Core Needle Biopsy For Nodules Research Articles

Complications and diagnostic accuracy of CT-guided 18G tru-cut versus end-cut percutaneous core needle biopsy of solitary solid lung nodules.

Percutaneous biopsy has demonstrated high accuracy in diagnosis of lung nodules, but the technique is not innocuous and a yield decrease in lesions smaller than 20 mm has been reported. We carried out a prospective study to evaluate and compare the complications and efficacy of percutaneous core needle biopsy (CNB) of solitary solid lung nodules, which were performed with two types of automatic guns. 330 consecutive CT-guided CNB were included. Tru-cut or end-cut 18G devices were used alternatively. Nodules were categorized by their size: ≤10 mm, 11-20 mm and >20 mm. Incidence of complications such as pneumothorax or hemoptysis and factors influencing them (nodule size and depth within lung parenchyma) were evaluated. Diagnostic accuracy of CNB achieved in the three groups of nodules regarding the two different needles were calculated and statistically evaluated and compared. We performed 68 CNB in nodules ≤10 mm, 130 in 11-20 mm and 132 in >20 mm. Pneumothorax appeared in 24.2% of them, but only 5.7% required drainage. Hemoptysis was developed in 9.4% and abundant hemoptysis with hypoxemia was observed in only 4.2% of patients. Regarding appearance of complications between the two needle types, no significant differences were found. A higher risk of hemoptysis was observed in nodules ≤10 mm (OR = 3.87; 95% CI = 1.24-12.06, P = 0.019) and in those located deeper in pulmonary parenchyma (OR = 2.21; 95% CI = 1.04-4.69, P = 0.038). End-cut needles reached a diagnostic accuracy of 93.7%, 92.1% and 98.3%, in nodules sized ≤10 mm, 11-20 mm and >20 mm, respectively. Corresponding results for tru-cut were 84.7%, 88.5% and 92.1%. In spite of differences reaching up to 9% in smaller nodules, intra-group results were not significant. Both needles have similar complications rate. Despite not having observed statistically significant differences between the two types of needles, end-cut devices have demonstrated a higher diagnostic yield in the three groups of nodules and could be a more suitable option especially for CNB of nodules ≤10 mm.

Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors.

ObjectivesThe usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors.MethodsA meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed.ResultsCNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur.ConclusionA reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.

Core-Needle Biopsy Does Not Show Superior Diagnostic Performance to Fine-Needle Aspiration for Diagnosing Thyroid Nodules.

PurposeTo compare the diagnostic performances of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for thyroid nodules according to nodule size.Materials and MethodsThis retrospective study included 320 thyroid nodules from 320 patients who underwent both FNA and CNB at outside clinics and proceeded with surgery in our institution between July 2012 and May 2019. According to nodule size, the diagnostic performances of FNA and CNB were calculated using various combinations of test-negatives and test-positives defined by the Bethesda categories and were compared using the generalized estimated equation and the Delong method.ResultsThere were 279 malignant nodules in 279 patients and 41 benign nodules in 41 patients. The diagnostic performance of FNA was mostly not different from CNB regardless of nodule size, except for negative predictive value, which was better for FNA than CNB when applying Criteria 1 and 2. When applying Criteria 3, the specificity and positive predictive value of FNA were superior to CNB regardless of size. When applying Criteria 4, diagnostic performance did not differ between FNA and CNB regardless of size. After applying Criteria 5, diagnostic performance did not differ between FNA and CNB in nodules ≥2 cm. However, in nodules ≥1 cm and all nodules, the sensitivity, accuracy, and negative predictive value of CNB were better than those of FNA.ConclusionCNB did not show superior diagnostic performance to FNA for diagnosing thyroid nodules.

Diagnostic performance of imaging-guided core needle biopsy of the mesentery and peritoneum

ObjectiveTo evaluate the diagnostic performance of imaging-guided core needle biopsy of nodules and diffuse infiltration of the omentum or of the peritoneum. Materials and methodsWe retrospectively evaluated 57 patients who underwent core needle biopsy of the peritoneum or of the omentum between March 2014 and January 2017. We used computed tomography (CT) to plan the biopsy. Biopsies were guided by CT or ultrasonography (US). We classified the results as diagnostic (benign/malignant) or inconclusive (inadequate sample). We calculated the sensitivity, specificity, positive-predictive value, and negative predictive value. We analyzed whether the specimen was diagnostic depending on the imaging technique used (CT or US) and on the type of omental or peritoneal involvement from which the specimen was obtained (mass, nodule, or diffuse involvement). ResultsAll (100%) the percutaneous biopsies were diagnostic. The sensitivity of the technique was 98.18% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value was 50%. Both the specimens obtained under CT guidance (n=10) and those obtained under US guidance (n=47) were diagnostic. Likewise, biopsies of masses (n=24), of nodules (n=17), and even of diffuse infiltration (n=16) of the peritoneum or omentum enabled the histologic diagnosis. The rate of complications was 1.75% (one death). ConclusionPercutaneous core needle biopsy has high sensitivity regardless of the imaging technique used to guide the technique (CT or US) and of the type of lesion biopsied (mass, nodule, diffuse infiltration). It is a useful technique with a very low rate of complications, although severe complications can occur.

Rentabilidad diagnóstica de la biopsia con aguja gruesa guiada por técnicas de imagen del mesenterio y del peritoneo

ObjectiveTo evaluate the diagnostic performance of imaging-guided core needle biopsy of nodules and diffuse infiltration of the omentum or of the peritoneum. Material and methodsWe retrospectively evaluated 57 patients who underwent core needle biopsy of the peritoneum or of the omentum between March 2014 and January 2017. We used computed tomography (CT) to plan the biopsy. Biopsies were guided by CT or ultrasonography (US). We classified the results as diagnostic (benign / malignant) or inconclusive (inadequate sample). We calculated the sensitivity, specificity, positive-predictive value, and negative predictive value. We analyzed whether the specimen was diagnostic depending on the imaging technique used (CT or US) and on the type of omental or peritoneal involvement from which the specimen was obtained (mass, nodule, or diffuse involvement). ResultsAll (100%) the percutaneous biopsies were diagnostic. The sensitivity of the technique was 98.18% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value was 50%. Both the specimens obtained under CT guidance (n=10) and those obtained under US guidance (n=47) were diagnostic. Likewise, biopsies of masses (n=24), of nodules (n=17), and even of diffuse infiltration (n=16) of the peritoneum or omentum enabled the histologic diagnosis. The rate of complications was 1.75% (one death). ConclusionPercutaneous core needle biopsy has high sensitivity regardless of the imaging technique used to guide the technique (CT or US) and of the type of lesion biopsied (mass, nodule, diffuse infiltration). It is a useful technique with a very low rate of complications, although severe complications can occur.