Diagnostic yield of image-guided biopsy in patients with suspected infectious spondylodiscitis

2022 ◽  
Vol 104-B (1) ◽  
pp. 120-126
Author(s):  
Gokul Kafle ◽  
Bhavuk Garg ◽  
Nishank Mehta ◽  
Raju Sharma ◽  
Urvashi Singh ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Histological Examination ◽  
Diagnostic Yield ◽  
Specific Treatment ◽  
Final Diagnosis ◽  
Image Guided ◽  
Pyogenic Spondylodiscitis ◽  
Guided Biopsy ◽  
Infectious Spondylodiscitis ◽  
Tuberculous Spondylodiscitis

Aims The aims of this study were to determine the diagnostic yield of image-guided biopsy in providing a final diagnosis in patients with suspected infectious spondylodiscitis, to report the diagnostic accuracy of various microbiological tests and histological examinations in these patients, and to report the epidemiology of infectious spondylodiscitis from a country where tuberculosis (TB) is endemic, including the incidence of drug-resistant TB. Methods A total of 284 patients with clinically and radiologically suspected infectious spondylodiscitis were prospectively recruited into the study. Image-guided biopsy of the vertebral lesion was performed and specimens were sent for various microbiological tests and histological examinations. The final diagnosis was determined using a composite reference standard based on clinical, radiological, serological, microbiological, and histological findings. The overall diagnostic yield of the biopsy, and that for each test, was calculated in light of the final diagnosis. Results The final diagnosis was tuberculous spondylodiscitis in 250 patients (88%) and pyogenic spondylodiscitis in 22 (7.8%). Six (2.1%) had a noninfectious condition-mimicking infectious spondylodiscitis, and six (2.1%) had no definite diagnosis and improved without specific treatment. The diagnosis was made by image-guided biopsy in 152 patients (56%) with infectious spondylodiscitis. Biopsy was contributory in identifying 132/250 patients (53%) with tuberculous spondylodiscitis, and 20/22 patients (91%) with pyogenic spondylodiscitis. Histological examination was the most sensitive diagnostic modality, followed by Xpert MTB/RIF assay. Conclusion Image-guided biopsy has a reasonably high diagnostic yield in patients with suspected infectious spondylodiscitis. A combination of histological examination, Xpert MTB/RIF assay, bacterial culture, and sensitivity provides high diagnostic accuracy in a country in which TB is endemic. Cite this article: Bone Joint J 2022;104-B(1):120–126.

scholarly journals Image-guided Biopsy of Mesenteric, Omental, and Peritoneal Disease

2018 ◽  
Vol 02 (02) ◽  
pp. 106-115
Author(s):  
Joshua Cornman-Homonoff ◽  
David Madoff
Keyword(s):  
Diagnostic Accuracy ◽  
Patient Care ◽  
Clinical History ◽  
Peritoneal Disease ◽  
Image Guided ◽  
High Diagnostic Accuracy ◽  
Guided Biopsy ◽  
Imaging Characteristics ◽  
Procedural Evaluation ◽  
Technical Considerations

AbstractThe peritoneum, omenta, and mesenteries can be affected by a myriad of disease processes, but many common pathologies cannot be definitively distinguished based on clinical history and imaging characteristics alone. Percutaneous image-guided biopsy is a safe, well-tolerated procedure with high diagnostic accuracy, which has supplanted more invasive means of obtaining tissue and is increasingly essential in directing patient care. An understanding of the indications, pre-procedural evaluation, technical considerations, and potential complications is essential for the radiologist who performs these procedures, and more broadly for any clinician who may request them.

Percutaneous Image-Guided Biopsy of the Spleen

2018 ◽  
Vol 02 (02) ◽  
pp. 101-105
Author(s):  
Alda Tam ◽  
Sharjeel Sabir
Keyword(s):  
Diagnostic Yield ◽  
Diagnostic Approach ◽  
Solid Organ ◽  
Appropriate Use ◽  
Image Guided ◽  
Guided Biopsy ◽  
Optimum Technique ◽  
Splenic Biopsy

AbstractPercutaneous spleen biopsy has a small but important role in the diagnostic approach to splenic lesions. Nonetheless, there remain concerns about the safety of the procedure, limiting its use despite evidence that splenic biopsy performed with optimum technique has comparable diagnostic yield and safety as other solid organ biopsies. To assure appropriate use of percutaneous image-guided spleen biopsy, we discuss the rationale, technique, and outcomes of the procedure.

