Modified Biopsy Technique Research Articles

Effectiveness of a modified biopsy technique in endobronchial ultrasound (EBUS) in the diagnosis of peripheral lung neoplasms: results of a clinical study

Introduction. The problem of lung malignant neoplasms diagnosis is extremely urgent. Verification of peripheral lung malignancies using ultrasound bronchoscopy does not exceed 70.6 %.The aim of the work is to demonstrate an increase in the verification of peripheral lung malignancies by endobronchial lung ultrasound examination.Materials and methods The study was conducted on the basis of the endoscopic department of the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from 2019 to 2021, in which 142 patients were included. The patients were divided into 2 groups. The main group included 68 patients whose examination included fibrobronchoscopy with endo ultrasound with biopsy according to a modified technique. The comparison group included 74 patients who underwent ultrasound bronchoscopy with biopsy according to the standard technique. The manipulation time with biopsy according to the standard technique ranged from 12 to 42 minutes, on the average 29 ± 5 minutes. Ultrasound bronchoscopy with biopsy to the modified technique lasted from 14 to 44 minutes, on average – 30 ± 5 minutes.Results The modified technique of biopsy with endosonographic control of endoscopic instrument position in the pathological focus during ultrasound bronchoscopy allows to increase the percentage of peripheral lung malignant neoplasms verification by 19.8% (p < 0.05). Ultrasound bronchoscopy with biopsy according to a modified technique is a relatively safe manipulation, complications were detected in 2.9 % of patients and were successfully treated conservatively.Discussion Endobronchial ultrasound examination of the lungs is a sufficiently effective and informative technique. Introduction of modified biopsy technique into clinical practice and its wide application will allow to replace more invasive and traumatic diagnostic procedures, to increase informative value of ultrasound bronchoscopy.Conclusion The use of a modified biopsy technique during ultrasound bronchoscopy will increase the verification by 19.8 % (p < 0.05), thus allowing to reduce the period of examination of patients and prescribe antitumor treatment earlier.

Improving the quality of diagnosis and verification of peripheral lung neoplasms by using a modified biopsy technique for ultrasonic bronchoscopy (EBUS)

BACKGROUND: The problem of diagnosis and treatment of malignant neoplasms of the lungs is extremely relevant. Verification of the malignant process in the case of peripheral localization of the neoplasm in the lung when using ultrasound bronchoscopy does not exceed 70.6%.
 AIMS: This study aimed to improve the effectiveness of ultrasound bronchoscopy in the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine by introducing into clinical practice a modified biopsy technique for ultrasound bronchoscopy. The technique is patented, patent for invention no. RU2719666 C1.
 MATERIALS AND METHODS: From 2019 to 2021, a study was conducted based on the endoscopic department of the State Medical Institution Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine, which included 137 patients. The patients were divided into two groups: the main group included 66 patients in whose examination FBS with endoussis with biopsy by a modified technique was used; the comparison group included 71 patients who underwent ultrasound bronchoscopy with biopsy by a standard technique. The time of biopsy manipulation according to the standard procedure ranged from 14 to 41 min, averaging 305 min. Ultrasound bronchoscopy with biopsy by a modified technique lasted from 16 to 45 minutes, on average 315 min.
 RESULTS: In the main group, where FBS with ENDOUSSI with biopsy was used in the diagnosis of patients using a modified technique with endosonographic control of the position of the endoscopic instrument in the pathological focus, the diagnosis of malignant neoplasm was verified in 52 patients (in 78.8% of cases). In the comparison group, where the standard biopsy technique was used in patients with ultrasound bronchoscopy, the diagnosis of malignant neoplasm was verified in 41 patients (in 57.7% of cases). Thus, the verification of peripheral lung malignancies when using a modified biopsy technique increases by 21.1% (p 0.05). FBS with endoussis with biopsy using a modified technique is satisfactorily tolerated by patients and is a relatively safe manipulation.
 CONCLUSION: modified biopsy technique developed by us with endosonographic control of the position of the endoscopic instrument in the pathological focus during ultrasound bronchoscopy makes it possible to increase the percentage of verification of peripheral lung malignancies by 21.1% (p 0.05). The introduction and widespread use of the modified biopsy technique for ultrasound bronchoscopy in the diagnosis of peripheral lung malignancies will reduce the time of examination of patients and prescribe antitumor treatment earlier.

