Comparison of CT-guided and stereotaxic cranial diagnostic needle biopsies

1987 ◽  
Vol 67 (3) ◽  
pp. 341-348 ◽  
Author(s):  
Simon Goldstein ◽  
Mary Katherine Gumerlock ◽  
Edward A. Neuwelt
Keyword(s):  
Diagnostic Yield ◽  
Diagnostic Technique ◽  
Specific Procedure ◽  
Ct Guided ◽  
Content Type ◽  
Significant Difference ◽  
Intracranial Lesions ◽  
Scan Data ◽  
Time Required ◽  
The Brain

Needle biopsy of the brain utilizing computerized tomography (CT) scan data is an accepted diagnostic technique that has been performed both with and without the aid of stereotaxic frames. Experience with both techniques has resulted in a specific procedure for CT-guided free-hand biopsy which is performed in the CT suite under local anesthesia. Over the last 6 years the authors have performed 64 CT-guided free-hand biopsies and 13 stereotaxic biopsies with the Brown-Roberts-Wells system. Nonspecific gliosis, tumor, infection, radiation necrosis, or vascular malformation, were diagnosed in all but one biopsy, for a clinically accurate diagnostic yield of 92%. A comparison of diagnostic yield, morbidity, and mortality has shown no significant difference between the free-hand and the stereotaxic techniques. The time required for the procedures and their cost have been compared and have been found to be significantly less for the free-hand biopsy group. Thus, CT-guided free-hand biopsy may still represent the method of choice for histological diagnosis of many intracranial lesions.

Simplified and accurate CT-guided needle biopsy of central nervous system lesions

1982 ◽  
Vol 57 (3) ◽  
pp. 390-393 ◽  
Author(s):  
Andrew Yeates ◽  
Dieter R. Enzmann ◽  
Richard H. Britt ◽  
Gerald Silverberg
Keyword(s):  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Simple Method ◽  
Ct Guided ◽  
Content Type ◽  
High Diagnostic Yield ◽  
Relative Safety ◽  
Intracranial Lesions ◽  
Malignant Lesions ◽  
Fine Print

✓ Computerized tomography-directed needle biopsy of intracranial lesions, when correctly performed, offers a high diagnostic yield for both benign and malignant lesions, with relative safety. The simple method described stresses how careful positioning of the patient simplifies the mechanics of the procedure. This non-stereotaxic approach has wide application.

A comparison of computerized tomography-guided stereotactic and ultrasound-guided techniques for brain biopsy

1991 ◽  
Vol 75 (5) ◽  
pp. 763-765 ◽  
Author(s):  
Nicola Di Lorenzo ◽  
Vincenzo Esposito ◽  
Pierpaolo Lunardi ◽  
Roberto Delfini ◽  
Aldo Fortuna ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Ultrasound Guidance ◽  
Diagnostic Yield ◽  
Brain Biopsy ◽  
Brain Lesions ◽  
Absolute Accuracy ◽  
Ultrasound Guided ◽  
Ct Guided ◽  
Content Type ◽  
Stereotactic Technique

✓ Forty-one patients with brain lesions underwent brain biopsy using either a computerized tomography (CT)-guided stereotactic approach or an ultrasound-guided technique. The cases were selected according to location and size of the mass lesion. Lesions 15 mm or less in diameter and those in the posterior fossa were biopsied by a CT-guided stereotactic technique (18 patients). Supratentorial lesions with a diameter larger than 15 mm were approached using ultrasound guidance (23 patients). These criteria for procedure selection provided a diagnostic yield of 94% for the CT-guided procedures and 91% for those guided by ultrasound. Safety for the two procedures was similar. The ultrasound procedure was more rapid, simpler, and less costly to perform. It is concluded that, with the protocol described, CT-guided stereotactic procedures could be reserved for cases in which absolute accuracy is mandatory.

scholarly journals Computed tomography–guided percutaneous biopsy for vertebral neoplasms: a department's experience and hybrid biopsy technique to improve yield

2016 ◽  
Vol 41 (2) ◽  
pp. E17 ◽  
Author(s):  
Vasant Garg ◽  
Christos Kosmas ◽  
Enambir S. Josan ◽  
Sasan Partovi ◽  
Nicholas Bhojwani ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Core Biopsy ◽  
Diagnostic Yield ◽  
Vertebral Osteomyelitis ◽  
Radiology Department ◽  
Percutaneous Needle Biopsy ◽  
Ct Guided ◽  
Biopsy Technique ◽  
Significant Difference ◽  
Higher Sensitivity

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.

scholarly journals CT-guided percutaneous lung biopsy: Correlation between diagnostic yield, lung lesion size, and lobar distribution

2021 ◽  
Vol 5 ◽  
pp. 14
Author(s):  
Matthew Wilson ◽  
Adib R. Karam ◽  
Grayson L. Baird ◽  
Michael S. Furman ◽  
David J. Grand
Keyword(s):  
Retrospective Study ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Lesion Size ◽  
Lung Lesion ◽  
Target Size ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Significant Difference

Objectives: The aim of this retrospective study was to investigate the relationship between lung lesion lobar distribution, lesion size, and lung biopsy diagnostic yield. Material and Methods: This retrospective study was performed between January 1, 2013, and April 30, 2019, on CT-guided percutaneous transthoracic needle biopsies of 1522 lung lesions, median size 3.65 cm (range: 0.5– 15.5 cm). Lung lesions were localized as follows: upper lobes, right middle lobe and lingual, lower lobes superior segments, and lower lobes basal segments. Biopsies were classified as either diagnostic or non-diagnostic based on final cytology and/or pathology reports. Results were considered diagnostic if malignancy or a specific benign diagnosis was established, whereas atypical cells, non-specific benignity, or insufficient specimen were considered non-diagnostic. Results: The positive predictive value (PPV) of a diagnostic yield was 85%, regardless of lobar distribution. Because all PPVs were relatively high across locations (84–87%), we failed to find statistically significant difference in PPV between locations (P = 0.79). Furthermore, for every 1 cm increase in target size, the odds of a diagnostic yield increased by 1.42-fold or 42% above 85%. Although target size increased the diagnostic yield differently by location (between 1.4- and 1.8-fold across locations), these differences failed to be statistically significant, P = 0.55. Conclusion: Percutaneous transthoracic needle biopsy of lung lesions achieved high diagnostic yield (PPV: 84– 87%) across all lobes. A 42% odds increase in yield was achieved for every 1 cm increase in target size. However, this increase in size failed to be statistically significant between lobes.

How reading in single- and multiple-column types influence our cognitive load: an EEG study

2019 ◽  
Vol 37 (4) ◽  
pp. 593-606 ◽  
Author(s):  
Hosam Al-Samarraie ◽  
Atef Eldenfria ◽  
Fahed Zaqout ◽  
Melissa Lee Price
Keyword(s):  
Cognitive Load ◽  
Cognitive Processing ◽  
Content Type ◽  
Brain Signals ◽  
Significant Difference ◽  
Reading Text ◽  
The Impact ◽  
Electroencephalogram Eeg ◽  
Instructional Design Practices ◽  
The Brain

Purpose The impact of different screen-based typography styles on individuals’ cognitive processing of information has not been given much consideration in the literature, though such differences would imply different learning outcomes. This study aims to enrich the current understanding of the impact of reading in single- and multiple-column types on students’ cognitive processing. Design/methodology/approach An electroencephalogram (EEG) was used to record and analyze the brain signals of 27 students while reading from single- and multiple- column layouts. Findings The results showed a significant difference in students’ cognitive load when reading text from different types of columns. All students exerted less processing efforts when text was presented in two-column format, thus experiencing less cognitive load. Originality/value Using EEG, this study examined the neural consequences of reading in single- and multiple-column types on cognitive load during reading. The findings can be used to enrich the current instructional design practices on how different typographical formats facilitate learners’ cognitive performance.

Monitoring of 57Co-bleomycin delivery to brain metastases and their tumors of origin

1987 ◽  
Vol 67 (4) ◽  
pp. 506-510 ◽  
Author(s):  
Dov Front ◽  
Einat Even-Sapir ◽  
Galina Iosilevsky ◽  
Ora Israel ◽  
Alex Frenkel ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Lung Tumor ◽  
Single Photon ◽  
Photon Emission ◽  
Lung Tumors ◽  
Drug Uptake ◽  
Content Type ◽  
Significant Difference ◽  
The Difference ◽  
The Brain

✓ The concentration of cobalt-57 (57Co)-labeled bleomycin delivered to three brain metastases and to their tumors of origin in the lungs was measured using a single-photon emission computerized tomography technique. In two brain metastases the 57Co-bleomycin concentration measured at different times after the intravenous injection was significantly lower than that in the originating lung tumors (p < 0.01 and p < 0.001). In these two patients, the tumor cumulative concentration (TCC) of drug in the brain neoplasm compared to the lung carcinoma was 12.92 versus 15.12 and 10.30 versus 19.74 µg/cc/min. In the third patient there was no significant difference in drug concentration between the tumor in the brain and in the lung (TCC 16.02 vs. 15.09 µg/cc/min). There was a significant difference in the drug TCC between the three brain metastases: the difference between the lowest and highest concentrations was more than 50% (10.3 vs. 16.02 µg/cc/min). When the concentration in the tumor over time (CT(t)) of the 57Co-bleomycin was compared in the brain and lung tumors, a good correlation was found in each of the three cases (r = 0.93, 0.99, and 0.97). This suggests that the difference in drug uptake between brain metastases and their originating lung tumor is a quantitative rather than a qualitative phenomenon. The results show that the amount of drug to which brain metastases are exposed varies and may be very low in some tumors; therefore, effectiveness of drug delivery may play a role in the nonresponsiveness of brain metastases to treatment.

Full core technology versus notch sampling technology: evaluation of the diagnostic accuracy and the risk of a pneumothorax after transthoracic needle biopsy of suspicious lung lesions

2020 ◽  
pp. 028418512098157
Author(s):  
Christophe Schroeder ◽  
Laura I Loebelenz ◽  
Johannes T Heverhagen ◽  
Gerd Noeldge ◽  
Michael P Brönnimann ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Minimal Invasive ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Core Technology ◽  
Significant Difference ◽  
Full Core

Background Percutaneous needle biopsy of the lung (PCBL) under image guidance has become a safe and effective minimal invasive method to obtain a specimen related histological diagnosis of pulmonary lesions. Purpose To evaluate the diagnostic yield and safety of two different coaxial biopsy technologies: full core and notch sampling technology. The former allowing the removal of full punch cylinders and the latter using a cutting-edge mechanism. Material and Methods A retrospective analysis of 48 consecutive PCBL procedures has been carried out for this prognostic study, involving patients with a documented pulmonary nodule or mass lesion on previous computed tomography (CT) scans. The study population included 38 men and 10 women (mean age = 67 years). Of these 48 patients who underwent a procedure with a co-axial cutting system, 24 have been performed with notch sampling technology and 24 with full core technology. Results Out of the 48 biopsy procedures, 46 yielded specimens were adequate for histopathological evaluation, consistent with a technical success rate of 96%. The most common induced image-guided biopsy complication was a pneumothorax, occurring in 14 patients (35%). Seven patients with a pneumothorax were attributed to the full core technology and seven to the notch sampling technology (odds ratio = 1, 95% confidence interval = 0.28–3.51, P = 1). Conclusion In the setting of full core versus notch sampling percutaneous CT-guided coaxial needle biopsy of the lung, no significant difference in the diagnostic accuracy and the incidence of pneumothoraces could be shown, while both technologies have an excellent diagnostic performance.

An unusual fibro-osseous lesion of the brain

1984 ◽  
Vol 60 (6) ◽  
pp. 1308-1311 ◽  
Author(s):  
Cecil Jun ◽  
Bruce Burdick
Keyword(s):  
Unusual Case ◽  
Content Type ◽  
Osseous Lesion ◽  
Intracranial Lesions ◽  
The Brain ◽  
Fine Print

✓ An unusual case is described of a fibro-osseous lesion of the brain. Some other causes of densely calcified intracranial lesions are briefly discussed.

Quality improvement measures: effects on rectal cancer tissue biopsy process

2018 ◽  
Vol 31 (7) ◽  
pp. 775-783
Author(s):  
Mansoor Akhtar ◽  
Mohamed Boshnaq ◽  
Sathyan Nagendram
Keyword(s):  
Rectal Cancer ◽  
Quality Improvement ◽  
Diagnostic Yield ◽  
Secondary Outcome ◽  
Cancer Tissue ◽  
Process Mapping ◽  
Content Type ◽  
Cancer Diagnostic ◽  
Tissue Biopsy ◽  
Significant Difference

Purpose Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention. Multidisciplinary colorectal meetings indicate that there are patients who require multiple tissue biopsy episodes prior to histologically confirming rectal cancer. The purpose of this paper is to examine a quality improvement (QI) measure’s impact on tissue biopsy process diagnostic yield. Design/methodology/approach The authors performed the study in two phases (pre- and post-QI), between February 2012 and April 2014 in a district general hospital. The QI measures were derived from process mapping a rectal cancer diagnostic pathway. The primary outcome was to assess the tissue biopsy process diagnostic yield. The secondary outcome included total breaches for a 62-day target in the pre- and post-QI study phases. Findings There was no significant difference in demographics or referral mode in both study phases. There were 81 patients in the pre-QI phase compared to 38 in the post-QI phase, 68 per cent and 74 per cent were referred via the two-week wait urgent pathway, respectively. Diagnostic tissue biopsy process yield improved from 58.1 to 77.6 per cent after implementing the QI measure (p=0.02). The 62-day target breach was reduced from 14.8 to 3.5 per cent (p=0.42). Practical implications Simple QI measures can achieve significant improvements in rectal cancer diagnostic tissue biopsy process yields. A multidisciplinary approach, involving process mapping and cause and effect modelling, proved useful tools. Originality/value A process mapping exercise and QI measures resulted in significant improvements in diagnostic yield, reducing the episodes per patient before histological diagnosis was confirmed.

Multiple radiation-induced intracranial lesions after treatment for pituitary adenoma

1998 ◽  
Vol 88 (1) ◽  
pp. 111-115 ◽  
Author(s):  
Michael J. Alexander ◽  
Antonio A. F. DeSalles ◽  
Uwamie Tomiyasu
Keyword(s):  
Cavernous Malformation ◽  
External Beam Radiation ◽  
Mr Image ◽  
Beam Radiation ◽  
Content Type ◽  
Radiation Fields ◽  
Intracranial Lesions ◽  
Radiation Induced ◽  
The Right ◽  
The Brain

✓ This 53-year-old man presented with a syncopal episode 31 years after undergoing craniotomy and external-beam radiation for a pituitary macroadenoma. A gadolinium-enhanced magnetic resonance (MR) image of the brain demonstrated a 2.5-cm enhancing mass in the right caudate region that had not been seen on previous studies. A stereotactically guided biopsy procedure was performed to obtain specimens from the mass, which were consistent with ependymoma. The MR image also revealed two additional lesions that appeared to be within the radiation fields: a right temporal meningioma and a left frontal cavernous malformation. A review of the literature found three previous reports in which ependymomas presented after radiation therapy.

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