Clinical value of percutaneous ultrasound-guided core needle biopsy and endoscopic ultrasound-guided fine needle aspiration in pancreas mass / 中华超声影像学杂志

Objective@#To explore the safety and clinical value of percutaneous ultrasound-guided core needle biopsy(PUS-CNB) and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in pancreas mass.@*Methods@#Ultrasound-guided biopsy were performed in 109 cases who were difficult to diagnose to get specimens from the highly suspicious parts of the lesions by avoiding vessels. PUS-CNB were performed in 82 cases, EUS-FNA in 19 cases and both in 8 cases. The site and size of lesions were recorded preopeartion. Specimens with clear pathological diagnosis were considered as satisfactory materials. Specimens that were impossible to puncture due to the existence of high risk factors in the process of puncture were considered as unsuccessful biopsy. All patients were followed up after biopsy and complications were recorded.@*Results@#The satisfaction rate and success rate of PUS-CNB were 98.89% and 100%, the diagnostic accuracy and false negative rate were 97.78% and 2.22%. The satisfaction rate and success rate of EUS-FNA were 96.15% and 96.30%, the diagnostic accuracy and false negative rate were 80.77% and 23.81%. There were no serious complications such as pancreatic fistula, hemorrhage and needle transfer at the needle site after puncture.@*Conclusions@#Both PUS-CNB and EUS-FNA are safe and effective methods for the diagnosis of benign and malignant pancreatic lesions and have high clinical values. Reasonable selection of EUS-FNA and PUS-CNB can safely and reliably identify and diffentiate the benign and malignant pancreatic lesions.

Clinical value of percutaneous ultrasound‐guided core needle biopsy and endoscopic ultrasound‐guided fine needle aspiration in pancreas mass / 中华超声影像学杂志

Objective To explore the safety and clinical value of percutaneous ultrasound‐guided core needle biopsy( PUS‐CNB) and endoscopic ultrasound‐guided fine needle aspiration( EUS‐FNA ) in pancreas mass . Methods Ultrasound‐guided biopsy were performed in 109 cases who were difficult to diagnose to get specimens from the highly suspicious parts of the lesions by avoiding vessels . PUS‐CNB were performed in 82 cases , EUS‐FNA in 19 cases and both in 8 cases . T he site and size of lesions were recorded preopeartion . Specimens with clear pathological diagnosis were considered as satisfactory materials . Specimens that were impossible to puncture due to the existence of high risk factors in the process of puncture were considered as unsuccessful biopsy . All patients were followed up after biopsy and complications were recorded . Results The satisfaction rate and success rate of PUS‐CNB were 98 .89% and 100% ,the diagnostic accuracy and false negative rate were 97 .78% and 2 .22% . T he satisfaction rate and success rate of EUS‐FNA were 96 .15% and 96 .30% ,the diagnostic accuracy and false negative rate were 80 .77% and 23 .81% . T here were no serious complications such as pancreatic fistula ,hemorrhage and needle transfer at the needle site after puncture . Conclusions Both PUS‐CNB and EUS‐FNA are safe and effective methods for the diagnosis of benign and malignant pancreatic lesions and have high clinical values . Reasonable selection of EUS‐FNA and PUS‐CNB can safely and reliably identify and diffentiate the benign and malignant pancreatic lesions .

Clinical value of ultrasound-guided core needle biopsy for detecting axillary lymph node metastasis in breast cancer / 军事医学

