underwent renal biopsies at two special hospitals affiliated to Kermanshah medical university during a six-year period (2003-2007). All were performed using Tru-Cut needle under ultrasound guidance. Twenty four specimens were unsatisfactory. There were 38 males (34.2%) and 73 females (65.7%) in 111 patients with adequate specimens (each specimen has more than 5 glomeruli); the mean age was 16.5 years (range 2-64 years). Side effects of the renal biopsies included pain at the site of biopsy in 2 (2.7%), gross hematuria in 1 (0.9%). Nephrotic syndrome was the most common indication for biopsy followed by acute renal failure of unknown etiology and nephritic syndrome. Primary glomerular disease was reported in 78 patients (70.2%) and also secondary glomerular disease in 33 patients (29.7%). Among the primary glomerulonephritis disease, minimal change disease and membranous glomerulonephritis were the commonest findings in children below the age of 16 years. Minimal change disease ranked first in adults whole membranous glomerular disease and focal segmental glomerulosclerosis were more common in the elderly. In all patients lupus glomerular disease was the commonest secondary glomerular disease. We conclude that study on renal biopsy makes final diagnosis which is associated with an acceptably low rate of complications in our practice, and in all, the patterns of renal histology in our study vary slightly from those reported from other countries. PMID:20368927

  2. Bone biopsy in the diagnosis of renal osteodystrophy.

    PubMed

    Spasovski, Goce B

    2004-01-01

    When renal disease develops, mineral and vitamin D homeostasis is disrupted, resulting in diverse manifestations in bone cells and structure as well as the rate of bone turnover. In ESRF when patients require chronic maintenance dialysis, nearly all of them have abnormal bone histology named renal osteodystrophy (ROD). On the other hand, survival rates of patients on dialysis have increased with improved dialytic therapy and the resultant increased duration of dialysis has led to a rise in renal osteodystrophy. Because this metabolic bone disease can produce fractures, bone pain, and deformities late in the course of the disease, prevention and early treatment are essential. Serum PTH levels are commonly used to assess bone turnover in dialyzed patients. However, it is found that serum PTH levels between 65 and 450 pg/ml seen in the majority of dialysis patients are not predictive of the underlying bone disease. To date, bone biopsy is the most powerful and informative diagnostic tool to provide important information on precisely the type of renal osteodystrophy affecting patients, the degree of severity of the lesions, and the presence and amount of aluminum and strontium deposition in bone. Bone biopsy is not only useful in clinical settings but also in research to assess the effects of therapies on bone. Although considered as an invasive procedure, bone biopsy has been proven as safe and free from major complications besides pain, haematoma or wound infections, but the operator's experience and skill is important in minimizing morbidity. Alternatives to bone biopsy continue to be pursued, but the non-invasive bone markers have not been proven to hold sufficient diagnostic performance related to the bone turnover, mineralization process and bone cell abnormality. At present however, the transiliac bone biopsy remains the golden standard in the diagnosis of renal osteodystrophy. PMID:15735537

  3. Imprint cytology on microcalcifications excised by Vacuum-Assisted Breast Biopsy: A rapid preliminary diagnosis

    PubMed Central

    Fotou, Maria; Oikonomou, Vassiliki; Zagouri, Flora; Sergentanis, Theodoros N; Nonni, Afroditi; Athanassiadou, Pauline; Drouveli, Theodora; atsouris, Efstratios; Kotzia, Evagelia; Zografos, George C

    2007-01-01

    Background To evaluate imprint cytology in the context of specimens with microcalcifications derived from Vacuum-Assisted Breast Biopsy (VABB). Patients and methods A total of 93 women with microcalcifications BI-RADS 3 and 4 underwent VABB and imprint samples were examined. VABB was performed on Fischer's table using 11-gauge Mammotome vacuum probes. A mammogram of the cores after the procedure confirmed the excision of microcalcifications. For the application of imprint cytology, the cores with microcalcifications confirmed by mammogram were gently rolled against glass microscope slides and thus imprint smears were made. For rapid preliminary diagnosis Diff-Quick stain, modified Papanicolaou stain and May Grunwald Giemsa were used. Afterwards, the core was dipped into a CytoRich Red Collection fluid for a few seconds in order to obtain samples with the use of the specimen wash. After the completion of cytological procedures, the core was prepared for routine histological study. The pathologist was blind to the preliminary cytological results. The cytological and pathological diagnoses were comparatively evaluated. Results According to the pathological examination, 73 lesions were benign, 15 lesions were carcinomas (12 ductal carcinomas in situ, 3 invasive ductal carcinomas), and 5 lesions were precursor: 3 cases of atypical ductal hyperplasia (ADH) and 2 cases of lobular neoplasia (LN). The observed sensitivity and specificity of the cytological imprints for cancer were 100% (one-sided, 97.5% CI: 78.2%–100%). Only one case of ADH could be detected by imprint cytology. Neither of the two LN cases was detected by the imprints. The imprints were uninformative in 11 out of 93 cases (11.8%). There was no uninformative case among women with malignancy. Conclusion Imprint cytology provides a rapid, accurate preliminary diagnosis in a few minutes. This method might contribute to the diagnosis of early breast cancer and possibly attenuates patients' anxiety. PMID

  4. Development and comparative assessment of Raman spectroscopic classification algorithms for lesion discrimination in stereotactic breast biopsies with microcalcifications

    PubMed Central

    Dingari, Narahara Chari; Barman, Ishan; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2014-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. Here, we develop and compare different approaches for developing Raman classification algorithms to diagnose invasive and in situ breast cancer, fibrocystic change and fibroadenoma that can be associated with microcalcifications. In this study, Raman spectra were acquired from tissue cores obtained from fresh breast biopsies and analyzed using a constituent-based breast model. Diagnostic algorithms based on the breast model fit coefficients were devised using logistic regression, C4.5 decision tree classification, k-nearest neighbor (k-NN) and support vector machine (SVM) analysis, and subjected to leave-one-out cross validation. The best performing algorithm was based on SVM analysis (with radial basis function), which yielded a positive predictive value of 100% and negative predictive value of 96% for cancer diagnosis. Importantly, these results demonstrate that Raman spectroscopy provides adequate diagnostic information for lesion discrimination even in the presence of microcalcifications, which to the best of our knowledge has not been previously reported. Raman spectroscopy and multivariate classification provide accurate discrimination among lesions in stereotactic breast biopsies, irrespective of microcalcification status. PMID:22815240

  5. Academic Rigor: The Core of the Core

    ERIC Educational Resources Information Center

    Brunner, Judy

    2013-01-01

    Some educators see the Common Core State Standards as reason for stress, most recognize the positive possibilities associated with them and are willing to make the professional commitment to implementing them so that academic rigor for all students will increase. But business leaders, parents, and the authors of the Common Core are not the only…

  6. Variation in the Attitudes of Medical Oncologists Toward Research Biopsies in Patients With Metastatic Breast Cancer

    PubMed Central

    Seah, Davinia S.; Scott, Sarah; Guo, Hao; Najita, Julie; Lederman, Ruth; Frank, Elizabeth; Sohl, Jessica; Stadler, Zsofia; Silverman, Stuart; Peppercorn, Jeffrey; Winer, Eric; Come, Steve

    2015-01-01

    Background. Tissue from research biopsies provides access to insights into tumor biology. We aimed to determine medical oncologists’ (MOs’) attitudes toward research biopsies in patients with metastatic breast cancer (MBC). Materials and Methods. A total of 309 breast MOs from National Cancer Institute (NCI)-designated cancer centers were invited to complete a self-administered survey about their attitudes toward approaching patients for research purpose-only biopsies (RPOBs), performed as a standalone procedure, or additional biopsies, performed with a clinically indicated biopsy. The MOs were asked to predict what proportion of their MBC patients would consider undergoing research biopsies. Results. Of the 309 MOs, 221 (72%) responded. Of these 221 MOs, 30 were ineligible, leaving 191 eligible responders. Nearly all the MOs reported they were comfortable approaching patients regarding research biopsies of blood or skin. One fifth of MOs were uncomfortable approaching patients for RPOBs of the breast. One half of MOs were uncomfortable approaching patients for RPOBs of the liver. A significant variation was found in the perceptions by MOs of their patients’ willingness to undergo research biopsies. The factors associated with increased comfort in approaching patients for research biopsies included fewer years in practice, caring for patients who had undergone recent research biopsies, and the predicted willingness of patients to consent to biopsies. The risk of a biopsy and biopsy-related pain were the most common reasons for reluctance to refer patients for research biopsies. Conclusion. Significant variation exists, even at NCI centers, in the comfort level of MOs in approaching MBC patients for research biopsies. MOs’ attitudes toward research biopsies might be a modifiable factor in increasing tissue collection for research. Implications for Practice: Tissue-based research is critical in advancing our understanding of cancer biology, and obtaining

