Percutaneous Image-Guided Biopsy of the Pancreas

2018 ◽  
Vol 02 (02) ◽  
pp. 095-100
Author(s):  
Stephen McRae
Keyword(s):  
Needle Aspiration ◽  
Target Lesion ◽  
Pathological Diagnosis ◽  
Surgical Biopsy ◽  
Cross Sectional ◽  
Image Guided ◽  
Guided Biopsy ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Mass Lesions

AbstractPercutaneous image-guided biopsy of the pancreas is a safe, effective, efficient, and minimally invasive way to obtain samples for pathological diagnosis of pancreatic mass lesions. The myriad of diseases that can involve the pancreas require different therapies. Therefore, pathological diagnosis is key. With proper imaging resources and techniques, most mass lesions of the pancreas that are visible on cross-sectional imaging can be approached safely and accurately percutaneously under either computed tomography (CT) or ultrasound guidance. These lesions may be accessed through anterior, posterior, and/or lateral approaches depending upon their proximity to the anticipated skin puncture site, and the presence or absence of intervening structures. While the ideal percutaneous route to any pancreatic target lesion is the one that has no vital structures in its path, methods and tools exist to make even the most seemingly obstructed paths to pancreatic targets navigable. Once accessed, the targets may be sampled by either fine-needle aspiration or core needle biopsy. The alternatives to percutaneous image-guided biopsy of the pancreas include open (surgical) biopsy and endoscopic ultrasound-guided (EUS) biopsy. Percutaneous image-guided biopsy poses less risk to the patient than open biopsy and has been shown to be as accurate as EUS biopsy with an even lower complication rate.

scholarly journals Evaluation of precision of guidance techniques in image guided fine needle aspiration cytology of thoracic mass lesions

2012 ◽  
Vol 29 (1) ◽  
pp. 6 ◽  
Author(s):  
Shivani Kalhan ◽  
Sonia Sharma ◽  
TS Ramakrishnan ◽  
Pankaj Sharma ◽  
Sharmila Dudani ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Image Guided ◽  
Needle Aspiration Cytology ◽  
Mass Lesions

Endoscopic ultrasound-guided fine needle core biopsy versus aspiration for gastrointestinal mass lesions: A randomized trial.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 161-161 ◽  
Author(s):  
Nam Q. Nguyen
Keyword(s):  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Histologic Diagnosis ◽  
Fine Needle ◽  
Guided Biopsy ◽  
Increased Risk ◽  
Core Tissue ◽  
Mass Lesions

161 Background: Endoscopic ultrasound (EUS) guided biopsy allows cytologic and/or histologic diagnosis of lesions within or adjacent to the gastrointestinal tract (GIT). However, the amount of tissue obtained with a regular aspirating needle is not always satisfactory. A newly developed Coo Pro-Core 22G needle has been proposed to obtain core tissue and may improve diagnostic yield. This study aimed to compare the performance of two EUS guided biopsy systems, Coo 22G fine needle aspiration (FNA) versus Coo 22G Pro-Core (PC) needle, in the evaluation of mass lesions within or adjacent to the GIT. Methods: 61 consecutive patients, who were referred for EUS guided biopsy of mass lesions within or adjacent to the upper GIT, were randomized to either the use of 22G FNA or 22G PC needle. The procedures were performed by a single experienced EUS-endoscopist. Four needle passes were taken from each lesion and all specimens were prepared as cell-block for histo-cytological analysis. Measured outcomes were diagnostic yield and complication. Results: EUS guided biopsy was performed with 22G FNA needle in 31patients and with 22G PC needle in 30 patients. There were no differences in age, gender, site or size of biopsied lesion between the groups. Diagnostic yield from the PC group was significantly higher than that of the FNA groups (27/30 vs. 22/31, P=0.04). The ability to obtain core-like tissue and provide “histological” detail were also higher in the PC group (16/30 vs. 0/31, P<0.001). Although no patients with FNA biopsy had complications, the first 4 cases of PC needle biopsy had abdominal pain (with 1 proven pancreatitis), requiring overnight admission. No further complications occurred after the number of PC passes was reduced to 2 per lesion. Conclusions: EUS guided biopsy with Pro-Core needles had a substantially higher diagnostic yield than that with FNA needles, with the ability to provide "histological" information in the majority of cases. Initial use of the Pro-Core needle, however, is associated with an increased risk of abdominal pain, which is reduced with fewer passes and more experience.