Modified Biopsy Assessment for Endobronchial Ultrasound in Diagnosis of Peripheral Lung Neoplasms

Background. Diagnosis and treatment of malignant lung neoplasms are pressing issues. Peripheral lung cancer verification rate with endobronchial ultrasound varies within 30–85 %.Aim. To advance endobronchial ultrasound precision, a modified biopsy technique has been developed and introduced into clinical practice at the Chelyabinsk Regional Clinical Centre for Oncology and Nuclear Medicine. The modification comprises real-time ultrasound image guidance of the biopsy forceps alignment and opening. The technique patent for invention is RU 2719666 C1.Materials and methods. Modified endobronchial ultrasound has been performed in 66 patients with suspected peripheral lung malignancy at the Centre’s Department of Endoscopy within 2019–2021. Bioptic material was delivered for histological and, when necessary, immunohistochemical examination.Results. Malignancy diagnosis was verified in 78.8 % cases. The modified technique is relatively safe, with complications detected in two patients (3.8 % cases) and managed conservatively with success. Discussion. The standard biopsy technique provided for a lung malignancy verification rate of 57.7 % over 2019–2021. Thus, the rate improvement by modified technique is 21.1 %. The modified technique is relatively safe, with complications reported in two patients (3.8 % cases) and managed conservatively with success. Modified endobronchial ultrasound was adequately tolerated, with no increase in patient examination time. The technique can supersede more invasive diagnostic procedures.Conclusion. We believe that the modified technique will improve the power of endobronchial ultrasound, reduce examination time and expedite prescription of special therapies.

The modified biopsy technique conducting ultrasound bronchoscopy with endosonographic-guided position of the endoscopic instrument in the area of the pathological focus. The results of the first phase of the clinical trial

Background. The problem of diagnostics and treatment of malignant neoplasms of the lungs is urgent. Verification of a malignant process in the case of peripheral localization of a neoplasm in the lung using ultrasound bronchoscopy ranges from 30 to 85%. To improve the efficiency of ultrasound bronchoscopy, a modified biopsy technique for ultrasound bronchoscopy was developed and introduced into clinical practice at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. The essence of the modified technique is that it becomes possible for ultrasound visual control over the passage and deployment of biopsy forceps in real time. The technique was patented, patent for invention RU №2719666 C1 was issued.
 Aim. To clarify the information content of ultrasound bronchoscopy using a modified technique.
 Materials and methods. On the basis of the endoscopic Department of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2019 and 2020, ultrasound bronchoscopy using this technique was performed on 40 patients with suspected peripheral malignant neoplasm of the lungs. The diagnosis of malignant neoplasm was verified in 67.5% of cases. Using the standard biopsy technique, the probability of verification of lung malignant neoplasms in 2019 and 2020 was 57.7%. Thus, the modified biopsy technique made it possible to increase the verification probability by 9.8%. The modified technique is relatively safe, complications during the procedure were detected in 2 patients (in 3.8% of cases) and were successfully treated conservatively. During and after the procedure, the patients were monitored and monitored. The ultrasound bronchoscopy according to the modified technique was satisfactorily tolerated by the patients.
 Results. The period of examination of patients when using this technique does not increase. The technique replaces more invasive diagnostic procedures.
 Conclusion. The use of the modified technique will improve the information content of ultrasound bronchoscopy, shorten the examination time for patients and accelerate the appointment of special treatment methods.