  7. Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result

    PubMed Central

    Fiamegos, Alexandros; Varkarakis, John; Kontraros, Michael; Karagiannis, Andreas; Chrisofos, Michael; Barbalias, Dimitrios; Deliveliotis, Charalampos

    2016-01-01

    Abstract Introduction: Data from animal, clinical and prevention studies support the role of androgens in prostate cancer growth, proliferation and progression. Results of serum based epidemiologic studies in humans, however, have been inconclusive. The present study aims to define whether serum testosterone can be used as a predictor of a positive second biopsy in males considered for re-biopsy. Material and Methods: The study included 320 men who underwent a prostatic biopsy in our department from October 2011 until June 2012. Total testosterone, free testosterone, bioavailable testosterone and prostate pathology were evaluated in all cases. Patients undergoing a second biopsy were identified and biopsy results were statistically analyzed. Results: Forty men (12.5%) were assessed with a second biopsy. The diagnosis of the second biopsy was High Grade Intraepithelial Neoplasia in 14 patients (35%) and Prostate Cancer in 12 patients (30%). The comparison of prostatic volume, total testosterone, sex hormone binding globulin, free testosterone, bioavailable testosterone and albumin showed that patients with cancer of the prostate had significantly greater levels of free testosterone (p=0.043) and bioavailable T (p=0.049). Conclusion: In our study, higher free testosterone and bioavailable testosterone levels were associated with a cancer diagnosis at re-biopsy. Our results indicate a possible role for free and bioavailable testosterone in predicting the presence of prostate cancer in patients considered for re-biopsy. PMID:27532110

  8. Ankylosing spondylitis and central core disease: case report.

    PubMed

    Scola, Rosana Herminia; Lin, Kátia; Iwamoto, Fãbio Massaiti; Arruda, Walter Oleschko; Werneck, Lineu Cesar

    2003-09-01

    Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

  9. Polyneuropathy due to acute arsenic intoxication: biopsy studies.

    PubMed

    Goebel, H H; Schmidt, P F; Bohl, J; Tettenborn, B; Krämer, G; Gutmann, L

    1990-03-01

    A 41-year-old vintner attempting suicide ingested 8-9 g of arsenic and developed a symmetric polyneuropathy with acute Wallerian degeneration of myelinated fibers. Under treatment with modified British Anti-Lewisite (BAL; "Dimaval") his polyneuropathy slowly, but incompletely, subsided over three years at which time another sural nerve biopsy specimen showed regenerative proliferation of myelinated and unmyelinated axons but no signs of Wallerian degeneration. By laser microprobe mass analysis (LAMMA) arsenic was located in the first biopsied sural nerve specimen but not in the second specimen. These findings demonstrated: 1) arsenic induced serial morphometric and electron microscopic findings of nerve fiber degeneration and regeneration, 2) documentation of arsenic within myelinated nerve fibers, and 3) the usefulness of the LAMMA technique as a diagnostic procedure in this context.

  10. Atrial fibrillation and pneumothorax after transthoracic needle lung biopsy

    PubMed Central

    Liu, Alexander; Southern, Iain; Nicol, Edward

    2012-01-01

    An obese 65-year-old male smoker with chronic obstructive pulmonary disease developed an iatrogenic pneumothorax with pulmonary haemorrhage during an elective transthoracic needle biopsy of a pulmonary lesion. Successful re-inflation was achieved with a chest drain which was then removed before transfer to the medical ward. He later developed persistent atrial fibrillation with breathlessness and haemoptysis. He was treated empirically for a pulmonary embolus, which was subsequently ruled out with CT pulmonary angiogram. Serial chest radiographs demonstrated recurrence of his pneumothorax and a chest drain was re-inserted. His atrial fibrillation was erroneously managed as supraventricular tachycardia, which was resistant to vagal manoeuvres and adenosine but later responded to intravenous amiodarone before a further relapse. Upon successful management of the pneumothorax, his atrial fibrillation terminated. This case highlighted the persistent and serious nature of complications posttransthoracic needle biopsy. PMID:22665868

  11. Profile of Lesions in Cystoscopic Bladder Biopsies: A Histopathological Study

    PubMed Central

    Srikousthubha; Sukesh; C.V, Raghuveer; Hingle, Sanjay

    2013-01-01

    Aim and Introduction: Urinary bladder lesions, non-neoplastic and neoplastic, are collectively responsible for significant morbidity and mortality throughout the world. The present study aimed to study the histopathology of various lesions of the bladder through cystoscopic biopsies. Material and Methods: The present prospective study aimed to study the histopathology of various lesions of the urinary bladder through cystoscopic biopsies. All patients who visited Urology Outpatients Department for haematuria and dysuria were subjected to cystoscopy. Results: Histopathological examinations revealed an equal share of non neoplastic lesions and neoplastic lesions. Amongst the non neoplastic lesions, 84% were inflammatory lesions. Urothelial tumours (96%) formed the bulk amongst neoplastic lesions. Conclusion: This article has stressed upon the importance of histopathological examinations in evaluating bladder pathologies. PMID:24086853

  12. Early Stage Relapsing Polychondritis Diagnosed by Nasal Septum Biopsy

    PubMed Central

    Kobayashi, Takaaki; Moody, Sandra; Komori, Masafumi; Jibatake, Akira; Yaegashi, Makito

    2015-01-01

    Relapsing polychondritis is a rare inflammation of cartilaginous tissues, the diagnosis of which is usually delayed by a mean period of 2.9 years from symptom onset. We present the case of a 36-year-old man with nasal pain and fever. Physical examination of the nose was grossly unremarkable, but there was significant tenderness of the nasal bridge. Acute sinusitis was initially diagnosed due to thickened left frontal sinus mucosa on computed tomography (CT); however, there was no improvement after antibiotic intake. Repeat CT showed edematous inflammation of the nasal septum; biopsy of this site demonstrated erosion and infiltration of lymphocytes, plasma cells, eosinophils, and neutrophils in the hyaline cartilage. Relapsing polychondritis was confirmed by the modified McAdam's criteria and can be diagnosed at an early stage by nasal septum biopsy; it should be considered as a differential diagnosis in patients presenting with nasal symptoms alone or persistent sinus symptoms. PMID:26843866

  13. Tests on reliability of a prostate biopsy telerobotic system.

    PubMed

    Rovetta, A

    1999-01-01

    This paper deals with the development of a robotic (mechanical-electronic) system that operates in the field of surgery, with new sensors and equipment ("Biopsy Program"). The system permits a rapid analysis of the mechanical needle + needle-holder + mechanism system for penetration and aspiration for surgery, for prostate biopsies. These operations benefit from the use of a SR 8438 Sankyo Scara robot; they are also remote-controlled, i.e. via telerobotics. They require accurate positioning in known points of three-dimensional space with a high degree of precision. The safety of the surgical operations is guaranteed by the most complete observance of regulations under European Union Directives and Decrees 626 and 242 of Italian laws. The system proposed represents a big step for the application of industrial solutions, precisely for industrial companies in the medical and surgical field.

  14. Clinical applications of liquid biopsies in gastrointestinal oncology

    PubMed Central

    Zhu, Jason

    2016-01-01

    “Liquid biopsies” are blood based assays used to detect and analyze circulating tumor products, including circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating messenger RNA (mRNA), circulating microRNA (miRNA), circulating exosomes, and tumor educated platelets (TEP). For patients with gastrointestinal (GI) malignancies, blood based biopsies may offer several advantages. First, tumor tissue samples are often challenging to procure, and when obtainable, are often insufficient for genomic profiling. Second, blood based assays offer a real-time overview of the entire tumor burden, and allow anatomically unbiased genomic profiling. Third, given the convenience and relative safety of liquid biopsies, this technology may facilitate identification of genomic alterations that confer sensitivity and resistance to targeted therapeutics. This review will assess the clinical applications of circulating tumor products for patients with GI tumors. PMID:27747082

  15. Stereotactic biopsy of cerebral lesions in acquired immunodeficiency syndrome.

    PubMed

    Davies, M A; Pell, M F; Brew, B J

    1995-01-01

    The efficacy, mortality and morbidity of CT directed stereotactic biopsy of a cerebral lesion in 32 Human Immunodeficiency Virus (HIV) infected patients between July 1991 and June 1994 who had an atypical presentation for toxoplasmosis or who were failing or intolerant of empirical antitoxoplasmosis treatment was evaluated. An histological diagnosis was able to be made in 85%: progressive multifocal leucoencephalopathy (PML) in 13, primary cerebral lymphoma in 10, toxoplasmosis in 3 and HIV encephalitis in one. Non-specific reactive changes or gliosis were seen in 5 patients. There was no mortality, and morbidity occurred in 2 patients: one intraventricular haemorrhage and one transient third nerve palsy. Correct diagnosis made by image-directed stereotactic biopsy of central nervous system (CNS) disease in acquired immunodeficiency syndrome (AIDS) patients may improve outcome, particularly in those diseases where effective treatment strategies already exist and become increasingly available in the future.