Percutaneous Image-Guided Biopsy of the Spleen: Experience at a Single Tertiary Care Center

2020 ◽  
pp. 084653712090369
Author(s):  
Susan John ◽  
Wael Shabana ◽  
Jean-Paul Salameh ◽  
Matthew D. F. McInnes
Keyword(s):  
Complication Rate ◽  
Diagnostic Yield ◽  
Care Center ◽  
Tertiary Care ◽  
Major Complication ◽  
Median Number ◽  
Needle Aspiration ◽  
Needle Size ◽  
Image Guided ◽  
Guided Biopsy

Purpose: The purpose of this study is to assess the complication rate of percutaneous image-guided biopsy of the spleen at our institution and to evaluate for variables associated with complication rate. Methods: This is a Research Ethics Board approved retrospective study of consecutive patients who underwent image-guided biopsy of the spleen at our institution from January 2010 to November 2019. Complications, imaging findings, and pathologic diagnosis were reviewed. Complications (major and minor) were classified per Society of Interventional Radiology Guidelines, and complication rate was calculated. Logistic regression was applied to determine factors associated with complications. Diagnostic yield was calculated. Results: In all, 55 patients (28 female) underwent splenic biopsy using ultrasound guidance. The most common indication was possible lymphoma in 41 (71.7%) patients followed by query metastasis 18 (31.5%) patients. Core biopsies (18 g/20 g) were done in 53 (92%) cases, and fine-needle aspiration (22 g) was performed in 4 (8%). The median number of samples collected was 4 (range: 2-9). The results were diagnostic in 54 cases (94.7%, 95% confidence interval [CI]: 88.7-100.0). There were 12 (21%, 95% CI: 10.1-31.9) patients with minor complications and 2 (3.5%, 95% CI: 0.0-8.4) with major complications (2 splenic bleeds requiring embolization, no splenectomy, or deaths). No variables (needle size, lesion size, and number of passes) were associated with complication rate. Conclusion: Percutaneous image-guided biopsy of the spleen at a single tertiary care institution demonstrates major complication rate comparable to that in the literature with no variables associated with complication rate; there were no cases of splenectomy or death.

scholarly journals Role of image guided fine needle aspiration cytology in the diagnosis of intra-abdominal and intra-thoracic lesions

2019 ◽  
Vol 7 (5) ◽  
pp. 1584
Author(s):  
Mehnaz Choudhary ◽  
Rajat Gupta ◽  
Kuldeep Singh
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Ct Guided ◽  
Fine Needle ◽  
Image Guided ◽  
Needle Aspiration Cytology ◽  
One Year

Background: Intrathoracic and intra-abdominal tumors at inaccessible sites pose difficulty in diagnosis. Ultrasonography and computed tomography guided fine needle aspiration cytology has an important role in the diagnosis and distinguishing them as benign and malignant lesions. Image guided FNA has proved to be safe, quick, reliable and cost-effective method for obtaining tissue for cytopathological examination. The objective was to describe the pattern of intra-abdominal and intra thoracic masses on FNAC.Methods: This cross-sectional study was done in the postgraduate Department of pathology Government, Medical college Jammu i.e. 1st September 2017 to 30th September,2018 for a period of one year under image guided FNAC. Air dried and wet fixed smears were stained with may Grunwald Giemsa (MGG) and Papinacolau (PAP) stains respectively. Acid fast bacilli stain was done on additional smears in case of suspected tubercular lesions.Results: A total of 60 patients were subjected to ultrasonography and CT guided intra-abdominal and intra thoracic FNACs in a period of one year. FNAC was performed from various anatomical sites of which intra-abdominal lesions were 40 (liver:21 cases, gallbladder:8 cases, ovary: 3 cases, lymph nodes 3 cases, pancreas: 2 cases, omentum 2 cases, GIT 1 case).  Intrathoracic lesions were twenty (20); out of which lung cases were eighteen (18) and two (2) were mediastinal aspirations.Conclusions: Percutaneous fine needle aspiration cytology under image guidance well described the pattern of deep-seated lesions.

scholarly journals Cytopathologic Evaluation of Image-Guided Fine-Needle Aspiration Cytology and Cell Block Correlation for Lung Neoplasm in a Tertiary Care Hospital VIMSAR, Burla - A Cross-Sectional Study

2021 ◽  
Vol 8 (23) ◽  
pp. 1927-1931
Author(s):  
Alaka Sahu ◽  
Santosh Gudaganatti ◽  
Swetalina Pandey
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Lung Neoplasm ◽  
Needle Aspiration ◽  
Cell Block ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Fine Needle ◽  
Image Guided ◽  
Needle Aspiration Cytology

BACKGROUND Fine-needle aspiration cytology (FNAC) is an easy, minimally invasive and useful investigation, and is considered important next to imaging in the rapid diagnosis of lung neoplasm for the last few decades. The purpose of this study was to evaluate the role of image-guided FNAC in pulmonary neoplasm, analyse the results and correlate with cell block histopathological findings. METHODS This is a cross sectional study conducted over a period of two years, involving fifty patients. All the clinical and radiological data were studied from the consenting patient. Then they underwent image-guided FNAC. The cytology smears and cell blocks were evaluated simultaneously to stick out a definitive diagnosis. RESULTS Out of all the 50 cases, we found the necessary FNAC smears and cell block material only in 41 cases. The age range varied from 18 to 90 years with a peak in the fifth to sixth decades. Benign lesions were 4 and malignant were 23 as shown by cytology study. Malignancy was proved in 27 cases in histopathology. The most common tumour was adenocarcinoma (41 %) followed by squamous cell carcinoma (19.5 %). Complications after the procedure were minimal and were noted only in two cases. CONCLUSIONS Image-guided fine needle aspiration cytology of lung tumours provide uncomplicated, cost effective, and a rapid method, for reaching a reliable diagnosis for lung neoplasms with minimum complication. KEYWORDS FNAC, Histological Correlation, Pulmonary Neoplasm

scholarly journals Current Role and Importance of USG Guided FNAC for Rapid Diagnosis of Suspicious Mass Lesions