Optimizing Renal Cortical Neoplasm Tissue Sampling Through a Modified Biopsy Technique: Laboratory Experience and Initial Clinical Experience

We evaluated 11 currently available biopsy devices using a standard and a novel renal biopsy technique in a porcine model. We then applied our laboratory findings to clinical practice to improve our biopsy results during laparoscopic renal cryoablation procedures. A total of 11 biopsy devices were applied to live porcine renal tissue using two different techniques. In groups 1 and 2, the biopsy devices were deployed external to the renal tissue and in a standard manner after insertion into the renal tissue, respectively. Ten biopsies were performed for each condition and with each device. The biopsy quality metrics included sample core length and width and number of glomeruli and vessels in each sample. Subsequently, we confirmed our laboratory finding regarding the optimal biopsy technique during 10 sequential laparoscopic renal cryoablation procedures. During these procedures, each renal mass underwent the standard and modified biopsy techniques. In the animal investigation, a total of 220 biopsies were performed. Regarding the biopsy technique, the mean core length for groups 1 and 2 was 7.32 and 4.91 mm (P <0.01) and the mean number of glomeruli was 7.6 and 4.2 (P <0.01), respectively. Clinically, 10 patients successfully underwent renal cryoablation in conjunction with the two renal biopsy groups. In all 10 cases, between the two biopsies, a histopathologic diagnosis was successfully obtained. The preablation standard and preablation modified biopsy technique established a diagnosis 7 of 10 and 9 of 10 times, respectively. Our preliminary laboratory and clinical data have demonstrated the effectiveness and safety of the modified biopsy technique.

A modified biopsy technique to improve histopathological evaluation of avian skin.

Skin biopsies are a viable diagnostic tool in avian dermatology, however, the thinness of avian skin makes it difficult to prevent rolling and contraction of skin biopsy specimens during collection and fixation. The difficulty orienting such rolled samples during processing ultimately interferes with the establishment of a histopathological diagnosis. We describe a modified skin biopsy procedure for obtaining avian skin biopsy specimens. In this technique nontranslucent self-adhesive tape (Scotch tape) was attached to skin biopsy sites before obtaining skin biopsies using a standard skin biopsy punch instrument. A total of 23 skin biopsy specimens were obtained: 15 from nonfeathered skin of 12 normal Hispaniolan parrots, 3 from feathered skin of 2 normal birds and 5 from feathered skin of 3 psittacines presented for pathologic feather-picking. All 23 skin specimens consistently adhered to the tape during the biopsy procedure. The specimens were fixed in 10% neutral phosphate-buffered formalin. During processing, no curling or rolling of specimens occurred, and all specimens could be easily orientated for correct trimming and subsequent histopathological evaluation. The tape technique did not produce any appreciable artefacts. Remnants of the tape were microscopically evident above the stratum corneum assuring that none of the stratum corneum was lost during processing. Obtaining avian skin biopsy specimens using this modified tape technique is easy and ensures flat fixation of the skin biopsy specimens, which later allows trimming at right angles, and through the longitudinal diameter of feather follicles for accurate histopathologic evaluation.

Semiautomatic core biopsy: A modified biopsy technique in breast diseases

To evaluate a semiautomatic gun to retrieve diagnostic core specimens of lesions in the breast and the axillary region. In a series of 180 consecutive core biopsies (2.1 mm), 145 (142 breasts and 3 axillae) were performed with a semiautomatic gun (18 stereotaxic and 127 US-guided) from lesions presenting mammographically as microcalcifications (n = 15) and opacities (n = 130). The gun did not work satisfactorily in 34 lesions, which were tumors with a very hard consistency. One additional patient was excluded because of technical failure. Biopsy diagnoses in the 145 patients were correlated to surgical histopathology, follow-up mammograms and/or clinical findings. Histologic examination of the specimens resulted in correct diagnoses in 89% (129/145) of the total material and in 87% (108/124) of cancers. In 107 cases, in which only 1 specimen was obtained, 83 of 89 cancers (87%) were detected. Length of specimens ranged from 3 mm (n = 2) to 17 mm (n = 31). Among patients with a 17-mm-long specimen, there was only 1 false-negative diagnosis. The semiautomatic gun provided diagnostic specimens in a majority of cases and could be used as an alternative to the automatic guns when size or location of the lesions necessitates a high precision. It was not suitable for use in very hard tumors.