  16. Microfluidic Exosome Analysis toward Liquid Biopsy for Cancer.

    PubMed

    He, Mei; Zeng, Yong

    2016-08-01

    Assessment of a tumor's molecular makeup using biofluid samples, known as liquid biopsy, is a prominent research topic in precision medicine for cancer, due to its noninvasive property allowing repeat sampling for monitoring molecular changes of tumors over time. Circulating exosomes recently have been recognized as promising tumor surrogates because they deliver enriched biomarkers, such as proteins, RNAs, and DNA. However, purification and characterization of these exosomes are technically challenging. Microfluidic lab-on-a-chip technology effectively addresses these challenges owing to its inherent advantages in integration and automation of multiple functional modules, enhancing sensing performance, and expediting analysis processes. In this article, we review the state-of-the-art development of microfluidic technologies for exosome isolation and molecular characterization with emphasis on their applications toward liquid biopsy-based analysis of cancer. Finally, we share our perspectives on current challenges and future directions of microfluidic exosome analysis. PMID:27215792

  17. Robotically assisted small animal MRI-guided mouse biopsy

    NASA Astrophysics Data System (ADS)

    Wilson, Emmanuel; Chiodo, Chris; Wong, Kenneth H.; Fricke, Stanley; Jung, Mira; Cleary, Kevin

    2010-02-01

    Small mammals, namely mice and rats, play an important role in biomedical research. Imaging, in conjunction with accurate therapeutic agent delivery, has tremendous value in small animal research since it enables serial, non-destructive testing of animals and facilitates the study of biomarkers of disease progression. The small size of organs in mice lends some difficulty to accurate biopsies and therapeutic agent delivery. Image guidance with the use of robotic devices should enable more accurate and repeatable targeting for biopsies and delivery of therapeutic agents, as well as the ability to acquire tissue from a pre-specified location based on image anatomy. This paper presents our work in integrating a robotic needle guide device, specialized stereotaxic mouse holder, and magnetic resonance imaging, with a long-term goal of performing accurate and repeatable targeting in anesthetized mice studies.

  18. Fine needle aspiration biopsy diagnosis of mucoepidermoid carcinoma. Statistical analysis.

    PubMed

    Cohen, M B; Fisher, P E; Holly, E A; Ljung, B M; Löwhagen, T; Bottles, K

    1990-01-01

    Fine needle aspiration (FNA) biopsy is an increasingly popular method for the evaluation of salivary gland tumors. Of the common salivary gland tumors, mucoepidermoid carcinoma is probably the most difficult to diagnose accurately by this means. A series of 96 FNA biopsy specimens of salivary gland masses, including 34 mucoepidermoid carcinomas, 51 other benign and malignant neoplasms, 7 nonneoplastic lesions and 4 normal salivary glands, were analyzed in order to identify the most useful criteria for diagnosing mucoepidermoid carcinoma. Thirteen cytologic criteria were evaluated in the FNA specimens, and a stepwise logistic regression analysis was performed. The three cytologic features selected as most predictive of mucoepidermoid carcinoma were intermediate cells, squamous cells and overlapping epithelial groups. Using these three features together, the sensitivity and specificity of accurately diagnosing mucoepidermoid carcinoma were 97% and 100%, respectively.

  19. Fine needle aspiration biopsy cytology of major salivary glands.

    PubMed

    Qizilbash, A H; Sianos, J; Young, J E; Archibald, S D

    1985-01-01

    Fine needle aspiration biopsy of the major salivary glands was performed on 160 patients. In 146 patients with satisfactory samples, the cytologic diagnosis was correlated with clinical follow-up and histologic findings. There were 122 benign lesions, including 47 tumors. There were 24 malignant lesions, 10 of which were primary and 14 metastatic. The overall accuracy was 98%. The sensitivity of the technique was 87.5%. There was no false-positive diagnosis. There were three false-negative diagnoses due to sampling errors and inexperience during the initial period of the study. This study documents that needle aspiration biopsy cytology of the salivary glands is accurate, simple, rapid, inexpensive, well tolerated and harmless to the patient.

  20. Major Bleeding after Percutaneous Image-Guided Biopsies: Frequency, Predictors, and Periprocedural Management

    PubMed Central

    Kennedy, Sean A.; Milovanovic, Lazar; Midia, Mehran

    2015-01-01

    Major bleeding remains an uncommon yet potentially devastating complication following percutaneous image-guided biopsy. This article reviews two cases of major bleeding after percutaneous biopsy and discusses the frequency, predictors, and periprocedural management of major postprocedural bleeding. PMID:25762845

  1. Needle biopsy of the liver. A critique of four currently available methods.

    PubMed Central

    Babb, R R; Jackman, R J

    1989-01-01

    There are currently four needle biopsy methods for obtaining tissue from patients with possible diffuse liver disease or cancer. These include percutaneous blind needle biopsy, a visually guided needle biopsy at laparoscopy, guided fine-needle biopsies with ultrasonography or computed tomography, and the transvenous liver biopsy. We and others have found the guided fine-needle biopsy technique to be safe, relatively cheap, and highly accurate in the diagnosis of liver cancer. Blind percutaneous biopsy should be reserved for patients with possible diffuse, noncancerous, liver disease. Guided biopsies at laparoscopy can be done if the other two methods fail to give a tissue diagnosis. The transvenous approach is useful in patients with a coagulation disorder. PMID:2660406

  2. Non-stereotactic method involving combination of ultrasound-guided wire localization and vacuum-assisted breast biopsy for microcalcification

    PubMed Central

    Lee, Jeeyeon; Park, Ho Yong; Jung, Jin Hyang; Kim, Wan Wook; Hwang, Seung Ook; Kwon, Taek Ju; Chung, Jin Ho

    2016-01-01

    Background Stereotactic breast biopsy is a standard intervention for evaluation of “microcalcification-only” lesions. However, an expensive stereotactic device and radiologic expertise are necessary for this procedure. We herein report a non-stereotactic technique involving the combination of wire localization and vacuum-assisted breast biopsy (VABB) under ultrasound (US) guidance. Methods Twenty-two consecutive patients with category 3 or 4a microcalcification only as shown by mammography underwent the above-mentioned non-stereotactic combination method involving US-guided wire localization and VABB. The location of the microcalcification was measured by manual stereotaxis, and the microcalcification was confirmed by specimen mammography after the procedure. Results The mean number ± standard deviation of removed cores and calcified cores was 28.4±13.4 and 2.2±0.9, respectively. In one case, the procedure was repeated 3 times. The histologic diagnoses were fibrocystic change (n=14), fibroadenoma (n=4), sclerosing adenosis (n=1), usual ductal hyperplasia (n=2), and atypical ductal hyperplasia (n=1). Conclusions “Microcalcification-only” breast lesions can be easily evaluated with the combination of non-stereotactic US-guided wire localization and VABB. This would be an effective diagnostic technique for breast lesion which reveals only microcalcification. PMID:27294037

  3. Application of statistical cancer atlas for 3D biopsy

    NASA Astrophysics Data System (ADS)

    Narayanan, Ramkrishnan; Shen, Dinggang; Davatzikos, Christos; Crawford, E. David; Barqawi, Albaha; Werahera, Priya; Kumar, Dinesh; Suri, Jasjit S.

    2008-02-01

    Prostate cancer is the most commonly diagnosed cancer in males in the United States and the second leading cause of cancer death. While the exact cause is still under investigation, researchers agree on certain risk factors like age, family history, dietary habits, lifestyle and race. It is also widely accepted that cancer distribution within the prostate is inhomogeneous, i.e. certain regions have a higher likelihood of developing cancer. In this regard extensive work has been done to study the distribution of cancer in order to perform biopsy more effectively. Recently a statistical cancer atlas of the prostate was demonstrated along with an optimal biopsy scheme achieving a high detection rate. In this paper we discuss the complete construction and application of such an atlas that can be used in a clinical setting to effectively target high cancer zones during biopsy. The method consists of integrating intensity statistics in the form of cancer probabilities at every voxel in the image with shape statistics of the prostate in order to quickly warp the atlas onto a subject ultrasound image. While the atlas surface can be registered to a pre-segmented subject prostate surface or instead used to perform segmentation of the capsule via optimization of shape parameters to segment the subject image, the strength of our approach lies in the fast mapping of cancer statistics onto the subject using shape statistics. The shape model was trained from over 38 expert segmented prostate surfaces and the atlas registration accuracy was found to be high suggesting the use of this method to perform biopsy in near real time situations with some optimization.

  4. Solitary fibrous tumour of the prostate identified on needle biopsy.

    PubMed

    Galosi, Andrea B; Mazzucchelli, Roberta; Scarpelli, Marina; Lopez-Beltran, Antonio; Cheng, Liang; Muzzonigro, Giovanni; Montironi, Rodolfo

    2009-09-01

    The clinical and radical prostatectomy features of a case of solitary fibrous tumour (SFT) of the prostate identified on needle biopsy are presented. The main differential diagnoses are discussed. SFTs involving the prostate are relatively uncommon, with only isolated cases reported in the literature. Owing to their relative rarity and lack of long-term follow-up, the clinical behaviour of prostatic SFTs is difficult to predict. Complete resection of the tumour is currently the single main prognostic factor.

