scholarly journals Ultrasound-Guided Percutaneous Liver Biopsy: A Review on Obtaining Adequate Specimens

2020 ◽  
Vol 14 (3) ◽  
Author(s):  
Danny de Lange ◽  
John J. van den Dobbelsteen ◽  
Adriaan Moelker ◽  
Nick J. van de Berg
Keyword(s):  
Liver Biopsy ◽  
Needle Aspiration ◽  
Complication Rates ◽  
Ultrasound Guided ◽  
Quality Outcomes ◽  
Prisma Statement ◽  
Needle Diameter ◽  
Number Of Passes ◽  
Portal Tracts

Abstract This literature review was conducted to evaluate liver biopsy adequacy, including total core length (TCL), number of portal tracts (PT), fragmentation, and complication rates, as a function of needle type and gauge. A systematic electronic search was performed in the Web of Science and Google Scholar databases, according to the PRISMA statement. Eligible data, describing in vivo percutaneous ultrasound-guided human liver biopsy quality outcomes, were compared to adequacy criteria of the American Association for the Study of Liver Diseases (AASLD, TCL ≥ 20 mm, PT ≥ 11). An adequate mean number of PTs was found in 83% of biopsy needles assessed between 2012 and 2019, compared to 0% between 1998 and 2004. For TCL, this was 44% and 33%, respectively. Increasing the needle diameter enhanced TCL (result in 50% of included studies) and PT count (100%), and reduced fragmentation rates (75%), whereas no effect on pain or complications was found (83%). In total, five needle types achieved adequate PT counts, using 16 G (3×), 17 G (1×), or 18 G (1×) needles. Adequacy was reached using either a core needle biopsy (CNB, 3×) approach with one pass, or a fine needle aspiration (FNA, 2×) approach with two passes. The recommendations for biopsy adequacy can be met using 16/17 G FNA or 16/18 G CNB needles. Currently, many publications still present substandard liver biopsy quality outcomes. Although minimizing biopsy invasiveness is desirable, a decreased diameter or number of passes is ill-judged when reliability of biopsy outcomes is at stake.

scholarly journals Utility and safety of cobalt chromium needles for endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective single-center study

2019 ◽  
Author(s):  
Keigo Uchimura ◽  
Kei Yamasaki ◽  
Sachika Hara ◽  
Takashi Tachiwada ◽  
Toshinori Kawanami ◽  
...  
Keyword(s):  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Complication Rates ◽  
Procedure Time ◽  
Cobalt Chromium ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Lymph Node Sampling ◽  
Single Center Study ◽  
Histological Data

Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard method for obtaining specimens of mediastinal and hilar lesions, and several types of needle of various sizes and materials are available. This study aimed to compare the utility and safety of two needles, cobalt chromium (CC) and stainless steel (SS), for EBUS-TBNA. Methods: This retrospective study included data of patients who underwent EBUS-TBNA with a 22-gauge needle made from either SS (38 patients, 121 punctures) or CC (39 patients, 145 punctures), and procedure time, histological data, complication rates were compared. Results: There were no significant differences between the groups in the baseline characteristics of the patients or lesions or in the complication rates. Although diagnostic yields in each patient who underwent EBUS-TBNA with the two needle types were similar, significantly shorter procedure time (22 min vs. 26 min, p = 0.007), diagnostic histologic sampling yield in each sample (71.0% vs. 58.7%, p = 0.039), fewer samples with cartilage alone (1.4% vs. 6.6%, p = 0.047) and fewer samples containing cartilage (7.6% vs. 16.5%, p = 0.034) were seen in the CC group compared with that in SS needle group. Conclusion: Compared with SS needles, CC needle for EBUS-TBNA showed significant shorter procedure time and higher ratio of getting diagnostic histological specimens in each sample. This might be because of better ability of CC needle to puncture through the trachea and bronchial cartilage to get appropriate lymph node sampling.

scholarly journals Characterization of Mediastinal Lymph Node Physiology In Vivo by Optical Spectroscopy during Endoscopic Ultrasound-Guided Fine Needle Aspiration

2010 ◽  
Vol 5 (7) ◽  
pp. 981-987 ◽  
Author(s):  
Stephen C. Kanick ◽  
Cor van der Leest ◽  
Remco S. Djamin ◽  
Andre M. Janssens ◽  
Henk C. Hoogsteden ◽  
...  
Keyword(s):  
Lymph Node ◽  
Optical Spectroscopy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle

scholarly journals Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2331
Author(s):  
Huzaifa A. Jaliawala ◽  
Samid M. Farooqui ◽  
Kassem Harris ◽  
Tony Abdo ◽  
Jean I. Keddissi ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Procedure Time ◽  
Ultrasound Guided ◽  
Benign Diseases ◽  
Transbronchial Needle Aspiration ◽  
Technical Aspects ◽  
Mediastinal Adenopathy ◽  
Number Of Passes

Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced. These have the potential to reduce the number of passes, reduce the procedure time, and increase the diagnostic yield, especially in rare tumors and benign diseases. Herein, we review the latest updates related to the technical aspects of EBUS-TBNA and their effects on the final cytopathological yield in malignant and benign diseases.

A real-world study evaluating ultrasound guided percutaneous non-targeted liver biopsy needle failures and pathology sample quality assessment in both end-cut and side-notch needles

2021 ◽  
pp. 20210475
Author(s):  
Jim Zhong ◽  
Rachel Allard ◽  
Dominic Hewitson ◽  
Michael Weston ◽  
Oliver Hulson ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Failure Rate ◽  
Portal Tract ◽  
Major Complication ◽  
Ultrasound Guided ◽  
Sample Quality ◽  
Needle Pass ◽  
Causative Factors ◽  
Biopsy Device ◽  
Portal Tracts

Objectives: To determine biopsy device failures, causative factors, complications and sample quality of the 16G end-cut Biopince™ and side-notch Bard™ needles. Methods: All ultrasound-guided non-targeted liver biopsies between 01/01/2016 to 31/12/2018 were included. Operator, device, number of failures, complications and repeat biopsies were recorded. Histopathology samples were reviewed for all cases of needle failure and a group with no failures, and graded “yes/no” for presence of steatosis, inflammation and fibrosis. The pathology slides from these cases were reviewed to assess biopsy sample quality (length and portal tract number). The failure and no-failure groups were compared in terms of device type/ histology and sample quality was compared between the needle types. Results: 1004 patients were included. 93.8% (n = 942) required one needle pass to obtain a sample and 6.2% (n = 62) required >1 pass due to needle failure. Total of 76 needle failures, more with end-cut than side-notch needles (8.7% vs 2.9%) (p < 0.001). No needle failures resulted in complication. The presence of liver fibrosis was associated with fewer needle failures (p = 0.036). The major complication rate was 0.4% (4/1044). A biopsy with >10 portal tracts was obtained in 90.2% of specimens > 20 mm long, compared with 66% of 16–20 mm biopsies and 21% of <16 mm biopsies. The target of >10 portal tracts was achieved in 10/26 (38.5%) of side-notch biopsies and 64/90 (71.1%) of end-cut biopsies (p = 0.004). Conclusion: Ultrasound-guided liver biopsy is safe and sample quality is consistently good when a core >20 mm long is obtained. The end-cut biopsy device generated reliably good quality biopsy samples, however the needle failure rate was significantly higher than the side-cut needle. Advances in knowledge: Ultrasound guided liver biopsy specimen quality is consistently good when a core >20 mm long is obtained which can be achieved with a single pass using the 16G BiopinceTM end-cut needle, although the needle failure rate is significantly higher than the 16G Max-Core™ Bard™ side-notch needle.

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