Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study

Abstract Background Aim of the study is to evaluate the role of ultrasound guided fine needle aspiration cytology (FNAC) in the restaging of node positive breast cancer after preoperative systemic therapy (PST). Methods From January 2016 – October 2020 106 node positive stage IIA-IIIC breast cancer cases undergoing PST were included in the study. 18 (17 %) were carriers of pathogenic variant in BRCA1/2. After PST restaging of axilla was performed with ultrasound and FNAC of the marked and/or the most suspicious axillary node. In 72/106 cases axilla conserving surgery and in 34/106 cases axillary lymph node dissection (ALND) was performed. Results False Positive Rate (FPR) of FNAC after PST in whole cohort and BRCA1/2 positive subgroup is 8 and 0 % and False Negative Rate (FNR) – 43 and 18 % respectively. Overall Sensitivity − 55 %, specificity- 93 %, accuracy 70 %. Conclusion FNAC after PST has low FPR and is useful to predict residual axillary disease and to streamline surgical decision making regarding ALND both in BRCA1/2 positive and negative subgroups. FNR is high in overall cohort and FNAC alone are not able to predict ypCR and omission of further axillary surgery. However, FNAC performance in BRCA1/2 positive subgroup is more promising and further research with larger number of cases is necessary to confirm the results.

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Mo1450 Is Ascites a Contra-Indication to Endoscopic Ultrasound-Guided Biliary Drainage in Case of Unsuccessful ERCP?: Results of a Pilot Study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.1614 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB424

Author(s):

Olivia B. Luna ◽

Ines Oria ◽

Fabien Fumex ◽

Julien Marsot ◽

Christine Lefort ◽

...

Keyword(s):

Pilot Study ◽

Endoscopic Ultrasound ◽

Biliary Drainage ◽

Ultrasound Guided

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Increased Needle Visibility in Ultrasound-Guided Percutaneous Liver Biopsy by an Echogenic Sheath: A Proof of Concept Study in a Human Cadaver

CardioVascular and Interventional Radiology ◽

10.1007/s00270-021-02783-8 ◽

2021 ◽

Author(s):

Jana S. Hopstaken ◽

Leon de Jong ◽

Jurgen J. Fütterer

Keyword(s):

Pilot Study ◽

Liver Biopsy ◽

Human Cadaver ◽

Percutaneous Liver Biopsy ◽

Ultrasound Guided ◽

Biopsy Needle ◽

Phantom Model ◽

Likert Score ◽

Contrast Analysis ◽

Needle Visibility

Abstract Purpose For the safety and success of an ultrasound-guided percutaneous liver biopsy, needle visibility and needle tip identification are critical. The aim of this pilot study was to evaluate the influence of an innovative echogenic sheath placed over a standard biopsy needle on needle visibility in ultrasound imaging. Materials and methods Ultrasound videos of three sheaths with different coating characteristics (echogenicity) and one conventional liver biopsy needle were recorded at two angles (30° and 60°) and two depths (5 and 10 cm) in a human cadaver. The videos were blinded for needle type and presented to five independent radiologists who used Likert-scale scoring to rank each video for six characteristics on needle visibility. In addition, a phantom model was used to acquire standardized images for quantitative evaluation of the ultrasound visibility. Comparative statistical analysis consisted of a one-way ANOVA. Results The three prototype sheaths were ranked higher than the control needle at 60° with 5 cm depth, with an equal performance for the other conditions. The radiologists expressed more confidence in taking a biopsy with the echogenic sheaths than with the control needle, with 1 Likert score difference at 30°. Contrast analysis in the phantom model showed a statistically significant effect of a sheath (p = 0.004) on echogenic intensity. Conclusion This pilot study suggests that the use of an echogenic sheath may increase needle visibility, particularly for trajectories requiring steeper insertion angles. To investigate the superiority of the echogenic sheath over conventional needles, a clinical study is necessary.

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