  5. Markers of Field Cancerization: Proposed Clinical Applications in Prostate Biopsies

    PubMed Central

    Trujillo, Kristina A.; Jones, Anna C.; Griffith, Jeffrey K.; Bisoffi, Marco

    2012-01-01

    Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. This paper tabulates markers of prostate field cancerization known to date and discusses their potential clinical value in the analysis of prostate biopsies, including diagnosis, monitoring progression during active surveillance, and assessing efficacy of presurgical neoadjuvant and focal therapeutic interventions. PMID:22666601

  6. Fabry's disease: An ultrastructural study of nerve biopsy

    PubMed Central

    Gayathri, N.; Yasha, T. C.; Kanjalkar, Makarand; Agarwal, Santosh; Sagar, B. K. Chandrashekar; Santosh, Vani; Shankar, S. K.

    2008-01-01

    Fabry's disease, an X linked recessive disorder caused by the deficiency of α-galactosidase A (α-gal A), leads to progressive accumulation of glycosphingolipids. We report this rare disease in a 19-year-old boy who presented with angiokeratomas, paresthesia and corneal opacities, and nerve biopsy revealed by electron microscopy lamellated inclusions in the smooth muscle, perineurial and endothelial cells characteristic of Fabry's disease. PMID:19893666

  7. [Standards for the punch biopsy of the prostate].

    PubMed

    Seitz, M; Schlenker, B; Gratzke, C; Weidlich, P; Stief, C G; Reich, O

    2007-01-25

    If, within the framework of screening examinations for the early detection of cancer of the prostate, the patient wishes a PSA test, the physician should accommodate him, but only after providing comprehensive information about the possible consequences and complications. If a certain threshold value is exceeded, a punch biopsy of the prostate is recommended. This procedure must be performed in accordance with accepted standards to enable, within the diagnostic chain, the reliable detection of a carcinoma of the prostate PMID:17615715

  8. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    PubMed Central

    Kayacetin, Ertugrul; Kayacetin, Serra

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base. PMID:15188520

  9. An Observation from Liver Biopsies Two Decades Post-Fontan.

    PubMed

    Evans, William N; Acherman, Ruben J; Reardon, Leigh C; Galindo, Alvaro; Rothman, Abraham; Ciccolo, Michael L; Carrillo, Sergio A; Winn, Brody J; Yumiaco, Noel S; Restrepo, Humberto

    2016-08-01

    This brief report describes an observation from liver biopsy results in nonfailing Fontan patients, currently in their second postoperative decade. In three patients, with either atriopulmonary or atrioventricular connections and functional left ventricles, we found no portal fibrosis. In contrast, we found portal fibrosis in three clinically similar, nonfailing Fontan patients with lateral tunnel connections and functional left ventricles. We recognize the results may be secondary to chance; nevertheless, we speculate about possible relevancy.

  10. Detection of preneoplasia in histologically normal prostate biopsies.

    PubMed

    Slater, M D; Delprado, W J; Murphy, C R; Barden, J A

    2001-01-01

    P2X immunolabeling of prostate detected preneoplastic changes in apparently normal tissue. Labeling occurred in two well-defined stages before the diagnostic histological markers of cancer were visible. As cancer progressed, the location of P2X expression changed from confinement within individual nuclei in the acini (stage 1) to a cytoplasmic punctate label in the acinal epithelium, with an associated removal of nuclear stain (stage 2). Finally, in advanced cases, where clear morphological evidence of cancer was apparent, the P2X label condensed exclusively on the apical epithelium (stage 3). BPH/normal tissue was entirely devoid of P2X label. Biopsy samples (77) were tested in three categories. One group (35) were diagnosed as normal benign prostatic hyperplasia (BPH) on the basis of haematoxylin and eosin (H&E) stain, although underlying disease was suspected. Of these, 14 (40%) were clearly normal and appeared entirely devoid of label, 13 (37%) exhibited the first stage of P2X receptor labeling and the remaining eight (23%) exhibited second stage labeling. The accompanying H&E-stained sections of all these cases had a normal appearance. Low grade cancer biopsy samples with Gleason scores G4-7 (25) all revealed widespread second stage receptor labeling in areas of both normal and cancerous morphology, while 17 high grade cancer biopsy samples (Gleason G8-10) all showed third stage labeling along with some residual second stage labeling. The features of each P2X labeling stage occupied the entire histological area affected, offering more opportunity to diagnose the tissue than was supplied by the more-localised diagnostic features identified by H&E-stain. Besides detecting cases of preneoplasia in biopsies with a normal H&E appearance, this technique was also able to rule out the presence of neoplasia in purely hyperplasic prostates by the absence of any P2X labeling.Prostate Cancer and Prostatic Diseases (2001) 4, 92-96 PMID:12497044

  11. Cardiac toxoplasmosis after heart transplantation diagnosed by endomyocardial biopsy.

    PubMed

    Petty, L A; Qamar, S; Ananthanarayanan, V; Husain, A N; Murks, C; Potter, L; Kim, G; Pursell, K; Fedson, S

    2015-10-01

    We describe a case of cardiac toxoplasmosis diagnosed by routine endomyocardial biopsy in a patient with trimethoprim-sulfamethoxazole (TMP-SMX) intolerance on atovaquone prophylaxis. Data are not available on the efficacy of atovaquone as Toxoplasma gondii prophylaxis after heart transplantation. In heart transplant patients in whom TMP-SMX is not an option, other strategies may be considered, including the addition of pyrimethamine to atovaquone.

  12. Transarterial embolization for serious renal hemorrhage following renal biopsy.

    PubMed

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei

    2013-01-01

    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  13. Pancreatic cancer: Are "liquid biopsies" ready for prime-time?

    PubMed

    Lewis, Alexandra R; Valle, Juan W; McNamara, Mairead G

    2016-08-28

    Pancreatic cancer is a disease that carries a poor prognosis. Accurate tissue diagnosis is required. Tumours contain a high content of stromal tissue and therefore biopsies may be inconclusive. Circulating tumour cells (CTCs) have been investigated as a potential "liquid biopsy" in several malignancies and have proven to be of prognostic value in breast, prostate and colorectal cancers. They have been detected in patients with localised and metastatic pancreatic cancer with sensitivities ranging from 38%-100% using a variety of platforms. Circulating tumour DNA (ctDNA) has also been detected in pancreas cancer with a sensitivity ranging from 26%-100% in studies across different platforms and using different genetic markers. However, there is no clear consensus on which platform is the most effective for detection, nor which genetic markers are the most useful to use. Potential roles of liquid biopsies include diagnosis, screening, guiding therapies and prognosis. The presence of CTCs or ctDNA has been shown to be of prognostic value both at diagnosis and after treatment in patients with pancreatic cancer. However, more prospective studies are required before this promising technology is ready for adoption into routine clinical practice. PMID:27621566

  14. Liquid biopsies in lung cancer: the new ambrosia of researchers.

    PubMed

    Rolfo, Christian; Castiglia, Marta; Hong, David; Alessandro, Riccardo; Mertens, Inge; Baggerman, Geert; Zwaenepoel, Karen; Gil-Bazo, Ignacio; Passiglia, Francesco; Carreca, Anna P; Taverna, Simona; Vento, Renza; Santini, Daniele; Peeters, Marc; Russo, Antonio; Pauwels, Patrick

    2014-12-01

    In the last decades the approach to cancer patient management has been deeply revolutionized. We are moving from a "one-fits-all" strategy to the "personalized medicine" based on the molecular characterization of the tumor. In this new era it is becoming more and more clear that the monitoring of the disease is fundamental for the success of the treatment, thus there is the need of new biomarker discovery. More precisely in the last years the scientific community has started to use the term "liquid biopsy". A liquid biopsy is a liquid biomarker that can be easily isolated from many body fluids (blood, saliva, urine, ascites, pleural effusion, etc.) and, as well as a tissue biopsy, a representative of the tissue from which it is spread. In this review we will focus our attention on circulating tumor cells, circulating tumor DNA, exosomes and secretomes with the aim to underlie their usefulness and potential application in a clinical setting for lung cancer patient management. PMID:25444714

  15. Pancreatic cancer: Are "liquid biopsies" ready for prime-time?

    PubMed

    Lewis, Alexandra R; Valle, Juan W; McNamara, Mairead G

    2016-08-28

    Pancreatic cancer is a disease that carries a poor prognosis. Accurate tissue diagnosis is required. Tumours contain a high content of stromal tissue and therefore biopsies may be inconclusive. Circulating tumour cells (CTCs) have been investigated as a potential "liquid biopsy" in several malignancies and have proven to be of prognostic value in breast, prostate and colorectal cancers. They have been detected in patients with localised and metastatic pancreatic cancer with sensitivities ranging from 38%-100% using a variety of platforms. Circulating tumour DNA (ctDNA) has also been detected in pancreas cancer with a sensitivity ranging from 26%-100% in studies across different platforms and using different genetic markers. However, there is no clear consensus on which platform is the most effective for detection, nor which genetic markers are the most useful to use. Potential roles of liquid biopsies include diagnosis, screening, guiding therapies and prognosis. The presence of CTCs or ctDNA has been shown to be of prognostic value both at diagnosis and after treatment in patients with pancreatic cancer. However, more prospective studies are required before this promising technology is ready for adoption into routine clinical practice.