Objective To analyze the clinical value of ultrasound and ultrasound-guided core needle biopsy ( UNB) in the evaluation of axillary lymph node metastasis for breast cancer.Methods A total of 454 cases of breast cancer treated between June 2008 and August 2014 at our hospital were retrospectively analyzed.UNB was performed on patients with abnormal ultrasonic diagnosis of axillary lymph nodes.Among them, 354 cases underwent neoadjuvant chemotherapy or endocrine therapy while 100 cases underwent surgery after UNB.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false negative rate of ultrasound and UNB were evaluated.Results Among the 454 patients with abnormal axillary lymph nodes of ultrasound imaging, the metastasis rate with UNB was 70.9%,while the negative rate was 29.1%.Among the 100 cases who underwent surgery after UNB, the metastasis rate was 25% while the ultrasound imaging lymph node longitudinal and transversal ( L/T)≤1.5,the lymph node size>1 cm,and the metastasis rate was 92.3%(12/13).UNB showed that sensitivity was 64.1%, specificity 100%, accuracy 86%, positive predictive value 100%, negative predictive value 81.3%,and false negative rate was 18.7%.The results of UNB seemed consistent with those of postoperative pathological diagnosis, the Kappa value being 0.685.Based on 2 and 3 needles, the above mentioned 6 indices were 50% and 77.8%, 100% and 100%, 77.8% and 92.5%, 100% and 100%, 71.4% and 89.7%,and 28.6%and 10.3%, respectively.The Kappa value of UNB based on 3 needles was higher than on 2 needles (0.822 vs 0.526 ) .Conclusion Ultrasound is a valuable tool for detecting axillary lymph node metastasis in breast cancer.UNB can accurately determine the axillary lymph node metastasis status.UNB based on 3 needles shows a higher accuracy than on 2 needles.

Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique / Passo-a-passo da core biópsia de mama guiada por ultrassonografia: revisão e técnica

Ultrasound-guided core-needle biopsy has high sensitivity in the diagnosis of breast cancer. The present study is aimed at detailing the main steps of such procedure, including indications, advantages, limitations, follow-up and description of the technique, besides presenting a checklist including the critical steps required for an appropriate practice of the technique. In the recent years, an increasing number of patients have required breast biopsy, indicating the necessity of a proportional increase in the number of skilled professionals to carry out the procedures and histological diagnoses. A multidisciplinary approach involving the tripod clinical practice-radiology-pathology is responsible for the highest rate of accuracy of the technique and must always be adopted.

A core biópsia de mama guiada por ultrassonografia possui alta sensibilidade no diagnóstico das doenças neoplásicas mamárias. O presente estudo tem por objetivo detalhar as principais etapas deste procedimento, incluindo indicações, vantagens, limitações, seguimento e técnica, e elaborar um checklist contendo os passos indispensáveis para uma boa prática da técnica. O número de pacientes que necessitam de biópsia mamária tem crescido nos últimos anos, indicando ser necessário haver um crescimento proporcional de profissionais habilitados que possam realizar os procedimentos diagnósticos histológicos. A abordagem multidisciplinar envolvendo o triângulo clínica-radiologia-patologia é responsável pelo mais alto índice de acurácia da técnica, devendo sempre ser utilizada.

Endoscopic Ultrasound-Fine Needle Aspiration versus Core Biopsy for the Diagnosis of Subepithelial Tumors

Subepithelial lesions are frequently encountered and remain a diagnostic challenge. Imaging of subepithelial lesions using endoscopic ultrasound (EUS) can be helpful in narrowing the differential diagnosis of the lesion; however, definitive diagnosis typically requires tissue. Many methods for acquiring tissue exist including EUS-guided fine needle aspiration, Trucut biopsy, and fine needle biopsy. Obtaining adequate tissue is important for cytologic and histologic exams including immunohistochemical stains, thus a great deal of effort has been made to increase tissue acquisition in order to improve diagnostic yield in subepithelial lesions.

The Usefulness of Immunohistochemical Staining for Diagnosis of Thyroid Nodule in Preoperative Ultrasonography-Guided Core Needle Biopsy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The diagnosis of thyroid nodular diseases is critical for clinical management. Because of the histological similarity of follicular patterned thyroid lesions, the differential diagnosis is often difficult to determine, even with permanent sections. For this reason, we assessed the preoperative diagnostic usefulness of immunohistochemical staining for the four potential markers of malignant thyroid nodule, beta-galactosil binding lectin (Galectin-3), Hector Battifora Mesothelial cell (HBME-1), cytokeratin-19 (CK-19) and high molecular weight cytokeratin (HMW-CK) in tissues obtained by ultrasound-guided core needle biopsy. SUBJECTS AND METHOD: The immunohistochemical expression of Galectin-3, HBME-1, CK-19 and HMW-CK were evaluated in 43 preoperative thyroid lesions obtained to assess their potential as markers in the diagnosis and classification of thyroid malignancy. We compared the preoperative expression of the four markers with the results of postoperative permanent pathology. RESULTS: The expression patterns and positive rates of four markers were the variables in 4 thyroid lesions; however, all markers were strong in malignant thyroid nodules, especially in papillary carcinoma. There were no significant differences in the expression rates of the four markers between follicular carcinoma and follicular adenoma. The sensitivity of HBME-1 for thyroid malignancy was the highest (86%) among the four markers, but the sensitivity of combinational expression using two markers, especially Galectin-3 or HBME-1 (95%), HBME-1 or HMW-CK (90%), was higher than that of the expression using one marker for thyroid malignancy. CONCLUSION: The four markers were reliable markers for papillary carcinoma. In preoperative differential diagnosis of thyroid nodule, we suggest that the combinational expression using two makers is more useful than a single marker expression.

Is US-guided 14-gauge Core Needle Biopsy Valid for Papillary Neoplasm of the Breast? / 한국유방암학회지

PURPOSE: We wanted to determine the underestimation rate of ultrasound (US)-guided 14-gauge core needle biopsy for papillary neoplasms that were treated with subsequent surgical excision or vacuum-assisted biopsy (VAB) and we also wanted to evaluate the sonographic findings of papillary neoplasms. METHODS: A retrospective review of the US-guided core needle biopsies of 984 consecutive lesions from January 2004 to April 2006 revealed 29 (3%) papillary neoplasms. Twenty five lesions were further excised by surgery (n=16) or VAB (n=9). The remaining 4 lesions were not further excised and they were excluded from this study. We evaluated the concordance between results of core needle biopsy and the final pathologic results. We reevaluate the sonographic findings of the papillary neoplasms included in our study. RESULTS: The pathologic results of core needle biopsy were benign in 21 and atypical in four. Of the 21 benign papillomas, none were revealed as carcinoma after further excision. Just one lesion showed focal atypical ductal hyperplasia (ADH) after VAB. Three intraductal papillomas with ADH underwent surgical excision (n=3) or VAB (n=1), and they were proved to be the same pathologic entities with (n=1) or without (n=3) lobular neoplasia. The sonographic findings were as follows: four intraductal masses, four intracystic masses, four solid masses with peripheral anechoic rims, five extraductal masses adjacent to dilated ducts, six pure solid masses, and two mixed masses. CONCLUSION: US-guide 14-gauge core needle biopsy for papillary neoplasm showed no underestimation after surgical excision or VAB in our study, and the procedure proved to be reliable for the assessment of papillary neoplasm if the imaging and pathologic findings were concordant. Papillary neoplasms showed variable sonographic findings.

Usefulness of Ultrasound Guided Core Needle Biopsy of Breast Lesions with Automated Gun / 한국유방암학회지

It is necessary to confirm disease pathologically even though there are several methods of diagnosis for breast abnormality. Ultrasound guided core needle biopsy (UGCNB) of breast lesions with automated gun is widely accepted as a simple and accurate procedure for avoiding open biopsy. From January 1996 to February 1998, 121 breast lesions of 117 women detected with mammogram, ultrasound, physical examination or any combination were selected. UGCNB was performed in all 121 cases with 7.5 MHz transducer and Manan Pro-mag 2.2 automated biopsy gun (2.2 cm excursion). After local anesthesia, 5-6 cores were obtained through 2mm skin incision site. Lesions categorized as probably benign to highly suspicious were included as indications for core biopsy. 67.5% of the 117 patients were in age thirties and forties. The results of the biopsy were benign in 65 lesions and malignant in 56. 15 patients showing benign results which were contrary to clinical findings and pathologic results, underwent open biopsy. Four patients who had previously been diagnosed as being benign, were found to be malignant (false-negative 3.3%). Primary results of four cases of false negative were intraductal papilloma, severe inflammatory change, atypical ductal hyperplasia, and insufficient sampling, respectively. In case of insufficient sampling resulted from small gauge needle (18G), correct diagnosis was possible in all lesions with large needle (14G). Also excisional biopsy was required in women having intraductal papilloma, severe inflammation and atypical ductal hyperplasia which were difficult to differenciate from malignancy. The UGCNB is excellent biopsy method for multiple breast lesions. The method has demonstrated a 96.7% sensitivity specificity 100%, and positive predictive value (PPV) of 46.3%. We also conclude that UGCNB is proved To be an useful alternative to surgical biopsy on simpler procedure with no adverse cosmetic results.