Biopsy Of Focal Lesions Research Articles

Clinical Significance of Spatial Heterogeneity in Newly Diagnosed and Relapsed Multiple Myeloma

Clinical Significance of Spatial Heterogeneity in Newly Diagnosed and Relapsed Multiple Myeloma

Percutaneous biopsy of focal lesions of the gastrointestinal tract

To evaluate the technical success and diagnostic accuracy of image-guided percutaneous biopsy of the gastrointestinal (GI) tract. An interventional radiology database was used to retrospectively identify patients who underwent image-guided percutaneous biopsy of the GI tract. The medical and imaging records were reviewed to assess biopsy results and complications. Twenty-nine patients (M:F = 19:10, mean age 65 years) were identified who underwent image-guided (CT/US) percutaneous biopsies of the GI tract. All biopsies were performed using coaxial technique with 18 g core and 22 g FNA needles. Twenty-two biopsies (76 %) were for circumferential or segmental wall thickening; the remaining were wall thickening with exophytic mass. Mean tumor diameter was 7.4 cm (SD = 3.4 cm), average wall thickening was 2.1 cm (SD 7.2), and exophytic mass was 10.0 cm (SD = 4.2). Tumor locations included stomach (n = 5), small bowel (n = 8), and colon (n = 16). Malignancy was confirmed in 22 patients, 12 of whom underwent excision, with 3 false positive samples. Benign disease was diagnosed in 7 patients, including 3 with pathology confirmation, with one false negative sample. The overall sensitivity was 83 % and accuracy was 84 %. There was one complication presenting as bleeding at the biopsy site, treated conservatively. Percutaneous biopsy of the GI tract is an uncommon procedure. The results of this study suggest that it is a safe and sensitive procedure that may be considered for small bowel lesions in which endoscopy is not feasible, for submucosal lesions, or in the setting of patients with previously negative endoscopic biopsies.

Contrast-enhanced doppler ultrasonography in the diagnosis of hepatocellular carcinoma and premalignant lesions in patients with cirrhosis

Hepatocellular carcinogenesis in cirrhosis is a multistage process that includes large regenerative nodules, dysplastic nodules, and hepatocarcinoma. The aim of this study was to establish whether contrast-enhanced Doppler ultrasonography (US) is able to distinguish between early hepatocellular carcinoma (HCC) and small nonmalignant nodules in cirrhosis. Between January 1998 and December 1999, 500 cirrhotic patients with no previous history of HCC or evidence of hepatic focal lesions were enrolled and prospectively followed-up with US every 6 months until December 2000. Sixty-one patients developed focal lesions, 12 multifocal, and 49 monofocal. Biopsy of focal lesions, contrast-enhanced Doppler US, and spiral computed tomography (CT) were performed in 41 consecutive patients with small ([lt ]3 cm) monofocal lesions. Twenty nodules were diagnosed as HCC and 21 as nonmalignant (14 large regenerative nodules, 3 low-grade, and 4 high-grade dysplastic nodules) by liver biopsy. Intratumoral arterial blood flow was detected in 19 of 20 (95%) HCC and 6 of 21 (28%) nonmalignant nodules by contrast-enhanced Doppler US (P[lt ].0001). The mean peak resistance and pulsatility indices were 0.82 [plusmn] 0.09 and 1.56 [plusmn] 0.2 in HCC and 0.62 [plusmn] 0.08 and 0.82 [plusmn] 0.08 in dysplastic lesions (P = .002 and .0001), respectively. Spiral CT revealed arterial perfusion in 19 of 20 HCC and in 4 of 21 nonmalignant nodules (high-grade dysplastic nodules). Four of the apparently false-positive nodules at enhanced Doppler US were high-grade dysplastic nodules and 2 evolved to HCC during follow-up. In conclusion, contrast-enhanced Doppler US is a noninvasive, very sensitive technique in differentiating malignant and premalignant lesions from nonmalignant focal lesions in the liver. (HEPATOLOGY 2001;34:1109-1112.)

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.

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.

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 automat...