  16. Neoadjuvant Therapy in Rectal Cancer - Biobanking of Preoperative Tumor Biopsies

    PubMed Central

    Jo, Peter; Nietert, Manuel; Gusky, Linda; Kitz, Julia; Conradi, Lena C.; Müller-Dornieden, Annegret; Schüler, Philipp; Wolff, Hendrik A.; Rüschoff, Josef; Ströbel, Philipp; Grade, Marian; Liersch, Torsten; Beißbarth, Tim; Ghadimi, Michael B.; Sax, Ulrich; Gaedcke, Jochen

    2016-01-01

    Translational research relies on high-quality biospecimens. In patients with rectal cancer treated preoperatively with radiochemotherapy tissue based analyses are challenging. To assess quality challenges we analyzed tissue samples taken over the last years in a multicenter setting. We retrospectively evaluated overall 197 patients of the CAO/ARO/AIO-94- and 04-trial with locally advanced rectal cancer that were biopsied preoperatively at the University Medical Center Goettingen as well as in 10 cooperating hospitals in Germany. The cellular content of tumor, mucosa, stroma, necrosis and the amount of isolated DNA and RNA as well as the RNA integrity number (RIN) as quality parameters were evaluated. A high RNA yield (p = 2.75e–07) and the content of tumor (p = 0.004) is significantly associated to high RIN-values, whereas a high content of mucosa (p = 0.07) shows a trend and a high amount of necrosis (p = 0.01) is significantly associated with RNA of poor quality. Correlating biopsies from Goettingen and the cooperating centers showed comparable tumor content results. By taking small sized biopsies we could assess a clear correlation between a good RNA quality and a high amount of RNA and tumor cells. These results also indicate that specimens collected at different centers are of comparable quality. PMID:27752113

  17. [Lung biopsy by thoracotomy. 23 cases (author's transl)].

    PubMed

    Legrand, M; Andreassian, B; Chemouilli, E

    1978-12-30

    This series of surgical lung biopsies performed for diffuse lung disease indicates the excellent tolerance of the procedure and the high diagnostic rate. It is indicated above all in the presence of bilateral reticulo-nodular radiological appearances, suggestive of focal lesions not identified by the usual means. The surgical procedure was felt to be justified on the one hand because of the time gained in reaching a precise diagnosis whilst the results of usual laboratory investigations, even the most sophisticated, remain uncertain, and secondly in view of the discovery by the method of malignant lesions which are still curable and which it would have been impossible to identify otherwise, except by awaiting the development of more accessible lesions. Whilst percutaneous needle biopsy found favour amongst many, it would now seem to have been virtually abandoned, particular in France, in view of its risks and it's poor diagnostic rate. By contrast, open surgical biopsy provides in all cases not only lung but also pleural and mediastinal tissue. Its risks are confined to those of any surgical procedure under general anaesthesia, but appear to be sufficiently slight (mortality of 0,5 to 2%) that the technique may be used successfully in intensive care units to obtain a diagnosis in cases of certain types of respiratory distress. PMID:311466

  18. Immunohistochemical Characterization of Facioscapulohumeral Muscular Dystrophy Muscle Biopsies

    PubMed Central

    Statland, Jeffrey M; Odrzywolski, Karen J; Shah, Bharati; Henderson, Don; Fricke, Alex F.; van der Maarel, Silvère M; Tapscott, Stephen J; Tawil, Rabi

    2015-01-01

    Background Posited pathological mechanisms in Facioscapulohumeral Muscular Dystrophy (FSHD) include activation in somatic tissue of normally silenced genes, increased susceptibility to oxidative stress, and induction of apoptosis. Objective To determine the histopathological changes in FSHD muscle biopsies and compare to possible pathological mechanisms of disease. Methods We performed a cross-sectional study on quadriceps muscle biopsies from 32 genetically confirmed FSHD participants, compared to healthy volunteers and myotonic dystrophy type 1 as disease controls. Biopsies were divided into groups to evaluate apoptosis rates, capillary density, myonuclear and satellite cell counts. Results Apoptosis rates were increased in FSHD (n=10, 0.74%) compared to myotonic dystrophy type 1 (n=10, 0.14%, P=0.003) and healthy volunteers (n=14, 0.13%, P=0.002). Apoptosis was higher in FSHD patients with the smallest residual D4Z4 fragments. Capillary density was decreased in FSHD1 (n=10, 316 capillaries/mm2) compared to healthy volunteers (n=15, 448 capillaries/mm2, P=0.001). No differences were seen in myonuclear or satellite cell counts. Conclusions Preliminary evidence for increased apoptosis rates and reduced capillary density may reflect histopathological correlates of disease activity in FSHD. The molecular-pathological correlates to these changes warrants further investigation. PMID:26345300

  19. Optical biopsy mapping for minimally invasive cancer screening.

    PubMed

    Mountney, Peter; Giannarou, Stamatia; Elson, Daniel; Yang, Guang-Zhong

    2009-01-01

    The quest for providing tissue characterization and functional mapping during minimally invasive surgery (MIS) has motivated the development of new surgical tools that extend the current functional capabilities of MIS. Miniaturized optical probes can be inserted into the instrument channel of standard endoscopes to reveal tissue cellular and subcellular microstructures, allowing excision-free optical biopsy. One of the limitations of such a point based imaging and tissue characterization technique is the difficulty of tracking probed sites in vivo. This prohibits large area surveillance and integrated functional mapping. The purpose of this paper is to present an image-based tracking framework by combining a semi model-based instrument tracking method with vision-based simultaneous localization and mapping. This allows the mapping of all spatio-temporally tracked biopsy sites, which can then be re-projected back onto the endoscopic video to provide a live augmented view in vivo, thus facilitating re-targeting and serial examination of potential lesions. The proposed method has been validated on phantom data with known ground truth and the accuracy derived demonstrates the strength and clinical value of the technique. The method facilitates a move from the current point based optical biopsy towards large area multi-scale image integration in a routine clinical environment. PMID:20426023

  20. Sentinel node biopsy for ipsilateral breast cancer recurrence: a review.

    PubMed

    Palit, G; Jacquemyn, Y; Tjalma, W

    2008-01-01

    The aim of this study was to review published reports on the feasability, results, and reliability of sentinel node biopsy in cases of ipsilateral recurrent breast cancer. A Medline search on publications from January 1999 to December 2007 and cross-references in published articles were looked for. We identified 16 reports on sentinel node biopsy in recurrent breast cancer, including a total of 287 patients. In 210/287 (73.2%) a sentinel node was identified, 77/210 (37.7%) had had previous axillary lymph node dissection and 131 (62.3%) a previous sentinel node procedure. Aberrant lymphatic drainage, other than the ipsilateral axilla was noted in 68/210 (32.4%). Of these 16/68 (23.6%) were located in the contralateral axilla. Of the removed contralateral axillary sentinel nodes 8/17 (47.1%) were invaded by cancer. We conclude that sentinel node biopsy in cases of recurrent ipsilateral breast cancer is feasible. In about one out of three cases drainage to the contralateral axilla with invasion in almost half the cases takes place. The therapeutical consequences of these findings need further study. PMID:19115679

  1. Application of a New Guiding System in Percutaneous Biopsies

    SciTech Connect

    Petsas, Theodore Tsota, Irene; Kalogeropoulou, Christina P.; Liatsikos, Evangelos N.

    2007-04-15

    We herein describe the application of a new guiding system designed for percutaneous biopsies. The guiding system set is composed of a 0.41 mm (27G) stainless steel guide stylet and a 22G Chiba needle. Following the initial insertion of the Chiba needle, the stylet is advanced via the needle toward the lesion. The stylet serves either as a guide for the Chiba needle or as an exchange wire for the introduction of larger or cutting biopsy needles. The stylet can also be curved prior to its insertion to facilitate access to lesions which require needle redirection. The technique was applied to 117 cases (54 thoracic, 31 abdominal, 21 pelvic, and 11 vertebral lesions.) The main advantage of the stylet is its small diameter, rendering it atraumatic and permitting multiple punctures for the successful final targeting of the lesion. With this guiding set we achieved targeting of difficult lesions. Furthermore, larger needles were more easily introduced in locations that posed technical difficulties. No major complications were observed. The complication rate was comparable to that of the conventional biopsy technique. The technique using the guide stylet was easily performed and could be applied to almost all organs.