Laparoscopy has a superior diagnostic yield than percutaneous image-guided biopsy for suspected intra-abdominal lymphoma

2014 ◽  
Vol 29 (9) ◽  
pp. 2496-2499 ◽  
Author(s):  
Shaun C. Daly ◽  
Matthew Klairmont ◽  
Bulent Arslan ◽  
Yalini Vigneswaran ◽  
Kevin F. Roggin ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Image Guided ◽  
Guided Biopsy

scholarly journals Diagnostic Accuracy of Ultrasound Versus Computed Tomographic Guided Fine Needle Aspiration Cytology

1970 ◽  
Vol 1 (1) ◽  
pp. 9-14 ◽  
Author(s):  
SMK Nahar Begum ◽  
ARMS Ekram ◽  
D Uddin ◽  
QT Islam ◽  
J Bhaduri
Keyword(s):  
Diagnostic Accuracy ◽  
Economic Status ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Late Complications ◽  
Ct Guidance ◽  
Ct Guided ◽  
Computed Tomographic ◽  
Image Guided ◽  
The Poor

 Image guided FNAC of pulmonary lesions are widely applied now a days. Most of the lesions which are located nearer to the chest wall can be well visualized by ultrasonography. Whereas smaller lesions, deeply located ones, mediastinal or juxtra-hilar lesions may not be visualized sonographically. In those cases CT-guidance becomes beneficial. We report 127 FNACs done during a 2 year period. In considering the poor economic ability of the patient USG-guidance was preferred provided the lesion could be well visualized. Ultrasound guided method was successfully performed in majority of cases except a few where CT-guidance was necessary. After first aspiration an immediate cytological assessment was done by a quick staining method and in case of inadequacy of the specimen a second pass was made within an hour. Different pathological spectrum of diseases were diagnosed cytologically and was compared with their final diagnosis. Negligible immediate or late complications were noticed. Image guided FNAB of intra-thoracic masses can therefore be made with minimum complication, can allow the physician to decide the mode of treatment in a shortest possible time and in most of the cases an ultrasound guidance is sufficient enough considering the poor economic status of people in this subcontinent. Key Words : CT Guided FNAC; USG FNAC; Diagnostic Accuracy DOI: 10.3329/akmmcj.v1i1.7453 Anwer Khan Modern Medical College Journal 2010; 1(1): 09-14

Diagnostic yield, accuracy, and complication rate of CT-guided biopsy for spinal lesions: a systematic review and meta-analysis

2021 ◽  
pp. neurintsurg-2021-017419
Author(s):  
Giorgos D Michalopoulos ◽  
Yagiz Ugur Yolcu ◽  
Abdul Karim Ghaith ◽  
Mohammed Ali Alvi ◽  
Carrie M Carr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Diagnostic Performance ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Ct Guided ◽  
Spinal Lesions ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

BackgroundCT-guided biopsy is a commonly used diagnostic procedure for spinal lesions. This meta-analysis aims to investigate its diagnostic performance and complications, as well as factors influencing outcomes.MethodsA systematic review of the literature was performed to identify studies reporting outcomes of CT-guided biopsies for spinal lesions. Diagnostic yield (ie, the rate of procedures resulting in a specific pathological diagnosis) and diagnostic accuracy (ie, the rate of procedures resulting in the correct diagnosis) were the primary outcomes of interest. Complications following biopsy procedures were also included.ResultsThirty-nine studies with 3917 patients undergoing 4181 procedures were included. Diagnostic yield per procedure was 91% (95% CI 88% to 94%) among 3598 procedures. The most common reason for non-diagnostic biopsies was inadequacy of sample. No difference in diagnostic yield between different locations and between lytic, sclerotic, and mixed lesions was found. Diagnostic yield did not differ between procedures using ≤13G and ≥14G needles. Diagnostic accuracy per procedure was 86% (95% CI 82% to 89%) among 3054 procedures. Diagnostic accuracy among 2426 procedures that yielded a diagnosis was 94% (95% CI 92% to 96%). Complication rate was 1% (95% CI 0.4% to 1.9%) among 3357 procedures. Transient pain and minor hematoma were the most common complications encountered.ConclusionIn our meta-analysis of 39 studies reporting diagnostic performance and complications of CT-guided biopsy, we found a diagnostic yield of 91% and diagnostic accuracy of 86% with a complication rate of 1%. Diagnostic yield did not differ between different locations, between lytic, sclerotic and mixed lesions, and between wide- and thin-bore needles.

Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features

2021 ◽  
pp. 028418512199028
Author(s):  
Anil Kumar Singh ◽  
Zafar Neyaz ◽  
Ritu Verma ◽  
Anshul Gupta ◽  
Richa Mishra ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Microbiological Analysis ◽  
Imaging Features ◽  
Imaging Findings ◽  
Chi Square ◽  
Tissue Samples ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

Background Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels. Purpose To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories. Material and Methods This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests. Results CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma. Conclusion Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.

scholarly journals Abstract No. 527 Diagnostic accuracy of image-guided biopsy of hepatic lesions

2020 ◽  
Vol 31 (3) ◽  
pp. S230-S231
Author(s):  
S. Haider ◽  
A. Sideris ◽  
S. Brejt ◽  
S. Reis ◽  
V. Sheynzon ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Image Guided ◽  
Guided Biopsy ◽  
Hepatic Lesions

