267 Retrospective study evaluating the role of transvaginal ultrasound guided biopsy in gynecological cancer patients

The aims of the present study was to develop and describe a transvaginal ultrasound-guided biopsy method for luteal tissue in the porcine and to evaluate the effects of the method on the reproductive tract, ovarian status and pregnancy status. Biopsies were performed in four multiparous sows on Days 9 and 15 of three consecutive oestrous cycles; the size and histological composition of the samples obtained were evaluated and the reproductive tract of the sows was monitored. Furthermore, biopsies were performed in 26 multiparous sows on Days 10 and 13 after insemination, and the pregnancy rate, gestation length and subsequent litter size were evaluated. RNA was extracted from the samples obtained and the quality and quantity were determined. Altogether, 76 biopsies were performed and 38 samples were obtained. Compared with sows from which no samples were obtained (n = 6), sows from which one or more samples were obtained (n = 24) were older (parity 5.0 ± 2.8 vs 2.2 ± 0.4, mean ± s.d.), heavier (290 ± 26 vs 244 ± 27 kg) and had higher back fat (11.4 ± 2.7 vs 6.4 ± 2.5 mm; P < 0.05 for all). No effect of the biopsies (P > 0.05) was observed on the cyclicity and reproductive organs of the sows, or on corpus luteum diameter on Day 13 (8.9 ± 1.0 vs 9.2 ± 1.1 mm), pregnancy rate (95% vs 96%), gestation length (115 ± 1 vs 115 ± 1 days) and subsequent litter size (12.7 ± 2.5 vs 13.3 ± 2.8) between sows from which samples were obtained and those from which no samples were obtained. The samples obtained had a diameter of 1 mm and contained heterogeneous tissue with various cell types. The RNA quantity was 520 ± 160 µg per sample and the RNA integrity number was 8.5 ± 1.0. In conclusion, an ultrasound-guided biopsy method for ovarian tissue, which can be used for gene expression studies, was established in the porcine. No effect on corpus luteum function was found.

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Role of transvaginal ultrasound-guided biopsy in gynecology

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-000734 ◽

2019 ◽

Vol 30 (1) ◽

pp. 128-132

Author(s):

Floriana Mascilini ◽

Lorena Quagliozzi ◽

Francesca Moro ◽

Maria Cristina Moruzzi ◽

Ilaria De Blasis ◽

...

Keyword(s):

Malignant Tumors ◽

Transvaginal Ultrasound ◽

Ultrasound Guided ◽

Primary Tumors ◽

Adequate Treatment ◽

Ct Guided ◽

Biopsy Needle ◽

Final Histology ◽

Guided Biopsy ◽

Ultrasound Guided Biopsy

BackgroundUltrasound-guided biopsy is an easy technique for obtaining tissue samples. It is commonly used for different types of tumors, such as breast and prostate cancers, in order to plan early and adequate treatment.ObjectiveTo evaluate the indications, adequacy, and safety of transvaginal ultrasound-guided biopsy in women with pelvic lesions suspected of gynecologic malignancy.MethodsA retrospective study including all patients who had undergone transvaginal ultrasound-guided biopsy between April 2015 and May 2018 was carried out at the division of gynecologic oncology. Inclusion criteria were the presence at imaging of abdominal or pelvic tumors in patients considered not ideal candidates for primary gynecological surgery, or the origin and/or nature of the tumor was unclear and further management required histological verification. Patients with planned surgery were excluded from the study. Transvaginal biopsies were performed with a 18 G/25 cm core-cut biopsy needle and histology was obtained. Tru-cut biopsies were performed using an automatic bioptic gun with a 18 G/25 cm core-cut biopsy needle. Results are presented as absolute frequency (percentage) for nominal variables and as median (range) for continuous variables.ResultsA total of 62 women were analyzed. An adequate sample for histological analysis was obtained in all cases. Histopathological examinations showed 24 (38.7%) benign lesions (fibrosis, inflammation, uterine or ovarian myoma) and 38 (61.3%) malignant tumors, distributed as follows: 34 (89.5%) malignant gynecological lesions and 4 (10.5%) non-gynecological malignant tumors. Among the malignant lesions, there were 12/38 (31.6%) primary tumors, 24/38 (63.2%) recurrent tumors, and 2/38 (5.3%) metastases from non-genital cancer. Ten patients eventually underwent surgery. Final histology was not in agreement with the results from transvaginal ultrasound-guided biopsy in 2 of 10 patients (20%); in particular, benign disease at transvaginal ultrasound-guided biopsy was malignant at final histology (two cases of recurrence of cervical cancer). Three patients (4.8%) had pain during the procedure, which was controlled by oral analgesic therapy and lasted for no longer than 10 min. No major complications were registered.ConclusionsTransvaginal ultrasound-guided biopsy is a minimally invasive method to obtain adequate material for histological diagnosis and could avoid unnecessary surgical procedures, costly CT-guided procedures, or prolonged waiting times.

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