  2. Isobaric (gasless) laparoscopic liver and kidney biopsy in standing steers

    PubMed Central

    Chiesa, O. Alberto; von Bredow, Jurgen; Li, Hui; Smith, Michelle

    2009-01-01

    The purpose of the current study was to investigate the suitability of an isobaric laparoscopic procedure, using a single port, for obtaining serial kidney and liver biopsy samples from standing steers. The samples were used in support of a pharmacokinetic tissue–fluid correlation study. Laparoscopic access was performed 3 times in each of 8 healthy Holstein steers, alternating from the right side to the left side and then to the right side again. The surgery was performed in standing stocks after the animals were given 3 doses of sulfadimethoxine sulfate intravenously and fasted for at least 18 h. Sedation and analgesia were achieved with acepromazine and xylazine. Lidocaine 2% was injected at the center of the paralumbar fossa (left or right), and an incision was made for introduction of a trocar–cannula assembly. Room air was allowed to enter the abdomen through the cannula at the time of insertion. Once the peritoneal cavity was reached, an operating endoscope was inserted. No pressurized insufflation was performed. A biopsy forceps was introduced into the operating channel of the endoscope to obtain a 100-mg kidney or liver sample. No complications were encountered. The 24 laparoscopic procedures provided 24 kidney and 16 liver samples. The results suggest that the isobaric (gasless) single-port laparoscopic technique is feasible for kidney and liver biopsy on standing steers. The procedure can be performed in a reliable and efficient manner in the sedated standing bovine. PMID:19337395

  3. Transjugular renal biopsy in a case of nephrotic syndrome with extrahepatic portal venous obstruction.

    PubMed

    Siddiqi, N; Someshwar, V; Roy, D; Anandh, U

    2013-03-01

    Renal biopsy in patients with nephrotic syndrome helps to establish the pathological diagnosis and subsequent treatment. In certain circumstances, biopsies are difficult to obtain because of the risk of bleeding. We report a case where renal biopsy was obtained through the transjugular route in a patient who had nephrotic syndrome with extrahepatic portal venous obstruction.

  4. Contribution of Transjugular Liver Biopsy in Patients with the Clinical Presentation of Acute Liver Failure

    SciTech Connect

    Miraglia, Roberto Luca, Angelo; Gruttadauria, Salvatore; Minervini, Marta Ida; Vizzini, Giovanni; Arcadipane, Antonio; Gridelli, Bruno

    2006-12-15

    Purpose. Acute liver failure (ALF) treated with conservative therapy has a poor prognosis, although individual survival varies greatly. In these patients, the eligibility for liver transplantation must be quickly decided. The aim of this study was to assess the role of transjugular liver biopsy (TJLB) in the management of patients with the clinical presentation of ALF. Methods. Seventeen patients with the clinical presentation of ALF were referred to our institution during a 52 month period. A TJLB was performed using the Cook Quick-Core needle biopsy. Clinical data, procedural complications, and histologic findings were evaluated. Results. Causes of ALF were virus hepatitis B infection in 7 patients, drug toxicity in 4, mushroom in 1, Wilson's disease in 1, and unknown origin in 4. TJLB was technically successful in all patients without procedure-related complications. Tissue specimens were satisfactory for diagnosis in all cases. In 14 of 17 patients the initial clinical diagnosis was confirmed by TJLB; in 3 patients the initial diagnosis was altered by the presence of unknown cirrhosis. Seven patients with necrosis <60% were successfully treated with medical therapy; 6 patients with submassive or massive necrosis ({>=}85%) were treated with liver transplantation. Four patients died, 3 had cirrhosis, and 1 had submassive necrosis. There was a strict statistical correlation (r = 0.972, p < 0.0001) between the amount of necrosis at the frozen section examination and the necrosis found at routine histologic examination. The average time for TJLB and frozen section examination was 80 min. Conclusion. In patients with the clinical presentation of ALF, submassive or massive liver necrosis and cirrhosis are predictors of poor prognosis. TLJB using an automated device and frozen section examination can be a quick and effective tool in clinical decision-making, especially in deciding patient selection and the best timing for liver transplantation.

  5. Core Design Applications

    1995-07-12

    CORD-2 is intended for core desigh applications of pressurized water reactors. The main objective was to assemble a core design system which could be used for simple calculations (such as frequently required for fuel management) as well as for accurate calculations (for example, core design after refueling).

  6. Electromyography (EMG) accuracy compared to muscle biopsy in childhood.

    PubMed

    Rabie, Malcolm; Jossiphov, Joseph; Nevo, Yoram

    2007-07-01

    Reports show wide variability of electromyography (EMG) in detecting pediatric neuromuscular disorders. The study's aim was to determine EMG/nerve conduction study accuracy compared to muscle biopsy and final clinical diagnosis, and sensitivity for myopathic motor unit potential detection in childhood. Of 550 EMG/nerve conduction studies performed by the same examiner from a pediatric neuromuscular service, 27 children (ages 6 days to 16 years [10 boys; M:F, 1:1.7]) with muscle biopsies and final clinical diagnoses were compared retrospectively. Final clinical diagnoses were congenital myopathies (5 of 27,18%), nonspecific myopathies (biopsy myopathic, final diagnosis uncertain; 6 of 27, 22%), congenital myasthenic syndrome (3 of 27, 11%), juvenile myasthenia gravis (1 of 27, 4%), arthrogryposis multiplex congenita (2 of 27, 7%), hereditary motor and sensory neuropathy (1 of 27, 4%), bilateral peroneal neuropathies (1 of 27, 4%), and normal (8 of 27, 30%). There were no muscular dystrophy or spinal muscular atrophy patients. EMG/nerve conduction studies had a 74% agreement with final clinical diagnoses and 100% agreement in neurogenic, neuromuscular junction, and normal categories. Muscle biopsies concurred with final diagnoses in 87%, and 100% in myopathic and normal categories. In congenital myasthenic syndrome, muscle biopsies showed mild variation in fiber size in 2 of 3 children and were normal in 1 of 3. EMG sensitivity for detecting myopathic motor unit potentials in myopathies was 4 of 11 (36%), greater over 2 years of age (3 of 4, 75%), compared to infants less than 2 years (1 of 7, 14%), not statistically significant (P = .0879). EMGs false-negative for myopathy in infants < 2 years of age were frequently neurogenic (3 of 6, 50%). In congenital myopathies EMG detected myopathic motor unit potentials in 40%, with false-negative results neurogenic (20%) or normal (40%). Because our study has no additional tests for active myopathies, for example Duchenne

  7. Electromagnetic-Tracked Biopsy under Ultrasound Guidance: Preliminary Results

    SciTech Connect

    Hakime, Antoine Deschamps, Frederic; Marques De Carvalho, Enio Garcia; Barah, Ali; Auperin, Anne; Baere, Thierry De

    2012-08-15

    Purpose: This study was designed to evaluate the accuracy and safety of electromagnetic needle tracking for sonographically guided percutaneous liver biopsies. Methods: We performed 23 consecutive ultrasound-guided liver biopsies for liver nodules with an electromagnetic tracking of the needle. A sensor placed at the tip of a sterile stylet (18G) inserted in a coaxial guiding trocar (16G) used for biopsy was localized in real time relative to the ultrasound imaging plane, thanks to an electromagnetic transmitter and two sensors on the ultrasound probe. This allows for electronic display of the needle tip location and the future needle path overlaid on the real-time ultrasound image. Distance between needle tip position and its electronic display, number of needle punctures, number of needle pull backs for redirection, technical success (needle positioned in the target), diagnostic success (correct histopathology result), procedure time, and complication were evaluated according to lesion sizes, depth and location, operator experience, and 'in-plane' or 'out-of-plane' needle approach. Results: Electronic display was always within 2 mm from the real position of the needle tip. The technical success rate was 100%. A single needle puncture without repuncture was used in all patients. Pull backs were necessary in six patients (26%) to obtain correct needle placement. The overall diagnostic success rate was 91%. The overall true-positive, true-negative, false-negative, and failure rates of the biopsy were 100% (19/19) 100% (2/2), 0% (0/23), and 9% (2/23). The median total procedure time from the skin puncture to the needle in the target was 30 sec (from 5-60 s). Lesion depth and localizations, operator experience, in-plane or out-of-plane approach did not affect significantly the technical, diagnostic success, or procedure time. Even when the tumor size decreased, the procedure time did not increase. Conclusions: Electromagnetic-tracked biopsy is accurate to determine

  8. Realtime TRUS/MRI Fusion Targeted-Biopsy for Prostate Cancer: A Clinical Demonstration of Increased Positive Biopsy Rates

    NASA Astrophysics Data System (ADS)

    Kadoury, Samuel; Yan, Pingkun; Xu, Sheng; Glossop, Neil; Choyke, Peter; Turkbey, Baris; Pinto, Peter; Wood, Bradford J.; Kruecker, Jochen

    In this paper, a system for fusion of realtime transrectal ultrasound (TRUS) with pre-acquired 3D images of the prostate is presented with a clinical demonstration on a cohort of 101 patients with suspicion of prostate cancer. Electromagnetically tracked biopsy guides for endocavity ultrasound transducers were calibrated and used to fuse MRI-based suspicious lesion locations with ultrasound image coordinates. The prostate shape is segmented from MRI in a semi-automated fashion via a model-based approach, and intraoperative image registration is performed between MR and ultrasound image space to superimpose target fiducials markers on the ultrasound image. In order to align both modalities, a surface model is automatically extracted from 2D swept TRUS images using a partial active shape model, utilizing image features and prior statistics. An automatic prostate motion compensation algorithm can be triggered as needed. The results were used to display live TRUS images fused with spatially corresponding realtime multiplanar reconstructions (MPRs) of the MR image volume. In this study, all patients were scanned with 3T MRI and TRUS for biopsy. Clinical results show significant improvement of target visualization and of positive detection rates during TRUS-guided biopsies. It also demonstrates the feasibility of realtime MR/TRUS image fusion for out-of-gantry procedures.

