Utility of rapid on-site evaluation for needle core biopsies and fine-needle aspiration cytology done for diagnosis of mass lesions of the liver

Walia, Saloni; Aron, Manju; Hu, Eugenia; Chopra, Shefali

doi:10.1016/j.jasc.2018.08.001

Cited by 13 publications

(11 citation statements)

References 30 publications

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“…3 FNAC and TIC provide the choice of rapid on-site examination (ROSE), which may be helpful for guidance of clinical practice at the time of sampling. 4 The FNAC is considered to be safer and less costly than CNB because it is usually performed with a 22-gauge fine needle. The drawbacks of the cytological examination include the lack of detailed diagnostic information regarding the tissue architectures.…”

Section: Introductionmentioning

confidence: 99%

Direct comparison of biopsy techniques for hepatic malignancies

et al. 2021

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Background/Aims: The core needle biopsy (CNB), fine needle aspiration cytology (FNAC) and touch imprint cytology (TIC) are commonly used tools for the diagnosis of hepatic malignancies. However, little is known about the benefits and criteria for selecting appropriate technique among them in clinical practice. We aimed to compare the sensitivity of ultrasound-guided CNB, FNAC, TIC as well as combinations for the diagnosis of hepatic malignancies, and to determine the factors associated with better sensitivity in each technique.Methods: From January 2018 to December 2019, a total of 634 consecutive patients who received ultrasound-guided liver biopsies at the National Taiwan University Hospital was collected, of whom 235 with confirmed malignant hepatic lesions receiving CNB, FNAC and TIC simultaneously were enrolled for analysis. The clinical and procedural data were compared.Results: The sensitivity of CNB, FNAC and TIC for the diagnosis of malignant hepatic lesions were 93.6%, 71.9%, and 85.1%, respectively. Add-on use of FNAC or TIC to CNB provided additional sensitivity of 2.1% and 0.4%, respectively. FNAC exhibited a significantly higher diagnostic rate in the metastatic cancers (P=0.011), hyperechoic lesions on ultrasound (P=0.028), and those with depth less than 4.5 cm from the site of needle insertion (P=0.036).Conclusions: The sensitivity of CNB is superior to that of FNAC and TIC for the diagnosis of hepatic malignancies. Nevertheless, for shallow (depth <4.5 cm) and hyperechoic lesions not typical for primary liver cancers, FNAC alone provides excellent sensitivity.

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Section: Introductionmentioning

confidence: 99%

Direct comparison of biopsy techniques for hepatic malignancies

et al. 2021

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“…In addition, rapid onsite pathology evaluation performed on cell aspirates derived from fine needle aspiration or on cytology imprint for core biopsies has been reported to have a positive predictive value for malignancy. However, this approach requires appropriate expertise and resources, results are generally qualitative not quantitative, and it is limited by the inability to distinguish hepatocellular adenomas, regenerative nodules, and well-differentiated HCC 17 , 26 , 27 . Alternative imaging techniques may allow for better target localization, including avoiding areas of necrosis and/or fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Variability in biopsy quality informs translational research applications in hepatocellular carcinoma

Weinfurtner

Cho

Ackerman

et al. 2021

Sci Rep

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In the era of precision medicine, biopsies are playing an increasingly central role in cancer research and treatment paradigms; however, patient outcomes and analyses of biopsy quality, as well as impact on downstream clinical and research applications, remain underreported. Herein, we report biopsy safety and quality outcomes for percutaneous core biopsies of hepatocellular carcinoma (HCC) performed as part of a prospective clinical trial. Patients with a clinical diagnosis of HCC were enrolled in a prospective cohort study for the genetic, proteomic, and metabolomic profiling of HCC at two academic medical centers from April 2016 to July 2020. Under image guidance, 18G core biopsies were obtained using coaxial technique at the time of locoregional therapy. The primary outcome was biopsy quality, defined as tumor fraction in the core biopsy. 56 HCC lesions from 50 patients underwent 60 biopsy events with a median of 8 core biopsies per procedure (interquartile range, IQR, 7–10). Malignancy was identified in 45/56 (80.4%, 4 without pathology) biopsy events, including HCC (40/56, 71.4%) and cholangiocarcinoma (CCA) or combined HCC-CCA (5/56, 8.9%). Biopsy quality was highly variable with a median of 40% tumor in each biopsy core (IQR 10–75). Only 43/56 (76.8%) and 23/56 (41.1%) samples met quality thresholds for genomic or metabolomic/proteomic profiling, respectively, requiring expansion of the clinical trial. Overall and major complication rates were 5/60 (8.3%) and 3/60 (5.0%), respectively. Despite uniform biopsy protocol, biopsy quality varied widely with up to 59% of samples to be inadequate for intended purpose. This finding has important consequences for clinical trial design and highlights the need for quality control prior to applications in which the presence of benign cell types may substantially alter findings.

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“…En las lesiones viscerales, la ACAF se puede realizar con guía ecográfica, ecografía endoscópica o tomográfica computarizada, como alternativa a otros métodos diagnósticos más invasivos [40,41]. Específicamente, la ACAF de hígado bajo guía radiológica ha sido considerada un procedimiento complejo, con factores que pueden interferir con su resultado, como la naturaleza y ubicación de la lesión, y la experiencia y habilidad del operador [42]. ROSE ha mostrado aumentar hasta un 90% el rendimiento diagnóstico de las ACAF radiológicamente guiadas, y reducir la necesidad de repetir el procedimiento hasta en un 30%.…”

Section: Hígadounclassified

Evaluación de nódulos tiroideos con interpretación citológica rápida en el sitio (ROSE)

Tapia-Vela¹,

Restrepo-Giraldo²

2021

Med. Lab.

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La aspiración con aguja fina (ACAF) es una técnica ampliamente utilizada por su alta seguridad y fácil uso. Sin embargo, al usarse en conjunto con la evaluación rápida de la muestra en el sitio de la toma (ROSE, del inglés, Rapid On-Site Evaluation), disminuyen los tiempos necesarios para la evaluación y el diagnóstico, mejora la calidad de la muestra, disminuye el número de punciones por procedimiento y limita la necesidad de repetir la prueba, lo que hace que el uso combinado de ambas técnicas sea de gran utilidad y cada vez más solicitado en los servicios de imágenes diagnósticas y patología. ROSE, además, permite una clasificación adecuada del material recolectado para cultivos, estudios de citometría de flujo y pruebas moleculares. Particularmente, en los pacientes con nódulos tiroideos, la realización de ROSE durante el procedimiento de evaluación ecográfica y punción, puede garantizar que la muestra extraída sea suficiente y adecuada para el diagnóstico, y, así mismo, permite evaluar la necesidad de estudios complementariosde manera inmediata, brindando un diagnóstico rápido y preciso, disminuyendo los costos relacionados con la repetición del procedimiento y la morbilidad asociada a complicaciones por punciones múltiples.

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Utility of rapid on-site evaluation for needle core biopsies and fine-needle aspiration cytology done for diagnosis of mass lesions of the liver

Cited by 13 publications

References 30 publications

Direct comparison of biopsy techniques for hepatic malignancies

Direct comparison of biopsy techniques for hepatic malignancies

Variability in biopsy quality informs translational research applications in hepatocellular carcinoma

Evaluación de nódulos tiroideos con interpretación citológica rápida en el sitio (ROSE)

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