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1.
Pediatr Surg Int ; 40(1): 98, 2024 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-38581446

RESUMO

INTRODUCTION: Historically, neuroblastoma has been diagnosed by surgical open biopsy (SB). In recent decades, core needle biopsy (CNB) has replaced surgical biopsy due to its safe and adequate method of obtaining tissue diagnosis. AIM: Our study aimed to assess the effectiveness of CNB in obtaining tissue diagnosis for neuroblastoma and evaluate its safety profile in terms of post-operative complications, in comparison to SB. METHODS: A retrospective cohort study, including all patients younger than 18 years who were diagnosed with neuroblastoma from 2012 until 2022 in a single tertiary medical center. Patients' demographics, tumor size and location, pathological results, and clinical outcomes were collected. RESULTS: 79 patients were included in our study: 35 biopsies were obtained using image-guided CNB and 44 using SB. Patients' and tumor characteristics including age, gender, tumor volume, and stage were similar in both groups. The biopsy adequacy rate in the CNB group was 91% and 3 patients in this group underwent repeated biopsy. The safety profile in the CNB group was similar to the SB group. CONCLUSIONS: CNB is a safe method and should be considered the first choice for obtaining tissue diagnosis when feasible due to its high adequacy in terms of tumor histopathological features.


Assuntos
Biópsia Guiada por Imagem , Neuroblastoma , Humanos , Criança , Biópsia com Agulha de Grande Calibre/métodos , Estudos Retrospectivos , Biópsia Guiada por Imagem/métodos , Neuroblastoma/diagnóstico , Neuroblastoma/cirurgia , Neuroblastoma/patologia , Complicações Pós-Operatórias
2.
Ann Diagn Pathol ; 70: 152288, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38452457

RESUMO

CONTEXT: Recent clinical trials indicate that HER2-targeted therapy may benefit HER2-low breast cancer patients including HER2 score 1+ or 2+ and no gene amplification. Concordance between pathologists and between core biopsy and surgical excision in establishing HER2-low status was evaluated. DESIGN: 57 patients with HER2 negative breast cancer (IHC 0, 1+, or 2+, no gene amplification) by core biopsy were included. Core biopsy and representative tumor from corresponding surgical excision was immunostained for HER2. Original HER2 IHC scores were interpreted using 2018 guidelines. Three pathologists independently interpreted again under 2023 guidelines. Kappa statistic evaluated agreement of HER2 IHC scores. RESULTS: Applying 2023 guidelines, HER2 IHC scores were concordant among study pathologists in 46 of 57 (81 %) core biopsy and 50 of 57 (88 %) surgical resections. Kappa statistics were 0.78 and 0.85 (substantial agreement), for inter-pathologist agreement of core biopsy and surgical resections under 2023 guidelines; 0.55 (moderate agreement) for agreement between first interpretation by 2018 guidelines and second interpretation by 2023 guidelines; and 0.13 (slight agreement) for agreement in HER2 consensus scores between outside core and surgical resection and 0.49 (moderate agreement) for inside core and surgical resection. Low HER2 expression was found in 28 of 57 (49 %) core biopsy and in 25 of 57 (44 %) surgical excisions. CONCLUSIONS: Interobserver agreement among study pathologists was good in core biopsy and surgical excisions, applying updated 2023 guidelines. Intratumoral heterogeneity in protein expression and preanalytical factors may result in variable identification of HER2-low status in core biopsy and surgical excision specimens.


Assuntos
Neoplasias da Mama , Imuno-Histoquímica , Patologistas , Receptor ErbB-2 , Humanos , Neoplasias da Mama/patologia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/diagnóstico , Receptor ErbB-2/metabolismo , Feminino , Imuno-Histoquímica/métodos , Biomarcadores Tumorais/metabolismo , Pessoa de Meia-Idade , Biópsia com Agulha de Grande Calibre/métodos , Variações Dependentes do Observador , Adulto , Idoso
3.
Front Endocrinol (Lausanne) ; 15: 1309005, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38356956

RESUMO

Purpose: To assess and compare the effectiveness of ultrasound-guided core needle biopsy (CNB) in comparison to repeat fine-needle aspiration(rFNA) for thyroid nodules that yield inconclusive results following the initial fine-needle aspiration (FNA). Methods: A cohort of 471 patients who received an inconclusive cytological diagnosis following the initial FNA were included in this study. These patients subsequently underwent either CNB (n=242) or rFNA (n=229). The inconclusive FNA results encompassed categories I, III, and IV of The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC), as well as the ultrasound images indicating malignancy despite FNA results falling under TBSRTC category II. This study assessed the sampling satisfaction rate, diagnostic efficacy, and complications associated with CNB compared to rFNA. Additionally, the impact of repeat puncture time and nodule size on diagnostic efficacy was analyzed. Results: Following repeat punctures, the satisfaction rate of the CNB sampling was found to be significantly higher than that of rFNA (83.9% vs 66.8%). The diagnostic rate in the CNB group was significantly greater compared to that of the rFNA group (70.7% vs 35.8%). In patients with nodule maximum diameters ranging from 5 mm to 20 mm, the diagnostic accuracy was significantly higher in the CNB group compared to that in the rFNA group. In patients with intervals less than 90 days, between 90 days and one year, the diagnostic rate in the CNB group was found to be higher compared to that in the rFNA group. In CNB, not immediately adjacent to the capsule was a risk factor for nodular puncture bleeding (37.0% vs 22.7%.). Conclusion: CNB demonstrated higher rates of satisfaction and diagnosis compared to the rFNA. The diagnostic effectiveness of CNB was not influenced by the time interval or the size of the thyroid nodule. Therefore, in cases where the initial FNA diagnosis of thyroid nodules is inconclusive, CNB should be considered as a viable option for re-puncture.


Assuntos
Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia , Biópsia por Agulha Fina/métodos , Biópsia com Agulha de Grande Calibre/métodos , Estudos Retrospectivos
4.
J Korean Med Sci ; 39(7): e63, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38412610

RESUMO

BACKGROUND: This study assessed the comparative effectiveness of sextant and extended 12-core systematic biopsy within combined biopsy for the detection of prostate cancer. METHODS: Patients who underwent combined biopsy targeting lesions with a Prostate Imaging Reporting and Data System (PI-RADS) score of 3-5 were assessed. Two specialists performed all combined cognitive biopsies. Both specialists performed target biopsies with five or more cores. One performed sextant systematic biopsies, and the other performed extended 12-core systematic biopsies. A total of 550 patients were analyzed. RESULTS: Cases requiring systematic biopsy in combined biopsy exhibited a significant association with age ≥ 65 years (odds ratio [OR], 2.32; 95% confidence interval [CI], 1.25-4.32; P = 0.008), PI-RADS score (OR, 2.32; 95% CI, 1.25-4.32; P = 0.008), and the number of systematic biopsy cores (OR, 3.69; 95% CI, 2.11-6.44; P < 0.001). In patients with an index lesion of PI-RADS 4, an extended 12-core systematic biopsy was required (target-negative/systematic-positive or a greater Gleason score in the systematic biopsy than in the targeted biopsy) (P < 0.001). CONCLUSION: During combined biopsy for prostate cancer in patients with PI-RADS 3 or 5, sextant systematic biopsy should be recommended over extended 12-core systematic biopsy when an effective targeted biopsy is performed.


Assuntos
Neoplasias da Próstata , Masculino , Humanos , Idoso , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Próstata/patologia , Imageamento por Ressonância Magnética/métodos , Biópsia Guiada por Imagem/métodos , Biópsia com Agulha de Grande Calibre/métodos , Gradação de Tumores , Biópsia
5.
Breast Cancer ; 31(3): 529-535, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38351366

RESUMO

This rapid communication highlights the correlations between digital pathology-whole slide imaging (WSI) and radiomics-magnetic resonance imaging (MRI) features in triple-negative breast cancer (TNBC) patients. The research collected 12 patients who had both core needle biopsy and MRI performed to evaluate pathologic complete response (pCR). The results showed that higher collagenous values in pathology data were correlated with more homogeneity, whereas higher tumor expression values in pathology data correlated with less homogeneity in the appearance of tumors on MRI by size zone non-uniformity normalized (SZNN). Higher myxoid values in pathology data are correlated with less similarity of gray-level non-uniformity (GLN) in tumor regions on MRIs, while higher immune values in WSIs correlated with the more joint distribution of smaller-size zones by small area low gray-level emphasis (SALGE) in the tumor regions on MRIs. Pathologic complete response (pCR) was associated with collagen, tumor, and myxoid expression in WSI and GLN and SZNN in radiomic features. The correlations of WSI and radiomic features may further our understanding of the TNBC tumoral microenvironment (TME) and could be used in the future to better tailor the use of neoadjuvant chemotherapy (NAC). This communication will focus on the post-NAC MRI features correlated with pCR and their association with WSI features from core needle biopsies.


Assuntos
Imageamento por Ressonância Magnética , Neoplasias de Mama Triplo Negativas , Humanos , Neoplasias de Mama Triplo Negativas/diagnóstico por imagem , Neoplasias de Mama Triplo Negativas/patologia , Feminino , Imageamento por Ressonância Magnética/métodos , Biópsia com Agulha de Grande Calibre/métodos , Pessoa de Meia-Idade , Adulto , Idoso , Microambiente Tumoral , Terapia Neoadjuvante/métodos , Resposta Patológica Completa , Radiômica
6.
Appl Spectrosc ; 78(5): 477-485, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38373402

RESUMO

Core needle biopsy is a part of the histopathological process, which is required for cancerous tissue examination. The most common method to guide the needle inside of the body is ultrasound screening, which in greater part is also the only guidance method. Ultrasound screening requires user experience. Furthermore, patient involuntary movements such as breathing might introduce artifacts and blur the screen. Optically enhanced core needle biopsy probe could potentially aid interventional radiologists during this procedure, providing real-time information on tissue properties close to the needle tip, while it is advancing inside of the body. In this study, we used diffuse optical spectroscopy in a custom-made core needle probe for real-time tissue classification. Our aim was to provide initial characteristics of the smart needle probe in the differentiation of tissues and validate the basic purpose of the probe of informing about breaking into a desired organ. We collected optical spectra from rat blood, fat, heart, kidney, liver, lungs, and muscle tissues. Gathered data were analyzed for feature extraction and evaluation of two machine learning-based classifiers: support vector machine and k-nearest neighbors. Their performances on training data were compared using subject-independent k-fold cross-validation. The best classifier model was chosen and its feasibility for real-time automated tissue recognition and classification was then evaluated. The final model reached nearly 80% of correct real-time classification of rat organs when using the needle probe during real-time classification.


Assuntos
Máquina de Vetores de Suporte , Animais , Ratos , Agulhas , Fígado/patologia , Fígado/diagnóstico por imagem , Rim/patologia , Rim/química , Pulmão/patologia , Pulmão/diagnóstico por imagem , Análise Espectral/métodos , Análise Espectral/instrumentação , Biópsia com Agulha de Grande Calibre/instrumentação , Biópsia com Agulha de Grande Calibre/métodos , Masculino , Aprendizado de Máquina
7.
Fr J Urol ; 34(2): 102572, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38330830

RESUMO

INTRODUCTION: In the era of targeted prostate biopsies, the necessity of performing randomized biopsies systematically is under question. Our objective is to evaluate the rate of clinically significant prostate cancer (csPCa), defined by presence of ISUP≥2 prostate cancer, diagnosed only on randomized cores in case of a PIRADS≥4 target lesion on MRI. The secondary objective is to evaluate whether specific variables can predict the presence of undetected csPCa in targeted biopsies. METHODS: Retrospective data on targeted biopsies performed from 2015 to 2021 in our hospital were collected. Procedures were performed with MRI/Transrectal US fusion Trinity platform from Koelis®. All the MRI images were reviewed and the targets were classified using the PIRADS V2.1 classification. Inclusion criteria comprised procedures featuring at least one PIRADS≥4 targeted lesion were included. All procedures consisted 1-4 targeted cores and 12-core systematic biopsy. RESULTS: We included 358 patients. In 44 patients (12.3%) csPCa was exclusively detected in randomized cores. Among these cases, only 12 patients (27.2%) showed no cancer on the targeted biopsies. Merely 4 patients (9.09%) lacked csPCa-positive cores on the same side as the index lesion. Factors such as PSA, PSA density, prostate volume, and digital rectal examination showed no significant association with the presence of csPCa exclusively on randomized cores. Likewise, the size, location, and PIRADS classification of the target demonstrated no significant impact. CONCLUSION: Our findings indicate that in 12.3% of cases, targeted biopsies alone are insufficient for detecting the presence of csPCa. As such, systematic biopsies remain necessary to date.


Assuntos
Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Próstata/patologia , Próstata/diagnóstico por imagem , Antígeno Prostático Específico/sangue , Biópsia com Agulha de Grande Calibre/métodos
8.
Endocrinol Metab (Seoul) ; 39(2): 300-309, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38171211

RESUMO

BACKGRUOUND: We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB). METHODS: This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy. RESULTS: Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system. CONCLUSION: Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery.


Assuntos
Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico por imagem , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Biópsia com Agulha de Grande Calibre/métodos , Adulto , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Idoso , Ultrassonografia
9.
Kurume Med J ; 69(3.4): 265-269, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38233178

RESUMO

Complex breast cysts (CBC) are characterized by a high (up to 31.0%) oncological potential and the need for a biopsy. In some clinical situations, navigating a biopsy using mammography (MG), ultrasound (US), endoscopy, and magnetic resonance imaging (MRI) may be difficult. The first case of stereotaxic core-needle biopsy (sCNB) under pneumocystography (PCG) guide is presented.


Assuntos
Cisto Mamário , Humanos , Feminino , Biópsia com Agulha de Grande Calibre/métodos , Cisto Mamário/patologia , Cisto Mamário/diagnóstico por imagem , Técnicas Estereotáxicas , Mamografia , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade
10.
Eur J Surg Oncol ; 50(1): 107298, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38086314

RESUMO

BACKGROUND: Histologic subtype of cancer guides treatment sequencing and the extent of surgery for retroperitoneal tumours (RPTs) but concerns persist regarding percutaneous core needle biopsy (CNB). OBJECTIVE: Endpoints were the incidence of early complications, needle tract seeding (NTS) after CNB, diagnostic accuracy. METHODS: Between 2015 and 2022, data from patients with RPT who underwent a CNB and who operated on at Institut Curie were collected. We retrospectively reviewed the medical records and microscopic analysis of both CNB and surgical specimens to evaluate the diagnostic accuracy of CNB (quantified using positive and negative predictive values, PPV/NPV). RESULTS: 313 patients underwent CNB. In 10/326 (3 %) procedures, minor complications were observed. One of 212 (0.47 %) resected RPSs exhibited a local recurrence compatible with NTS. Microscopic analysis of CNB specimens allowed the classification of tumours between groups of cancers and benign/intermediate mesenchymal tumours in 307/313 (98 %) patients. Among the 204 patients with retroperitoneal sarcoma, the overall concordance between CNB and final pathology following resection was 178/204 (87.2 %). The respective PPVs of solitary fibrous tumour, dedifferentiated liposarcoma, leiomyosarcoma and well-differentiated liposarcoma were 100 %, 98 %, 97 % and 68 %, respectively. The diagnosis of a high-grade (G 2-3) sarcoma resulted in a high specificity (97 %) and PPV (98 %) but low sensitivity (76 %). CONCLUSIONS: CNB allowed the classification of RPT in the vast majority of patients with a low morbidity rate. Concordance with final diagnosis was high for sarcomas with the exception of well-differentiated liposarcoma. As a result, CNB results should be integrated with imaging/radiomics by multidisciplinary tumour boards.


Assuntos
Lipossarcoma , Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias Retroperitoneais/cirurgia , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Sarcoma/cirurgia , Lipossarcoma/patologia , Neoplasias de Tecidos Moles/patologia
11.
IEEE Trans Biomed Eng ; 71(3): 1084-1091, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37874731

RESUMO

OBJECTIVE: To compute a dense prostate cancer risk map for the individual patient post-biopsy from magnetic resonance imaging (MRI) and to provide a more reliable evaluation of its fitness in prostate regions that were not identified as suspicious for cancer by a human-reader in pre- and intra-biopsy imaging analysis. METHODS: Low-level pre-biopsy MRI biomarkers from targeted and non-targeted biopsy locations were extracted and statistically tested for representativeness against biomarkers from non-biopsied prostate regions. A probabilistic machine learning classifier was optimized to map biomarkers to their core-level pathology, followed by extrapolation of pathology scores to non-biopsied prostate regions. Goodness-of-fit was assessed at targeted and non-targeted biopsy locations for the post-biopsy individual patient. RESULTS: Our experiments showed high predictability of imaging biomarkers in differentiating histopathology scores in thousands of non-targeted core-biopsy locations (ROC-AUCs: 0.85-0.88), but also high variability between patients (Median ROC-AUC [IQR]: 0.81-0.89 [0.29-0.40]). CONCLUSION: The sparseness of prostate biopsy data makes the validation of a whole gland risk mapping a non-trivial task. Previous studies i) focused on targeted-biopsy locations although biopsy-specimens drawn from systematically scattered locations across the prostate constitute a more representative sample to non-biopsied regions, and ii) estimated prediction-power across predicted instances (e.g., biopsy specimens) with no patient distinction, which may lead to unreliable estimation of model fitness to the individual patient due to variation between patients in instance count, imaging characteristics, and pathologies. SIGNIFICANCE: This study proposes a personalized whole-gland prostate cancer risk mapping post-biopsy to allow clinicians to better stage and personalize focal therapy treatment plans.


Assuntos
Neoplasias da Próstata , Masculino , Humanos , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Biomarcadores
12.
Gastrointest Endosc ; 99(6): 931-937, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38141686

RESUMO

BACKGROUND AND AIMS: EUS-guided liver biopsy (EUS-LB) sampling is being increasingly used. We performed a prospective randomized trial to compare specimen adequacy of a 19-gauge fine-needle biopsy (FNB) needle with a 22-gauge FNB Franseen tip needle for EUS-LB sampling. METHODS: Forty-two consecutive patients referred for EUS-LB sampling were prospectively randomized to a 19-gauge or 22-gauge FNB needle. When the specimen with the 22-gauge needle was macroscopically inadequate, an additional pass with the 19-gauge needle was done. Bilobar EUS-LB sampling was performed with heparinized wet suction using 1 pass and 3 actuations per lobe. Descriptive statistics were computed for all variables. RESULTS: Biopsy sampling was performed for abnormal liver enzymes in 95.5% of patients (57% women; average age, 51 years). Five patients undergoing sampling with the 22-gauge FNB needle had macroscopically inadequate specimens and required additional biopsy sampling with the 19-gauge FNB needle. Mean preprocessing length of the longest tissue core was 21.5 ± 6.3 mm with a 19-gauge FNB needle compared with 9.4 ± 5.5 mm with the 22-gauge FNB needle (P < .001). Postprocessing specimens were significantly longer with 19-gauge than with 22-gauge FNB needles (17.4 mm vs 6.8, P < .001). There were no adverse events, and postprocedure pain and discomfort was similar in both groups (14% for 19-gauge vs 10% for 22-gauge, P = .99). CONCLUSIONS: Liver core biopsy sampling using the 19-gauge FNB needle is superior to the 22-gauge FNB needle in terms of length of longest core and aggregate specimen length. Considerably more fragmentation of the 22-gauge cores occurs during tissue processing. No increased postprocedure pain or AEs were found with the 19-gauge needle. A 19-gauge FNB needle is preferred to the 22-gauge FNB needle for EUS-LB. (Clinical trial registration number: NCT04806607.).


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Fígado , Agulhas , Humanos , Feminino , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Pessoa de Meia-Idade , Masculino , Estudos Prospectivos , Adulto , Fígado/patologia , Idoso , Neoplasias Hepáticas/patologia , Biópsia com Agulha de Grande Calibre/instrumentação , Biópsia com Agulha de Grande Calibre/métodos , Hepatopatias/patologia
13.
Pol J Pathol ; 74(3): 203-210, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37955539

RESUMO

Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease and the basis for the treatment planning. The concordance rate between CNB and surgical excision specimen in determination of histological grade (HG) varies widely across literature, ranging from 59-91%. The aim of our study was to investigate the level of concordance between CNB and surgical excision specimen for the determination of HG for breast cancer patients. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. The concordance level between core needle biopsy and surgical resection specimen for overall histologic grading was 73%: for tubule formation - 71%, for nuclear pleomorphism - 91%, for the mitotic index - 59%. Our study shows that our institution's histologic grading of CNBs and surgical excisions shows a fairly good correlation and is useful for the planning of treatment.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Mama/diagnóstico , Gradação de Tumores , Mama/patologia
14.
Medicine (Baltimore) ; 102(46): e34951, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37986279

RESUMO

Splenic diseases may be caused by infections and can be either malignant, such as lymphoma and lung cancer, or benign, such as hemangioma. In some cases, diagnostic uncertainty of imaging persists, and image-guided splenic needle biopsy is a useful diagnostic tool to avoid the disadvantages of incorrect diagnosis, including performing unnecessary splenectomy or not giving the necessary treatment. Splenic biopsies can be divided into ultrasound-guided, computed tomography (CT)-guided fine-needle aspiration, or core needle biopsy (CNB). However, few studies have focused exclusively on complications associated with CT-guided CNB of the spleen. Therefore, we assessed bleeding, the most common complication of CT-guided CNB of the spleen, and evaluated factors associated with the bleeding. Using the biopsy database maintained at the institution, all patients who underwent CT-guided CNB of the spleen between May 2012 and September 2022 were identified retrospectively. The 18 identified patients were divided into post-biopsy bleeding and non-bleeding groups for analysis. In total, 17 patients (94.4%) could be diagnosed accurately with CT-guided CNB. Bleeding complications occurred in 7 cases of CT-guided CNB; of these, 2 patients with Common Terminology Criteria for Adverse Events grade 4 disease required transcatheter arterial embolization. The bleeding group was characterized by diffuse spleen tumors in all cases, with significantly more diffuse spleen tumors than the non-bleeding group. CT-guided CNB is a useful option for neoplastic lesions of the spleen that are difficult to diagnose using imaging alone. However, consideration should be given to post-biopsy bleeding in patients with diffuse splenic tumors.


Assuntos
Neoplasias Esplênicas , Humanos , Estudos Retrospectivos , Neoplasias Esplênicas/diagnóstico por imagem , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/métodos , Tomografia Computadorizada por Raios X/métodos , Hemorragia/etiologia , Biópsia com Agulha de Grande Calibre/efeitos adversos , Biópsia com Agulha de Grande Calibre/métodos
15.
BMC Urol ; 23(1): 189, 2023 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-37980518

RESUMO

BACKGROUND: Small renal mass (SRM) biopsy remains under-utilized due to stigma. Meanwhile, the alarmingly high benign findings in resected kidney masses highlight the need for improved preoperative diagnosis and patient selection. METHODS: The purpose of this study is to review the success rate of SRM biopsy and to evaluate its impact on patient management. A total of 168 percutaneous image-guided core needle biopsies (CNBs) of SRMs were retrieved at a tertiary academic center between 2015 and 2019. Subsequent treatment choices, side effects and outcomes were retrospectively reviewed. RESULTS: The diagnostic rate of CNB was 86.9%. Benign neoplasms accounted for a significant portion (14.3%) of SRM. Renal cell carcinomas (RCCs) were the most common diagnoses (69.6%) as expected. In biopsy-resection correlation, the positive predictive value of CNB was 100%. Tumor typing and subtyping by CNB were highly accurate, 100% and 98.3% respectively. Nuclear grading for clear cell RCC was accurate in 83.8% cases. The CNB results had significant impact on treatment. Most patients with RCCs underwent either resection (54.1%) or ablation (33.9%), in contrast to observation in benign neoplasms (90.5%). Most importantly, the benign resection rate (3.2%) in this series was much lower than the national average. CONCLUSION: CNB provided accurate diagnoses for the majority of SRMs and revealed benign diagnoses in a subset of clinically suspicious lesions. Employment of CNB in suspicious SRM may help avoid overtreatment for benign lesions.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Biópsia com Agulha de Grande Calibre/métodos , Estudos Retrospectivos , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/patologia , Biópsia Guiada por Imagem/métodos , Neoplasias Renais/cirurgia , Neoplasias Renais/patologia
16.
Endokrynol Pol ; 74(6)2023.
Artigo em Inglês | MEDLINE | ID: mdl-37994586

RESUMO

Fine needle aspiration biopsy (FNAB) guided by ultrasonography is routinely used to identify thyroid nodules prior to surgery. Although FNAB has great diagnostic accuracy and safety, it is limited by its relatively low diagnostic accuracy in follicular lesions, such as non-diagnostic or atypia of unclear significance (AUS)/follicular lesion of uncertain significance (FLUS). Additional diagnostic tests are required to overcome these challenges in evaluating thyroid nodules. Thyroid nodules can now be diagnosed with spring-activated single- or double-action needles following the introduction of core needle biopsy (CNB). CNB has the ability to address the limitations of FNAB by obtaining a sizeable tissue sample with more details on the histological structure supporting the capsule and fewer non-diagnostic effects brought on by the absence of follicular cells. Compared to repeated FNAB, CNB has been demonstrated to produce fewer ambiguous results, such as non-diagnostic or AUS/FLUS results. The Korean Endocrine Pathology Thyroid CNB Working Group issued its first set of guidelines for "Pathology Reporting of Thyroid Core Needle Biopsy" in 2015. In 2017, the Korean Society of Thyroid Radiology (KSThR) published "Core Needle Biopsy of Thyroid: 2016 Consensus Statement and Recommendations from the Korean Society of Thyroid Radiology". The main objectives of thyroid CNB are to detect individuals with thyroid illness who require surgery and to obtain a significant number of thyroid lesions with low morbidity.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Glândula Tireoide/diagnóstico , Estudos Retrospectivos
17.
Cancer Imaging ; 23(1): 93, 2023 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-37789413

RESUMO

PURPOSE: To compare the genomic testing based on specimens obtained from percutaneous core-needle biopsy (CNB) before and immediately after coaxial microwave ablation (MWA) in solid non-small cell lung cancer (NSCLC), and to investigate the diagnostic performance of CNB immediately after coaxial MWA in solid NSCLC. METHODS: Coaxial MWA and CNB were performed for NSCLC patients, with a power of 30 or 40 watts (W) in MWA between the pre- and post-ablation CNB, followed by continuous ablation after the second CNB on demand. The paired specimens derived from the same patient were compared for pathological diagnosis and genomic testing. DNA/RNA extracted from the paired specimens were also compared. RESULTS: A total of 33 NSCLC patients with solid lesions were included. There were two patients (6.1%) without atypical cells and three patients (9.1%) who had the technical failure of genomic testing in post-ablation CNB. The concordance rate of pathological diagnosis between the twice CNB was 93.9% (kappa = 0.852), while that of genomic testing was 90.9% (kappa = 0.891). For the comparisons of DNA/RNA extracted from pre- and post-ablation CNB in 30 patients, no significant difference was found when the MWA between twice CNB has a power of 30 or 40 W and ablation time within five minutes (P = 0.174). CONCLUSIONS: If the pre-ablation CNB presented with a high risk of pneumothorax or hemorrhage, the post-ablation CNB could be performed to achieve accurate pathological diagnosis and genomic testing and the maximum effect of ablation, which might allow for the diagnosis of genomic testing in 90.9% of solid NSCLC.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirurgia , Micro-Ondas/uso terapêutico , Biópsia com Agulha de Grande Calibre/métodos , Testes Genéticos , DNA , RNA , Estudos Retrospectivos
18.
Eur J Radiol ; 168: 111114, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37778147

RESUMO

OBJECTIVE: To evaluate the effectiveness of contrast-enhanced ultrasound (CEUS) guided core needle biopsy (CNB) in diagnosing soft tissue tumors (STTs) and to identify the conventional ultrasonography (US) features of STTs that are recommended for CEUS-guided CNB. MATERIALS AND METHODS: A retrospective study was conducted on 123 patients with surgically confirmed STTs. Before surgeries, all subjects underwent CNB under the guidance of US or CEUS. The histopathological results of surgical specimens were considered as the gold standards. A successful biopsy diagnosis was defined as the pathological subtypes obtained by biopsy consistent with the gold standard. The diagnostic yields were compared between the US and CEUS groups, and the diagnostic yields based on various conventional US features of STTs were also compared between the two groups. RESULTS: Sixty-seven cases underwent US-guided CNB and fifty-six cases underwent CEUS-guided CNB. The clinical, biopsy, and conventional US characteristics revealed no significant difference between the two groups. The diagnostic yield of the CEUS group was statistically higher than that of the US group (p = 0.011). In the CEUS group, more STTs with the anechoic areas were identified after CEUS examination (p = 0.031). Furthermore, the diagnostic yields based on the conventional US features of STTs, including deep fascia layer (p = 0.010), a maximum diameter ≥5 cm (p = 0.037), rough margin (p = 0.016), heterogeneous echotexture (p = 0.017), and absence of anechoic area (p = 0.013), were significantly different between the two groups, and the CEUS group exhibited higher diagnostic yields. CONCLUSION: CEUS-guided CNB was found to be an efficient method for STTs diagnosis. It is particularly recommended for STTs with the following conventional US features, including location in deep fascia layer, a maximum diameter ≥5 cm, rough margin, heterogeneous echotexture, or absence of anechoic area.


Assuntos
Biópsia Guiada por Imagem , Neoplasias de Tecidos Moles , Humanos , Biópsia com Agulha de Grande Calibre/métodos , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Meios de Contraste , Ultrassonografia de Intervenção
19.
Br J Radiol ; 96(1151): 20230528, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37750833

RESUMO

OBJECTIVE: To evaluate the use of vacuum-assisted excisions (VAEs) in the management of B3 lesions within a single UK breast care centre. Assessment was made by determining the upgrade rates of the different B3 lesions at VAE. METHODS AND MATERIALS: The study population comprised all patients who had a B3 result and subsequently underwent a VAE between November 2016 and October 2021. Patients with ipsilateral cancers were excluded. Retrospective biopsy and VAE results were reviewed. Upgrade rates and confidence intervals were calculated, and statistical significance was tested to determine any differences between upgrade rates of the B3 groups. RESULTS: 480 VAEs for B3 lesions were performed, with 10 excluded. Overall upgrade rate was 5%. 87.5% of upgrades were to non-invasive disease. Atypical intraductal epithelial proliferation (AIDEP) had a 15% upgrade rate, significantly different to lobular neoplasia (2%), papilloma without atypia (0%), and radial scar without atypia (0%). 10% of B3 lesions with atypia were upgraded, significantly different to 0% of B3 lesions without atypia. B3 lesions diagnosed by vacuum-assisted biopsy (VAB) had a significantly higher upgrade rate of 8% compared with 2% for lesions diagnosed by core biopsy (CBX), although this result was impacted by high numbers of AIDEP diagnosed by VAB. CONCLUSIONS: The results suggest using VAE for the management of AIDEP is appropriate. However, they also indicate that by performing VAEs of papillomas and radial scars without atypia, overtreatment may be occurring. ADVANCES IN KNOWLEDGE: This study adds to the ongoing discussion on the best treatment of B3 breast lesions.


Assuntos
Neoplasias da Mama , Carcinoma Intraductal não Infiltrante , Papiloma , Humanos , Feminino , Estudos Retrospectivos , Neoplasias da Mama/patologia , Mama/cirurgia , Mama/patologia , Biópsia com Agulha de Grande Calibre/métodos , Mamografia , Biópsia Guiada por Imagem , Carcinoma Intraductal não Infiltrante/patologia
20.
Hematol Oncol ; 41(5): 817-827, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37415412

RESUMO

The reliability and safety of front-line ultrasonography guided core needle biopsy (UG-CNB) performed with specific uniform approach have never been evaluated in a large series of patients with lymphadenopathies suspected of lymphoma. The aim of this study was to assess the overall accuracy of UG-CNB in the lymph node histological diagnosis, using a standard reference based on pathologist consensus, molecular biology, and/or surgery. We retrospectively checked the findings concerning the application of lymph node UG-CNB from four Italian clinical units that routinely utilized 16-gauge diameter modified Menghini needle under power-Doppler ultrasonographic guidance. A data schedule was sent to all centers to investigate the information regarding techniques, results, and complications of lymph node UG-CNB in untreated patients over a 12-year period. Overall, 1000 (superficial target, n = 750; deep-seated target, n = 250) biopsies have been evaluated in 1000 patients; other 48 biopsies (4.5%), screened in the same period, were excluded because inadequate for a confident histological diagnosis. Most patients were suffering from lymphomas (aggressive B-cell non-Hodgkin lymphoma [aBc-NHL], 309 cases; indolent B-cell [iBc]-NHL, 279 cases; Hodgkin lymphoma [HL], 212 cases; and nodal peripheral T-cell [NPTC]-NHL, 30 cases) and 100 cases from metastatic carcinoma; 70 patients had non-malignant disorders. The majority of CNB results met at least one criterion of the composite reference standard. The overall accuracy of the micro-histological sampling was 97% (95% confidence interval: 95%-98%) for the series. The sensitivity of UG-CNB for the detection of aBc-NHL was 100%, for iBc-NHL 95%, for HL 93%, and for NPTC-NHL 90%, with an overall false negative rate of 3.3%. The complication rate was low (6% for all complications); no patient suffered from biopsy-related complications of grade >2 according to the Common Terminology Criteria for Adverse Events. Lymph node UG-CNB as mini-invasive diagnostic procedure is effective with minimal risk for the patient.


Assuntos
Doença de Hodgkin , Linfadenopatia , Linfoma , Humanos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Linfoma/diagnóstico por imagem , Linfoma/patologia , Linfadenopatia/diagnóstico , Ultrassonografia , Doença de Hodgkin/diagnóstico por imagem , Biópsia por Agulha/métodos , Itália , Biópsia com Agulha de Grande Calibre/métodos
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