  9. Banded transformer cores

    NASA Technical Reports Server (NTRS)

    Mclyman, C. W. T. (Inventor)

    1974-01-01

    A banded transformer core formed by positioning a pair of mated, similar core halves on a supporting pedestal. The core halves are encircled with a strap, selectively applying tension whereby a compressive force is applied to the core edge for reducing the innate air gap. A dc magnetic field is employed in supporting the core halves during initial phases of the banding operation, while an ac magnetic field subsequently is employed for detecting dimension changes occurring in the air gaps as tension is applied to the strap.

  10. Comparison of flexible fiberoptic bronchoscopy and scalene lymph node biopsy in the diagnosis of sarcoidosis.

    PubMed

    Stjernberg, N; Thunell, M; Lundgren, R

    1983-09-01

    The diagnostic accuracy achieved by taking bronchial mucosal and lung biopsies through flexible fiberoptic bronchoscopes was compared with scalene lymph node biopsy in 55 patients with sarcoidosis. The diagnostic yield with flexible fiberoptic bronchoscopy was 62 per cent in the whole material and increased to 76 per cent in patients with stage II sarcoidosis. Scalene lymph node biopsy was positive in 80 per cent. Flexible fiberoptic bronchoscopy is a useful method for obtaining biopsy material in sarcoidosis, especially in stage II sarcoidosis. We consider flexible fiberoptic bronchoscopy and scalene lymph node biopsy the methods of choice in the diagnosis of sarcoidosis. PMID:6628338

  11. Multiparametric MRI and targeted prostate biopsy: Improvements in cancer detection, localization, and risk assessment

    PubMed Central

    Bjurlin, Marc A.; Mendhiratta, Neil; Wysock, James S.

    2016-01-01

    Introduction Multiparametric-MRI (mp-MRI) is an evolving noninvasive imaging modality that increases the accurate localization of prostate cancer at the time of MRI targeted biopsy, thereby enhancing clinical risk assessment, and improving the ability to appropriately counsel patients regarding therapy. Material and methods We used MEDLINE/PubMed to conduct a comprehensive search of the English medical literature. Articles were reviewed, data was extracted, analyzed, and summarized. In this review, we discuss the mp-MRI prostate exam, its role in targeted prostate biopsy, along with clinical applications and outcomes of MRI targeted biopsies. Results Mp-MRI, consisting of T2-weighted imaging, diffusion-weighted imaging, dynamic contrast-enhanced imaging, and possibly MR spectroscopy, has demonstrated improved specificity in prostate cancer detection as compared to conventional T2-weighted images alone. An MRI suspicion score has been developed and is depicted using an institutional Likert or, more recently, a standardized reporting scale (PI-RADS). Techniques of MRI-targeted biopsy include in-gantry MRI guided biopsy, TRUS-guided visual estimation biopsy, and software co-registered MRI-US guided biopsy (MRI-US fusion). Among men with no previous biopsy, MRI-US fusion biopsy demonstrates up to a 20% increase in detection of clinically significant cancers compared to systematic biopsy while avoiding a significant portion of low risk disease. These data suggest a potential role in reducing over-detection and, ultimately, over-treatment. Among men with previous negative biopsy, 72–87% of cancers detected by MRI targeted biopsy are clinically significant. Among men with known low risk cancer, repeat biopsy by MR-targeting improves risk stratification in selecting men appropriate for active surveillance secondarily reducing the need for repetitive biopsy during surveillance. Conclusions Use of mp-MRI for targeting prostate biopsies has the potential to reduce the

  12. HYDRATE CORE DRILLING TESTS

    SciTech Connect

    John H. Cohen; Thomas E. Williams; Ali G. Kadaster; Bill V. Liddell

    2002-11-01

    The ''Methane Hydrate Production from Alaskan Permafrost'' project is a three-year endeavor being conducted by Maurer Technology Inc. (MTI), Noble, and Anadarko Petroleum, in partnership with the U.S. DOE National Energy Technology Laboratory (NETL). The project's goal is to build on previous and ongoing R&D in the area of onshore hydrate deposition. The project team plans to design and implement a program to safely and economically drill, core and produce gas from arctic hydrates. The current work scope includes drilling and coring one well on Anadarko leases in FY 2003 during the winter drilling season. A specially built on-site core analysis laboratory will be used to determine some of the physical characteristics of the hydrates and surrounding rock. Prior to going to the field, the project team designed and conducted a controlled series of coring tests for simulating coring of hydrate formations. A variety of equipment and procedures were tested and modified to develop a practical solution for this special application. This Topical Report summarizes these coring tests. A special facility was designed and installed at MTI's Drilling Research Center (DRC) in Houston and used to conduct coring tests. Equipment and procedures were tested by cutting cores from frozen mixtures of sand and water supported by casing and designed to simulate hydrate formations. Tests were conducted with chilled drilling fluids. Tests showed that frozen core can be washed out and reduced in size by the action of the drilling fluid. Washing of the core by the drilling fluid caused a reduction in core diameter, making core recovery very difficult (if not impossible). One successful solution was to drill the last 6 inches of core dry (without fluid circulation). These tests demonstrated that it will be difficult to capture core when drilling in permafrost or hydrates without implementing certain safeguards. Among the coring tests was a simulated hydrate formation comprised of coarse, large

  13. Adverse Effects of Vapocoolant and Topical Anesthesia for Tail Biopsy of Preweanling Mice

    PubMed Central

    Braden, Gillian C; Brice, Angela K; Hankenson, F Claire

    2015-01-01

    Tail biopsy of laboratory mice for genotyping purposes has been studied extensively to develop refinements for this common procedure. Our prior work assessed tail vertebral development in different mouse strains (age, 3 to 42 d) and analyzed behavior and activity in mice (age, 21 to 45 d) biopsied under isoflurane anesthesia. To assess the effects of biopsy on preweanling mice, we here evaluated BALB/cAnNCrl mice (n = 80; age, 18 to 21 d) that received topical vapocoolant (ethyl chloride), topical anesthetic (Cetacaine), or isoflurane anesthesia before undergoing a 5-mm or sham biopsy. Control mice did not receive any anesthetic intervention. Regardless of the anesthetic used, acute observation scores indicative of distress were increased at 10 min after biopsy, and locomotor activity was decreased, in biopsied compared with control mice. Acute observation scores at 10 min after biopsy were higher in mice that received ethyl chloride compared with isoflurane or no anesthesia. Microscopic analysis revealed that inflammatory changes in the distal tail remained elevated until 7 d after biopsy and were higher in tails exposed to ethyl chloride. Our findings indicate that vapocoolant, topical anesthesia, and inhaled isoflurane do not enhance the wellbeing of preweanling mice undergoing tail biopsy. Due to the lack of appreciable benefits and the presence of notable adverse effects, using vapocoolants or Cetacaine for this tail biopsy procedure in laboratory mice is unadvisable and we encourage the removal of these agents from institutional tail biopsy guidelines. PMID:26045455

  14. Adverse effects of vapocoolant and topical anesthesia for tail biopsy of preweanling mice.

    PubMed

    Braden, Gillian C; Brice, Angela K; Hankenson, F Claire

    2015-05-01

    Tail biopsy of laboratory mice for genotyping purposes has been studied extensively to develop refinements for this common procedure. Our prior work assessed tail vertebral development in different mouse strains (age, 3 to 42 d) and analyzed behavior and activity in mice (age, 21 to 45 d) biopsied under isoflurane anesthesia. To assess the effects of biopsy on preweanling mice, we here evaluated BALB/cAnNCrl mice (n = 80; age, 18 to 21 d) that received topical vapocoolant (ethyl chloride), topical anesthetic (Cetacaine), or isoflurane anesthesia before undergoing a 5-mm or sham biopsy. Control mice did not receive any anesthetic intervention. Regardless of the anesthetic used, acute observation scores indicative of distress were increased at 10 min after biopsy, and locomotor activity was decreased, in biopsied compared with control mice. Acute observation scores at 10 min after biopsy were higher in mice that received ethyl chloride compared with isoflurane or no anesthesia. Microscopic analysis revealed that inflammatory changes in the distal tail remained elevated until 7 d after biopsy and were higher in tails exposed to ethyl chloride. Our findings indicate that vapocoolant, topical anesthesia, and inhaled isoflurane do not enhance the wellbeing of preweanling mice undergoing tail biopsy. Due to the lack of appreciable benefits and the presence of notable adverse effects, using vapocoolants or Cetacaine for this tail biopsy procedure in laboratory mice is unadvisable and we encourage the removal of these agents from institutional tail biopsy guidelines.

