Automated Biopsy Gun Research Articles

Automated large-core needle biopsy of surgically removed breast lesions: comparison of samples obtained with 14-, 16-, and 18-gauge needles.

To determine the needle size that would consistently enable the pathologist to correctly diagnose tissue core biopsy specimens. Fifty-seven surgically removed mass lesions of the breast were sampled with a short-throw automated biopsy gun and an 18-gauge needle first, followed by a 16- and a 14-gauge needle. Samples were evaluated independently by three pathologists, and findings were compared with the final diagnosis made at surgical excision biopsy. The sensitivity for the diagnosis of all 26 malignant lesions was 100%, 92%, and 65% for biopsy samples obtained with 14-, 16-, and 18-gauge needles, respectively. Specificity for malignancy was 100% for all three needle sizes. All of the benign diseases were correctly diagnosed in samples obtained with all three size needles except for two samples that did not survive processing. Biopsy samples obtained with a 14-gauge needle provide the most accurate diagnosis, which correlates with the diagnosis made with the surgical excision biopsy technique.

Yield and Complications in Ultrasound-Guided Biopsy of Abdominal Lesions

A series of 458 consecutive ultrasound-guided biopsies in 347 patients − 171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs) − was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%) − 3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p<0.001), while the complication rate remains the same.

CT-guided renal biopsy using a coaxial technique and an automated biopsy gun.

In this series, 35 patients with medical renal disease had renal biopsy guided by computed tomography (CT). Biopsies were done by a coaxial technique in which a thin-walled 16 guage guide needle is placed adjacent to the renal capsule of the lower pole. An 18 gauge cutting needle is then placed through the guide needle, and multiple samples (2 to 4) are obtained with an automated biopsy gun. Adequacy of specimens is immediately checked in the CT suite using low-power microscopy. Specimens are submitted for light, electron, and immunofluorescence microscopy. Adequate tissue for definite diagnosis was obtained in 33 of the 35 patients (94%). One patient had moderate postbiopsy bleeding and was hospitalized. There were no major complications. CT-guided renal biopsy using a coaxial technique and automated biopsy gun is an effective means of obtaining tissue for the evaluation of medical renal disease.

Yield and Complications in Ultrasound-Guided Biopsy of Abdominal Lesions

A series of 458 consecutive ultrasound-guided biopsies in 347 patients-171 fine-needle aspiration biopsies (FNABs) and 287 1.2-mm needle core biopsies (NCBs)-was analysed for diagnostic yield and complications. FNAB was diagnostic in 107 (64%) biopsies of focal lesions with a correct diagnosis of malignancy in 86 of 125 biopsies (69%) and of benign disease in 21 of 43 (49%) biopsies. NCB provided a correct diagnosis in 189 (90%) biopsies for focal lesions, divided into 140 of 159 (88%) correct for malignancy and 49 of 50 (98%) correct for benign disease. In 69 patients examined with both FNAB and NCB on the same occasion, 50 out of 55 malignant lesions were identified with NCB but only 34 with FNAB; all 14 benign lesions were correctly identified by NCB, and only 6 by FNAB. Clinical relevant bleeding complications occurred in 6 out of 458 biopsies (1.3%)-3 out of 287 following NCB (1.0%) and 3 out of 171 following FNAB (1.8%). It is concluded that if FNAB is replaced with 1.2-mm NCB using an automated biopsy gun, the diagnostic accuracy for abdominal lesions increases significantly (p < 0.001), while the complication rate remains the same.

Ultrasound Guided Biopsy of Malignant Focal Liver Lesions: Comparison of Automated Gun Biopsy with Fine Needle Aspiration Biopsy

Ultrasound Guided Biopsy of Malignant Focal Liver Lesions: Comparison of Automated Gun Biopsy with Fine Needle Aspiration Biopsy

Percutaneous Automated Gun Biopsy of Localized Pulmonary Lesions

Percutaneous Automated Gun Biopsy of Localized Pulmonary Lesions

Transrectal ultrasound guided biopsies in 266 patients

The objective of this study is to evaluate the diagnostic utility of digital rectal examination (DRE), prostate specific antigen (PSA) and transrectal ultrasonography (TRUS) for prostate cancer. On 266 patients ultrasonography guided transrectal biopsies were performed using the automatic biopsy gun fitted with an 18 gauge biopsy needle. There was no major complication. Cancers were found in 52 patients (19.5%), and 16 of them were not identified by echography. Among 67 hypoechoic areas detected by echography, 36 (53.7%) were found to be cancer. The positive predictive value of DRE was 52.1% and that of PSA and TRUS were 24.4% and 53.7%, especially the rate increased to 93.7% by combining of these three techniques. These results suggest that the use of DRE, PSA in conjunction with TRUS enhances early detection of prostate cancer.

Image-guided automated core biopsies of the breast, chest, abdomen, and pelvis.

A prospective study was undertaken to measure success at obtaining definitive histologic diagnoses with an automated biopsy gun technique. Image-directed biopsies (n = 300) were performed between November 1989 and June 1992 in 288 patients. Biopsy specimens of breast lesions were obtained with ultrasound (US) or stereotaxic mammographic guidance. Biopsy samples of lesions from other areas of the body were obtained with computed tomographic or US guidance. Clinical follow-up and surgical biopsy were used to measure diagnostic accuracy. Overall, a definitive diagnosis was reached with core specimen biopsy techniques in 95.3% of cases (286 of 300), and all 286 definitive findings were accurate. Because of the success of this approach, the adoption of an automated biopsy gun technique that includes histologic examination of a core specimen should be considered by all radiologists who perform image-guided biopsies.

Systematic Sextant Biopsies in 651 Patients Referred for Prostate Evaluation

In 651 patients mapping of the prostate by 6 systematic sextant ultrasonography guided biopsies was performed without major side effects using the automatic biopsy gun. The histological findings provided data on patients with normal and abnormal prostates as determined by digital rectal examination. Only 3 of 72 nonurological patients (4%) with normal prostate specific antigen (PSA) levels of less than 4 ng./ml. had prostate cancer.Of the 259 patients with a firm prostate on digital rectal examination 105 (41%) had prostate cancer. For those with a PSA level of less than 4 and 4 ng./ml. or greater the positive biopsy rates were 13% and 58%, respectively. Of 56 patients with clinical stage B or C disease and a PSA level of less than 4 ng./ml. 20 (36%) had prostate cancer, compared to 155 of 187 (83%) with a PSA level of 4 ng./ml. or greater. Transrectal ultrasound was not helpful in screening for prostate cancer due to the low positive biopsy rate for hypoechoic lesions. However, among 175 patients with clinical stage B or C disease transrectal ultrasound identified 157 (90%) with prostate cancer.

Automated Gun Biopsy of the Prostate under Ultrasound Guide

Automated Gun Biopsy of the Prostate under Ultrasound Guide

Usefulness of Automated Biopsy Guns in Image-guided Biopsy

Usefulness of Automated Biopsy Guns in Image-guided Biopsy

THE TECHNIQUE OF PERCUTANEOUS ULTRASOUND GUIDED FINE‐NEEDLE ASPIRATION BIOPSY AND AUTOMATED MICROCORE BIOPSY IN SMALL ANIMAL GASTROINTESTINAL DISEASES

Techniques for obtaining percutaneous ultrasound‐guided biopsies of the gastrointestinal tract were evaluated. The efficacity of ultrasonographic detection of gastrointestinal lesions has been established in veterinary medicine. Percutaneous ultrasound‐guided aspiration biopsies were performed using either a 22 gauge spinal needle or a 20 gauge Westcott needle. The microcore automated biopsy was performed using a 18 gauge Tru‐cut‐like needle, assisted by an automated biopsy gun. These techniques are rapid, and easily performed. The techniques were considered safe for the patient, no complications such as hemorrhage, peritonitis or abscessation have occured in our study. These techniques are of particular interest when lesion can not be biopsied successfully by endoscopy and when surgical resection is not recommended.

Percutaneous Needle Biopsy of the Renal Allograft Using the Automated Needle System: Evaluation of 87 Procedures

Between April 1991 and February 1992 we obtained 87 percutaneous core needle biopsy specimens from 60 patients with the automatic biopsy gun. In 78 cases (89.7%) enough renal tissue was obtained for histological analysis. Acute rejection was present on 35 biopsies (40.3%) indicating antirejection therapy. No pathological signs of rejection were detected on 43 biopsies (49.4%). In 38 instances (43.7%) biopsy diagnosis differed from clinical presumptive diagnosis, affecting patient management, while in the remainder it was helpful to confirm clinical impressions. The only complication of the procedure was gross hematuria (requiring vesical irrigation in 1 patient). Due to its simplicity and low morbidity rate, renal biopsy with the automated needle system is the procedure of choice for evaluation and management of renal allograft dysfunction.

The roles of needle biopsy and periodic follow-up in the evaluation and diagnosis of breast lesions.

T HE GOAL OF screening mammography is to diagnose early breast cancer. In order to do so, it is necessary to separate the vast majority of normal mammograms from the relatively small number that requires further investigation. Women with the latter must undergo a diagnostic work-up in order to analyze and characterize the apparent mammographic abnormality. Once appropriate investigation is completed, lesions may be characterized by one of the following descriptions: (1) (2) malignant, (3) probably and (4) probably malignant. Until recently, except for cases considered clearly benign, all other categories have resulted in invasive procedures to obtain an unequivocal histological diagnosis. In most cases, this has entailed needle localization of the lesion followed by open surgical biopsy. However, in more recent years the technique of fine-needle aspiration biopsy (FNAB) has been used to obtain cells for cytological diagnosis. Although FNAB leads to an unequivocal diagnosis in many cases, especially when practiced by a specially trained cytopathologist, there are obvious limitations of the method (eg, when obtaining material from small breast lesions or fibrous cellular lesions). Core biopsy of breast lesions, using an automated biopsy gun guided either stereotactically or ultrasonographically, is another method that has recently become available for diagnosis. This presentation will discuss the advantages and disadvan-

Renal biopsy in diffuse renal disease — Experience with a 14-gauge automated biopsy gun

The diagnostic and complication rates of 104 percutaneous renal biopsies performed for diffuse renal disease in native kidneys were retrospectively reviewed. Biopsies were performed by one radiologist using continuous ultrasound guidance and a 14-gauge biopsy needle in an automated gun (Biopty TM, Radiplast TM, Uppsala). 103 of 104 (99%) biopsies resulted in adequate tissue for a definitive histological diagnosis which improves on previously published diagnostic rates. Four patients (3.8%) experienced transient macroscopic haematuria. There were two symptomatic peri-renal haematomas, both of whom required transfusion, and one arteriovenous fistula which was successfully embolized (total 2.9% significant complications). Our results compare favourably with results using more conventional techniques. We suggest that use of real-time ultrasound with the 14-gauge Biopty needle should be the method of choice for percutaneous renal biopsy in adults.

Efficacy of Automated Biopsy Guns versus Conventional Biopsy Needles in the Pygmy Pig

Efficacy of Automated Biopsy Guns versus Conventional Biopsy Needles in the Pygmy Pig

Efficacy of automated biopsy guns versus conventional biopsy needles in the pygmy pig.

Debate over which biopsy needle is the best has intensified recently with the introduction of automated biopsy guns including the 18-gauge long-throw and short-throw Biopty, the 18-gauge Cook, and the 14- and 18-gauge Klear Kut. To evaluate the efficacy of these mechanized biopsy guns versus that of conventional manual biopsy needles in the acquisition of adequate tissue for histopathologic evaluation, open hepatic and renal biopsies were performed in 15 pygmy pigs. The specimens were evaluated separately in a double-blind fashion by two histopathologists using graded criteria. Overall, the best results were obtained with the manual 14-gauge Tru-Cut needle, the long-throw 18-gauge Biopty gun, and the 18-gauge Cook biopsy gun. By comparison, the aspiration-type needles did not perform as well when considered as a group. Several other needles scored well in the biopsy of either the liver or kidney, but not in both. Disappointing results were obtained with the Klear Kut guns (both 14- and 18-gauge) and the Vacu Cut and PercuCut needles.

Transrectal Ultrasound-Guided Prostate Biopsies Using New Automatic Gun: Analysis of 100 Consecutive Cases

Ultrasound-guided biopsies were performed on 100 outpatients with suspicious prostate lesions detected by either digital rectal examination (DRE) or transrectal ultrasound procedures. The automatic biopsy gun was used without anesthesia, and a good core of tissue was obtained with each biopsy. There were no serious complications. Biopsies showed carcinoma in 27 patients, atypia in 8, prostatitis in 10, and unremarkable benign tissue in 55. Of 56 patients with suspicious DRE, carcinoma was present in 23 cases (41%), whereas 44 with nonsuspicious DRE revealed carcinoma in 4 cases (9%). Our results indicate that the biopsy gun is a safe, effective technique for prostate gland biopsy and, in specific situations, can obtain tissue from the seminal vesicles or from suspicious areas after radical prostatectomy.