Image-Guided Biopsy of Intracranial Lesions with a Small Robotic Device (iSYS1): A Prospective, Exploratory Pilot Study

2019 ◽  
Vol 17 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Federico G Legnani ◽  
Andrea Franzini ◽  
Luca Mattei ◽  
Andrea Saladino ◽  
Cecilia Casali ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Surface Registration ◽  
Reference Image ◽  
Stereotactic Brain Biopsy ◽  
Tissue Samples ◽  
Registration Method ◽  
Image Guided ◽  
Guided Biopsy ◽  
Surgical Data ◽  
Intracranial Lesions

Abstract BACKGROUND Robotic technologies have been used in the neurosurgical operating rooms for the last 30 yr. They have been adopted for several stereotactic applications and, particularly, image-guided biopsy of intracranial lesions which are not amenable for open surgical resection. OBJECTIVE To assess feasibility, safety, accuracy, and diagnostic yield of robot-assisted frameless stereotactic brain biopsy with a recently introduced miniaturized device (iSYS1; Interventional Systems Medizintechnik GmbH, Kitzbühel, Austria), fixed to the Mayfield headholder by a jointed arm. METHODS Clinical and surgical data of all patients undergoing frameless stereotactic biopsies using the iSYS1 robotized system from October 2016 to December 2017 have been prospectively collected and analyzed. Facial surface registration has been adopted for optical neuronavigation. RESULTS Thirty-nine patients were included in the study. Neither mortality nor morbidity related to the surgical procedure performed with the robot was recorded. Diagnostic tissue samples were obtained in 38 out of 39 procedures (diagnostic yield per procedure was 97.4%). All patients received a definitive histological diagnosis. Mean target error was 1.06 mm (median 1 mm, range 0.1-4 mm). CONCLUSION The frameless robotic iSYS1-assisted biopsy technique was determined to be feasible, safe, and accurate procedure; moreover, the diagnostic yield was high. The surface matching registration method with computed tomography as the reference image set did not negatively affect the accuracy of the procedure.

Image-guided frameless stereotactic biopsy without intraoperative neuropathological examination

2010 ◽  
Vol 113 (2) ◽  
pp. 170-178 ◽  
Author(s):  
David Shooman ◽  
Antonio Belli ◽  
Paul L. Grundy
Keyword(s):  
Stereotactic Biopsy ◽  
Diagnostic Yield ◽  
False Negative ◽  
Gliomatosis Cerebri ◽  
Histological Evaluation ◽  
Intracerebral Hematoma ◽  
Image Guided ◽  
Guided Biopsy ◽  
Retrospective Audit ◽  
Neuropathological Examination

Object Stereotactic biopsy is a safe and effective technique for the diagnosis of brain tumors. The use of intraoperative neuropathological examination has been routinely advocated to increase diagnostic yield, but the procedure lengthens surgical time, may produce false-negative and -positive results, and current biopsy techniques have a very low nondiagnostic rate. Therefore, the authors questioned the need for intraoperative histological evaluation. Methods The authors prospectively studied all patients undergoing image-guided biopsy under the care of a single surgeon (P.L.G.) between July 2005 and October 2007. A Stryker neuronavigation system with a trajectory guide was used to plan a single trajectory, and, using a side-cutting biopsy cannula, multiple biopsy samples were taken from between 1 and 4 sites within the tumor. Tissue was inspected macroscopically by the surgeon and was only submitted for neuropathological assessment postoperatively. Results One hundred thirty-four biopsies were performed during the study. A positive diagnosis was established in 133 cases (99.3%). One biopsy was negative (0.7%) and postoperative imaging (performed because the tissue was macroscopically normal) demonstrated inaccurate targeting of the lesion. Significant complications were seen in 3 patients (2.2%) who all had preoperative WHO performance scores of III or IV. Two patients suffered delayed deterioration and died due to probable surgical complications—one with thalamic glioblastoma multiforme (GBM) and one with gliomatosis cerebri. One patient with GBM suffered an intracerebral hematoma that was managed conservatively. Postoperative seizures were seen in 4 patients (3%), and 2 patients (1.5%) experienced a transient neurological deficit. Histological diagnosis showed a GBM in 64 cases, Grade III glioma in 19, Grade I or II in 23, metastasis in 10, lymphoma in 13, and other disease in 4. There were 32 patients discharged to home on the same day as surgery. Compared with the authors' previous retrospective audit into 127 biopsies, this technique showed improved diagnostic yield (99.3 vs 94.5%, p = 0.032) with fewer complications (2.2 vs 4.7% [not statistically significant]). Conclusions This technique of image-guided biopsy has high diagnostic yield with acceptably low morbidity and may be performed as a day case. Intraoperative neuropathological examination would not have increased the diagnostic yield further in this study, and its routine use may not be necessary. In the authors' department £70,350 (UK)/$114,522 (US) would have been saved by not using intraoperative neuropathology in this series. Therefore, intraoperative neuropathology should no longer be routinely recommended.

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