Semiautomatic Core Biopsy. A modified biopsy technique in breast diseases

Purpose: To evaluate a semiautomatic gun to retrieve diagnostic core specimens of lesions in the breast and the axillary region. Material and Methods: In a series of 180 consecutive core biopsies (2.1 mm), 145 (142 breasts and 3 axillae) were performed with a semiautomatic gun (18 stereotaxic and 127 US-guided) from lesions presenting mammographically as microcalcifications (n = 15) and opacities (n = 130). The gun did not work satisfactorily in 34 lesions, which were tumors with a very hard consistency. One additional patient was excluded because of technical failure. Biopsy diagnoses in the 145 patients were correlated to surgical histopathology, follow-up mammograms and/or clinical findings. Results: Histologic examination of the specimens resulted in correct diagnoses in 89% (129/145) of the total material and in 87% (108/124) of cancers. In 107 cases, in which only 1 specimen was obtained, 83 of 89 cancers (87%) were detected. Length of specimens ranged from 3 mm (n = 2) to 17 mm (n = 31). Among patients with a 17-mm-long specimen, there was only 1 false-negative diagnosis. Conclusion: The semiautomatic gun provided diagnostic specimens in a majority of cases and could be used as an alternative to the automatic guns when size or location of the lesions necessitates a high precision. It was not suitable for use in very hard tumors.

Technical Notes: A Liver and Muscle Biopsy Technique for Electrophoretic Evaluation of Largemouth Bass

Abstract A biopsy technique was modified to include the extraction of muscle as well as liver tissue for the electrophoretic identification of largemouth bass (Micropterus salmoides). One hundred twelve largemouth bass, 0.2–1.6 kg, were anesthetized and biopsied by making an incision between the left pectoral and pelvic fins and extracting a 1-g sample of muscle tissue and a 1-g sample of liver tissue. Incisions were closed with absorbable sutures. All fish recovered from surgery and were stocked into a 0.1-ha research pond within 24 h. Fish were inspected after 11 weeks and survival was 90%. All incisions had completely healed. This modified biopsy technique allows for nondestructive subspecific evaluation of largemouth bass in zones of high intergradation, when both liver and muscle tissues need to be examined for genetic markers.

Ultrasound Guided Needle Biopsy of Brain Tumors Using an Automatic Sampling Instrument

All ultrasound (US) guided needle biopsies of brain tumors performed during an 8-year period were reviewed. Tissue samples were obtained in 112 of 115 biopsy procedures, and a histologic diagnosis was established in 99 cases (88.4%). The rate of major complications was 8.0%. The mortality is similar as in reports on stereotactic and CT-guided biopsy procedures while the morbidity is higher in our material. There are no large series available on US guided intracranial biopsy with adequate reports of complications. A modified biopsy technique is introduced here using a cutting needle and an automatic sampling instrument. The modified technique, which has been used in all cases since 1985, yielded diagnostic material in 91.5%. This method consistently provides a tissue core which is essential for a confident histopathologic diagnosis.

Ultrasound Guided Needle Biopsy of Brain Tumors Using an Automatic Sampling Instrument

All ultrasound (US) guided needle biopsies of brain tumors performed during an 8-year period were reviewed. Tissue samples were obtained in 112 of 115 biopsy procedures, and a histologic diagnosis was established in 99 cases (88.4%). The rate of major complications was 8.0%. The mortality is similar as in reports on stereotactic and CT-guided biopsy procedures while the morbidity is higher in our material. There are no large series available on US guided intracranial biopsy with adequate reports of complications. A modified biopsy technique is introduced here using a cutting needle and an automatic sampling instrument. The modified technique, which has been used in all cases since 1985, yielded diagnostic material in 91.5%. This method consistently provides a tissue core which is essential for a confident histopathologic diagnosis.