  15. Evaluation of Common Anesthetic and Analgesic Techniques for Tail Biopsy in Mice

    PubMed Central

    Jones, Carissa P; Carver, Scott; Kendall, Lon V

    2012-01-01

    Tail biopsy in mice is a common procedure in genetically modified mouse colonies. We evaluated the anesthetic and analgesic effects of various agents commonly used to mitigate pain after tail biopsy. We used a hot-water immersion assay to evaluate the analgesic effects of isoflurane, ice-cold ethanol, ethyl chloride, buprenorphine, and 2-point local nerve blocks before studying their effects on mice receiving tail biopsies. Mice treated with ethyl chloride spray, isoflurane and buprenorphine, and 2-point local nerve blocks demonstrated increased tail-flick latency compared with that of untreated mice. When we evaluated the behavior of adult and preweanling mice after tail biopsy, untreated mice demonstrated behavioral changes immediately after tail biopsy that lasted 30 to 60 min before returning to normal. The use of isoflurane, isoflurane and buprenorphine, buprenorphine, 2-point nerve block, or ethyl chloride spray in adult mice did not significantly improve their behavioral response to tail biopsy. Similarly, the use of buprenorphine and ethyl chloride spray in preweanling mice did not improve their behavioral response to tail biopsy compared with that of the untreated group. However, immersion in bupivacaine for 30 s after tail biopsy decreased tail grooming behavior during the first 30 min after tail biopsy. The anesthetic and analgesic regimens tested provide little benefit in adult and preweanling mice. Given that tail biopsy results in pain that lasts 30 to 60 min, investigators should carefully consider the appropriate anesthetic or analgesic regimen to incorporate into tail-biopsy procedures for mice. PMID:23294888

  16. Novel Jumbo Biopsy Forceps for Surveillance of Inflammatory Bowel Disease: A Comparative Retrospective Assessment

    PubMed Central

    Song, Kenneth; Toweill, Daniel; Rulyak, Stephen J.; Lee, Scott D.

    2011-01-01

    Background and Study Aims. Most available jumbo cup forceps require a 3.7 mm biopsy channel, necessitating the use of standard-sized colonoscope. A newer jumbo forceps (Radial Jaw 4 Jumbo Biopsy Forceps [RJ4]) fits within a 3.2 mm biopsy channel, allowing use with a pediatric colonoscope. To assure the RJ4 did not alter biopsy adequacy, we compared the size and quality of specimens to a historical jumbo cup forceps (Radial Jaw 3 Max Capacity Biopsy Forceps, [RJ3 MC]). Patients and Methods. A retrospective comparative study of biopsies taken with either forceps. Biopsies were compared for diameter, depth, crush artifact, and acceptability for diagnosis. Results. 333 specimens were taken with RJ4 and 335 specimens with the RJ3 MC. Mean sample diameter was 4.45 mm and 4.55 mm for the RJ4 and RJ3 MC (P = 0.41). Mean depth of biopsies with the RJ4 was greater (P < 0.01). Conclusions. Biopsies from the RJ4 are similar in size and quality to biopsies from the RJ3 MC. The RJ4 has the advantage of fitting in a smaller biopsy channel. PMID:22007197

  17. Novel jumbo biopsy forceps for surveillance of inflammatory bowel disease: a comparative retrospective assessment.

    PubMed

    Song, Kenneth; Toweill, Daniel; Rulyak, Stephen J; Lee, Scott D

    2011-01-01

    Background and Study Aims. Most available jumbo cup forceps require a 3.7 mm biopsy channel, necessitating the use of standard-sized colonoscope. A newer jumbo forceps (Radial Jaw 4 Jumbo Biopsy Forceps [RJ4]) fits within a 3.2 mm biopsy channel, allowing use with a pediatric colonoscope. To assure the RJ4 did not alter biopsy adequacy, we compared the size and quality of specimens to a historical jumbo cup forceps (Radial Jaw 3 Max Capacity Biopsy Forceps, [RJ3 MC]). Patients and Methods. A retrospective comparative study of biopsies taken with either forceps. Biopsies were compared for diameter, depth, crush artifact, and acceptability for diagnosis. Results. 333 specimens were taken with RJ4 and 335 specimens with the RJ3 MC. Mean sample diameter was 4.45 mm and 4.55 mm for the RJ4 and RJ3 MC (P = 0.41). Mean depth of biopsies with the RJ4 was greater (P < 0.01). Conclusions. Biopsies from the RJ4 are similar in size and quality to biopsies from the RJ3 MC. The RJ4 has the advantage of fitting in a smaller biopsy channel.

  18. Evaluation of common anesthetic and analgesic techniques for tail biopsy in mice.

    PubMed

    Jones, Carissa P; Carver, Scott; Kendall, Lon V

    2012-11-01

    Tail biopsy in mice is a common procedure in genetically modified mouse colonies. We evaluated the anesthetic and analgesic effects of various agents commonly used to mitigate pain after tail biopsy. We used a hot-water immersion assay to evaluate the analgesic effects of isoflurane, ice-cold ethanol, ethyl chloride, buprenorphine, and 2-point local nerve blocks before studying their effects on mice receiving tail biopsies. Mice treated with ethyl chloride spray, isoflurane and buprenorphine, and 2-point local nerve blocks demonstrated increased tail-flick latency compared with that of untreated mice. When we evaluated the behavior of adult and preweanling mice after tail biopsy, untreated mice demonstrated behavioral changes immediately after tail biopsy that lasted 30 to 60 min before returning to normal. The use of isoflurane, isoflurane and buprenorphine, buprenorphine, 2-point nerve block, or ethyl chloride spray in adult mice did not significantly improve their behavioral response to tail biopsy. Similarly, the use of buprenorphine and ethyl chloride spray in preweanling mice did not improve their behavioral response to tail biopsy compared with that of the untreated group. However, immersion in bupivacaine for 30 s after tail biopsy decreased tail grooming behavior during the first 30 min after tail biopsy. The anesthetic and analgesic regimens tested provide little benefit in adult and preweanling mice. Given that tail biopsy results in pain that lasts 30 to 60 min, investigators should carefully consider the appropriate anesthetic or analgesic regimen to incorporate into tail-biopsy procedures for mice.

  19. The value of hysteroscopic biopsy in the diagnosis of endometrial polyps.

    PubMed

    Spadoto-Dias, Daniel; Bueloni-Dias, Flávia Neves; Elias, Leonardo Vieira; Leite, Nilton José; Modotti, Waldir Pereira; Lasmar, Ricardo Bassil; Dias, Rogério

    2016-07-01

    Several studies have demonstrated that the combination of hysteroscopy with endometrial biopsy is more accurate in differentiating endometrial polyps from endometrial hyperplasia and cancer. However, blind biopsy not always confirms hysteroscopic findings due to high rates of inadequate or insufficient material. The objective of this clinical, prospective, and comparative study was to establish a correlation between the histological results of office-based endometrial biopsies (hysteroscopically guided and blind) with the surgical polypectomy specimens. We evaluated 82 patients with hysteroscopic diagnosis of endometrial polyp, who randomly underwent hysteroscopically guided biopsy or blind biopsy, referred for surgical resection. A total of 36 women (43.9%) underwent hysteroscopically guided biopsy and 46 women (56.1%) underwent blind biopsy. The sensitivity of hysteroscopically guided biopsy for the diagnosis of endometrial polyps ranged between 35.3 and 36.8%, when carried out at the apex and base of the lesion, compared with 29.2% for blind biopsy. Specificity was 33.3, 50, and 60%, respectively, for each biopsy. The positive predictive values were 75, 77.8, and 87.5%, and negative predictive values were 8.3, 14.3, and 8.1% respectively, compared with surgical polypectomy specimens. The office-based endometrial biopsies had low diagnostic accuracy for endometrial polyps compared with surgical polypectomy specimens. PMID:27638896

  20. 23. CORE WORKER OPERATING A COREBLOWER THAT PNEUMATICALLY FILLED CORE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. CORE WORKER OPERATING A CORE-BLOWER THAT PNEUMATICALLY FILLED CORE BOXES WITH RESIGN IMPREGNATED SAND AND CREATED A CORE THAT THEN REQUIRED BAKING, CA. 1950. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL