Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive value.

Abstract

Three hundred percutaneous biopsies were performed in 267 consecutive patients by means of a coaxial technique with use of 18- and 20-gauge automated cutting biopsy devices and 22-gauge aspiration needles. Thoracic, hepatic, renal, pancreatic, adrenal, splenic, retroperitoneal, and musculoskeletal soft-tissue masses were sampled. For malignant masses (229 cases), the sensitivity was 79% for cytologic analysis, 88% for histologic analysis, and 92% for both combined. In benign disease (71 cases), a correct specific diagnosis was made with cytologic analysis in 38%, with histologic analysis in 97%, and with both combined in 97%. The negative predictive value was 60% for cytologic analysis, 72% for histologic analysis, and 80% for both combined. When only cancer-negative results in which a specific benign diagnosis was made were considered, the negative predictive value was 100% for cytologic analysis, 97% for histologic analysis, and 97% for both combined. The positive predictive value was 100% for both cytologic and histologic analysis. Bleeding complications occurred in 3% of biopsies, including in one patient who died.

Computed tomography-guided cutting needle biopsy of pulmonary lesions

“…Despite the popularity of automated systems for obtaining tissue samples in several solid organs 3 , their use in lung lesions has been very restricted in our country. Previous studies have demonstrated the advantage of the diagnostic yield of the cutting needle biopsy, with acceptable incidence of complications, when compared to fine-needle aspiration biopsy.…”

“…On the other hand, for non-carcinomatous lesions, the accuracy of the method is inferior, reported in the range of 46% to 68% [2][3][4] . Difficulties in diagnosing benign lesions and the unavailability of a cytopathologist in the radiology department have mandated the need to perform biopsies that could supply material for histological analysis.…”

“…Difficulties in diagnosing benign lesions and the unavailability of a cytopathologist in the radiology department have mandated the need to perform biopsies that could supply material for histological analysis. Several successful experiences with core biopsy using automated cutting needles in several solid organs 3 encouraged the use of the same method in lung lesions [5][6][7][8] . Previous studies reported sensitivity, specificity, and complication rate of this procedure [5][6][7][8] .…”

Needle Gauge and Cytological Yield in CT-Guided Lung Biopsy

“…We reason that this lower number of passes would likely decrease procedure time without compromising the yield or the safety of the procedure based on our results, and, therefore, the use of larger gauge needle is supported. There are multiple studies that have shown core biopsies to be superior to fine-needle aspiration biopsies [2,10,11]. The exact reason for the superior rate of yield with core biopsy has not been determined.…”

“…Percutaneous CTguided needle lung biopsy has a high diagnostic accuracy and is a well-established procedure for obtaining a cytological evaluation of pulmonary nodules [2,3]. Factors affecting diagnostic accuracy are lesion size, immediate on-site sample evaluation by a cytologist, and technique, including type of biopsy device [4][5][6][7][8][9][10]. A previous study has shown core biopsies to be a more accurate method of tissue sampling without increasing risk of complications when compared to fine-needle aspiration [11].…”