2020 ◽  
Vol 8 (1) ◽  
pp. 89-92
Author(s):  
Maulik Jethva ◽  
Parth Dholakiya ◽  
Hiral Hapani
Keyword(s):  
Real Time ◽  
Needle Aspiration ◽  
Target Lesion ◽  
Rapid Diagnosis ◽  
Ultrasound Guided ◽  
Radiation Hazards ◽  
Medical College ◽  
Experienced Radiologist ◽  
Small Needle ◽  
Mass Lesions

Background: Ultrasound guided Fine needle aspiration is a diagnostic procedure that inserts a small needle into a suspicious mass to extract some cells which are then visualized under the microscope. The aim of the present study was to determine utility and safety of ultrasound guided FNAC in rapid evaluation of various mass lesions. Subjects and Methods: In this study, 120 patients of age between 20-60 years with various mass lesions referred for ultrasonography guided FNAC to the department of radiodiagnosis, PDU Medical College and Civil hospital, Rajkot, Gujarat over a period of 1.5 years from 1/5/2018 to 1/11/2019are included. Results: Ultrasonography guided FNAC was performed by the same investigator, an experienced radiologist, using a real time scanner (logicP9; GE Healthcare) under standard septic precautions. Conclusion: Our study contributes to the conclusion that USG guided FNAC can easilybe used for the aspiration of lesion of the breast, thyroid, lymph nodes, liver, lung, musculoskeletal system etc. It does not use ionizing radiation, has no known harmful effects, and provides rapid diagnosis of the suspicious mass lesions &a firm diagnosis of impalpable lesions can be made preoperatively. Advantages of USG guided FNAC:- 1. Cost effectiveness, 2. No radiation hazards, 3. Easy to perform, 4. Dynamic evaluation of vessels, 5. Perfect real time Localization of the target lesion,

scholarly journals OPEN PROSTATECTOMY

2006 ◽  
Vol 13 (01) ◽  
pp. 125-132
Author(s):  
JAVAID IQBAL ◽  
MUHAMMAD REHMAN GULZAR ◽  
MUHAMMAD AFZAL ◽  
Irshad Ahmed
Keyword(s):  
Hospital Stay ◽  
Open Prostatectomy ◽  
Cross Sectional ◽  
Osteitis Pubis ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Secondary Haemorrhage ◽  
One Year ◽  
Stitch Abscess ◽  
Deep Vein

Objectives: To study the morbidity of open prostatectomy. To assessthe frequency of complications after open prostatectomy. Study design: Descriptive cross sectional. Setting: SurgicalUnit-IV, DHQ Hospital, Faisalabad. Duration: 01-01-2003 to 31-12-2003 (One Year). Subjects: Patients of bladderoutlet obstruction due to benign prostatic hyperplasia (PBH) were operated by open surgery (Transvesical or retropubicprostatectomy). Results: Open prostatectomy was performed in 54 cases. In 38 cases, suprapubic transvesicalprostatectomy was performed, while in 6 cases, retropubic prostatectomy was done. Our youngest patient was 42 yearsold and oldest 90 years. Mean age was 62 years. In our study, the most common complications were wound associatedseen in 7(12.96%) cases. They included cellulites in 3(5.56%) cases, stitch abscess in 1(1.85%) cases, seroma in1(1.85%) cases, and abscess in 2(3.70%) cases. Other complications were bleeding in the form of reactionaryhaemorrhage/clot retention in 2(3.70%) cases and secondary haemorrhage in 3(5.56%) cases. Urinary fistula was seenin 5(9.26%) cases while retrograde ejaculation in 6(11.11%) cases, stricture urethra in 3(5.56%) cases, urinaryincontinence in 4(7.41%) cases and urinary tract infection in 5(9.26%) cases. Epididimo-orchitis, deep vein thrombosisand osteitis pubis were not seen in our study. The average duration of hospital stay was 6 days. Most cases weredischarged within five days of operation, while stitches were removed on the eighth postoperative day. Conclusions:The morbidity of open prostatectomy is higher than transurethral resection (TURP), as TURP is better procedure dueto lower complication rate, short hospital stay, cost effectiveness and better tolerated by old and unfit patients,presenting with small fibrotic prostate. Open prostatectomy is still a good option for BPH where TURP facilities are notavailable.

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