CT guided percutaneous needle biopsy of the chest: initial experience

OBJECTIVE Recent articles have identified the poor diagnostic yield of percutaneous needle biopsy for vertebral osteomyelitis. The current study aimed to confirm the higher accuracy of CT-guided spinal biopsy for vertebral neoplasms and to identify which biopsy technique provides the highest yield. METHODS Over a 9-year period, the radiology department at University Hospitals Case Medical Center performed 222 CT-guided biopsies of vertebral lesions, of which clinicians indicated a concern for vertebral neoplasms in 122 patients. A retrospective chart review was performed to confirm the higher sensitivity of the percutaneous intervention for vertebral neoplasms. RESULTS A core sample was obtained for all 122 biopsies of concern (100.0%). Only 6 cases (4.9%) were reported as nondiagnostic per histological sampling, and 12 cases (9.8%) were negative for disease. The question of vertebral neoplastic involvement warrants follow-up, and the current study was able to determine the subsequent diagnosis of each lesion. Of the 122 total, 94 (77.0%) core samples provided true-positive results, and the sensitivity of core biopsy measured 87.9%. The technical approach did not demonstrate any significant difference in diagnostic yield. However, when the vertebral cortex was initially pierced with a coaxial bone biopsy system and subsequently a 14-gauge spring-loaded cutting biopsy needle was coaxially advanced into lytic lesions, 14 true positives were obtained with a corresponding sensitivity of 100.0%. CONCLUSIONS This study confirms the higher sensitivity of image-guided percutaneous needle biopsy for vertebral neoplasms. In addition, it demonstrates how the use of a novel cutting needle biopsy approach, performed coaxially through a core biopsy track, provides the highest yield.

Download Full-text

Fluorescence in situ hybridization (FISH) and array-comparative genomic hybridization (a-CGH) from percutaneous needle biopsy compared to renal mass histology.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.471 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 471-471

Author(s):

Massimiliano Spaliviero ◽

Kelly Lynn Stratton ◽

Timothy F. Donahue ◽

Banumathy Gowrishankar ◽

Charles Ma ◽

...

Keyword(s):

Needle Biopsy ◽

Renal Mass ◽

Renal Tumors ◽

Comparative Genomic ◽

Initial Experience ◽

Percutaneous Needle Biopsy ◽

Renal Masses ◽

Surgical Specimen ◽

Subtype Classification ◽

Biopsy Specimens

471 Background: Image-guided percutaneous needle biopsies are increasingly utilized for the diagnosis of renal tumors. Histologic diagnosis of renal mass subtypes, including malignant clear cell (ccRCC), papillary (pRCC), chromophobe (chrRCC) renal cell carcinoma, and benign oncocytomas (OC) can be challenging due to the low cellularity and damaged architecture of needle biopsy specimens. However, each subtype exhibits unique genetic aberrations that can assist in histologic classification and potentially assist in guiding management decisions. We report our initial experience correlating renal mass histology to subtype-associated genomic alterations detected by FISH and a-CGH of percutaneous needle biopsy specimens. Methods: In an ongoing IRB-approved blinded study, 17 samples obtained from 15 patients with known renal masses were submitted to FISH (FReCaD) and targeted a-CGH (UroGenRA-Kidney). Specimens were classified using a subtype classification decision tree algorithm based on the presence/absence of genomic abnormalities. The results were compared to biopsy histology or surgical specimen when available. Results: Histology revealed ccRCC in 6 patients, pRCC in 4, OC in 2, Angiomyolipoma in 1, and unclassified type RCC in 2. In 6 of 9 cases FISH achieved a diagnosis, which correlated with histology in 4. FISH incorrectly classified as ccRCC two cases with pRCC on histology. A-CGH was diagnostic in 14 of 15 cases and correlated with histology in 13. In one case, a-CGH showed a genomic profile not consistent with ccRCC, pRCC, chrRCC, or OC according to the algorithm. Conclusions: The addition of genetic tumor tissue studies to complement histology from biopsy tissues may supplement or improve the accuracy of classification and biological characterization of renal tumor biopsies and influence treatment planning. In our initial experience, a-CGH showed better correlation with histology in subtype classification of malignant and benign renal masses than FISH. Prospective testing will be required to validate these results.

Download Full-text

Pathological Examination and Differential Diagnosis of Pulmonary Ground-Glass Opacities by CT-Guided Percutaneous Needle Biopsy

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3522 ◽

2021 ◽

Vol 11 (3) ◽

pp. 912-920

Author(s):

Yong Li ◽

Yanxin Sun ◽

Jingqi Han ◽

Hualong Yu ◽

Chuanyu Zhang ◽

...

Keyword(s):

Differential Diagnosis ◽

Needle Biopsy ◽

Ground Glass ◽

Bronchioloalveolar Carcinoma ◽

Pathological Examination ◽

Special Treatment ◽

Percutaneous Needle Biopsy ◽

Pulmonary Tissue ◽

Ct Guided ◽

Sensitivity Specificity

In order to explore the pathological examination and differential diagnosis of pulmonary ground-glass opacities (GGO) with CT-guided percutaneous needle biopsy (CTPNB), this study retrospectively analyzed the medical records of 120 cases of patients who were diagnosed with pulmonary GGO and underwent CTPNB in a hospital designated by this study from December 2014 to December 2018. The results showed that all the 120 cases of patients were successfully punctured at one time and obtained sufficient tissue specimens with the puncture success rate and diagnostic accuracy both of 100%, being able to make a clear qualitative diagnosis. Among them, 30 cases were malignant lesions including 14 cases of bronchioloalveolar carcinoma and 16 cases of metastatic carcinoma; 90 cases were benign lesions including 52 cases of hematogenous pulmonary tuberculosis, 14 cases of sarcoidosis, 12 cases of silicosis and coal workers’ pneumoconiosis, 6 cases of interstitial pneumonia, 4 cases of alveolar proteinosis, and 2 case of allergic pneumonia. The complications of the 120 patients during the treatment included 8 cases of pneumothorax with an incidence of 6.67% (8/120), in which 2 case had the pulmonary tissue compression rate of about 25% and the other cases had no obvious perceived symptoms and required no special treatment, and 10 cases of hemoptysis with an incidence of 8.33% (10/120), whose symptoms disappeared after the treatment with batroxobin, and had no serious symptoms such as air embolism complication. The sensitivity, specificity, and accuracy of CTPNB in the diagnosis of malignant pulmonary GGO were 83.67% (82/98), 100% (22/22), and 86.67% (104/120), respectively, without statistically significant differences in diagnostic efficacy (P > 0.05). In summary, the CTPNB for the diagnosis of malignant pulmonary GGO has high sensitivity, specificity, and accuracy, and the CTPNB is also the simplest and most important approach to obtain effective pathological examinations and differential diagnoses of pulmonary GGO, which has simple operation, high accuracy and few complications, and has high application value for the qualitative diagnosis of pulmonary GGO.

Download Full-text