Curved Needles in CT-Guided Fine Needle Biopsies of Abdominal and Retroperitoneal Small Lesions

Filippo, Massimo De; Saba, Luca; Rossi, Enrica; Nizzoli, Rita; Tiseo, Marcello; Pedrazzi, Giuseppe; Brunese, Luca; Rotondò, Antonio; Rossi, Cristina

doi:10.1007/s00270-015-1107-2

Cited by 17 publications

(4 citation statements)

References 20 publications

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“…Seven out of 8 (87.5%) trajectories were out of plane (≥ 5° in the z -axis), thus countering one of the CT limitations in guiding needle insertion when outside the axial plane identified by Wood et al [ 12 ]. Indeed, visualisation of the full length of needles outside the axial plane is difficult on CT imaging as several axial planes must be reviewed to visualise the full length of the needle, or volume with multiplanar reconstruction must be performed thus losing the nearly real-time ability of the CT and increasing irradiation [ 13 ]. Slight angulation can be managed with an associated gantry angulation when possible.…”

Section: Discussionmentioning

confidence: 99%

Robotic assistance for percutaneous needle insertion in the kidney: preclinical proof on a swine animal model

et al. 2022

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Background We evaluated the accuracy, safety, and feasibility of a computed tomography (CT)-guided robotic assistance system for percutaneous needle placement in the kidney. Methods Fiducials surgically implanted into the kidneys of two pigs were used as targets for subsequent robotically-assisted needle insertion. Robotically-assisted needle insertions and CT acquisitions were coordinated using respiratory monitoring. An initial scan volume data set was used for needle insertion planning defining skin entry and target point. Then, needle insertion was performed according to robot positioning. The accuracy of needle placement was evaluated upon the distance between the needle tip and the predefined target on a post needle insertion scan. A delayed contrast-enhanced CT scan was acquired to assess safety. Results Eight needle trajectories were performed with a median procedural time measured from turning on the robotic system to post needle insertion CT scan of 21 min (interquartile range 15.5−26.5 min). Blind review of needle placement accuracy was 2.3 ± 1.2 mm (mean ± standard deviation) in lateral deviation, 0.7 ± 1.7 mm in depth deviation, and 2.8 ± 1.3 mm in three-dimensional Euclidian deviation. All needles were inserted on the first attempt, which determined 100% feasibility, without needle readjustment. The angulation and length of the trajectory did not impact on the needle placement accuracy. Two minor procedure-related complications were encountered: 2 subcapsular haematomas (13 × 6 mm and 35 × 6 mm) in the same animal. Conclusions Robotically-assisted needle insertion was shown feasible, safe and accurate in a swine kidney model. Further larger studies are needed.

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Section: Discussionmentioning

confidence: 99%

Robotic assistance for percutaneous needle insertion in the kidney: preclinical proof on a swine animal model

et al. 2022

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“…3). 28,29 The first step of this technique involves advancement of a 13-to 18-gauge guide needle close to the intended target. The tip of a 22-gauge needle (Chiba, Cook Medical, Bloomington, IN) is then gently curved with hemostat forceps based on the curvature needed to bridge the gap between the guide needle tip and the target.…”

Section: Curved Needle Tipmentioning

confidence: 99%

“…De Filippo et al found that the curved needle technique facilitated cytological diagnosis in 25 of 25 cases with no complications. 29 A novel, commercially available, steerable needle is also available (Morrison; AprioMed AB, Uppsala, Sweden). This device is a 21-gauge, 17-cm-long needle with a Menghini double bevel tip.…”

Section: Curved Needle Tipmentioning

confidence: 99%

Methods to Obtain Percutaneous Access to Difficult-to-Reach Masses and Collections in the Abdomen and Pelvis

Low

Huang

2018

Dig Dis Interv

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Image-guided biopsy and drainage of collections in the abdomen and pelvis are frequently performed in interventional radiology practices. Many options are available to facilitate access to masses and collections in challenging locations. This review focuses on the technique and efficacy associated with the various options available, including out-of-plane access, patient positioning, needle techniques (i.e., blunt and curved needle tip), adjunctive use of electromagnetic tracking devices, organ displacement, and transorgan access.

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“…In order to avoid these complications and obtain pathological con rmation, more and more oncologists adopt and approve percutaneous image-guided biopsy technique that is routinely used for differential diagnosis, clinical staging, biological analysis and therapeutic strategy. Although CT-guided biopsy has high spatial resolution and visibility to achieve relatively satisfactory samples, the presence of nonportability, ionizing radiation, and high operating cost and time obviously hinder its clinical application (10,11). Interestingly, US-FNAC is obtaining a important impact owing to real-time precise visualization and tracking, especially when there are vital structures adjacent to target lesion, including abdominal aorta, inferior vena cava, and gastrointestinal tract (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

US-Guided Fine-Needle Aspiration Cytology of Para-Aortic Lymph Nods Metastasis in Uterine Cervical Cancer: Accuracy and Impact on Clinical Decision Making

Liu¹,

Liu²,

Guo³

et al. 2021

Preprint

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Objective: To investigate whether ultrasound guided fine-needle aspiration cytology(US-FNAC) is an effective technique for diagnosing para-aortic lymph nodes(PALNs) metastasis in uterine cervical cancer and access the impact on clinical therapeutic decision. Methods: We retrospectively reviewed the clinical data of 92 patients with PALN enlargement in cervical cancer between 2010 and 2018. The US-FNAC cytological results were classified by the same experienced cellular pathologists. The diagnostic indicators were calculated according to biopsy , imaging and clinical follow-up results. Univariate and multivariate analysis was used to analyze the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated. Results: The results of cytological diagnosis by US-FNAC were categorized as malignancy(n=62;67.4%), suspicious malignancy(n=11;12.0%), undetermined(n=5;5.4%), benign (n=10;10.9%), and inadequacy(n=4;4.3%). The satisfactory biopsy samples were obtained from 95.7% of PLANs (88/92). The sensitivity, specificity, PPV, NPV and accuracy of FNAC in distinguishing benign from malignant were 90.1%(95%CI:0.809-0.953), 100%(95%CI:0.561-1), 100%(95%CI:0.938-1), 46.7%(95%CI:0.223-0.726) and 90.9%(95%CI:0.848-0.970) respectively. Univariate analysis indicated that experience of the puncture physicians(radiologists) was significant differences between the correct diagnosis group and wrong diagnosis group (P<0.05); the experience was confirmed as independent predictor of diagnostic accuracy by multivariate analysis (p=0.031,OR=0.077,95%CI:0.354-0.919). All patients tolerated the US-FNAC procedure well and only nine patients presented slight abdominal discomfort. Through US-FNAC technique, the therapeutic methods of 74 patients (80.4%) were subjected to affect.Conclusions: US-FNAC is a relatively safe and effective examination technique for enlarged para-aortic lymph nodes, which can be considered as a routine examination before treatment of cervical cancer to guide clinical decision-making.

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Curved Needles in CT-Guided Fine Needle Biopsies of Abdominal and Retroperitoneal Small Lesions

Abstract: Using curved needles, there is an effective improvement in CT-guided FNA of abdominal and retroperitoneal small lesions which are difficult to achieve with conventional CT or ultrasound guide.

Cited by 17 publications

References 20 publications

Robotic assistance for percutaneous needle insertion in the kidney: preclinical proof on a swine animal model

Robotic assistance for percutaneous needle insertion in the kidney: preclinical proof on a swine animal model

Methods to Obtain Percutaneous Access to Difficult-to-Reach Masses and Collections in the Abdomen and Pelvis

US-Guided Fine-Needle Aspiration Cytology of Para-Aortic Lymph Nods Metastasis in Uterine Cervical Cancer: Accuracy and Impact on Clinical Decision Making

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