Percutaneous Biopsy Technique Research Articles

Breast biopsy techniques in a global setting-clinical practice review.

Breast cancer is a disease of global concern, regardless of economic status. A significant disparity in breast cancer care between low- and high-income countries is not unexpected, but consideration can be given to particular aspects of therapy to allow as much equitability as possible. One of these aspects involves biopsy of breast lesions. With available resources, management in developed countries focuses on dealing with screening and image-detected lesions. In such circumstances, advanced percutaneous biopsy techniques are utilized liberally. However, where resources are less forthcoming for mammographic screening, women frequently present with symptomatic, palpable and larger tumours. This scenario behooves the clinician to modify treatment approaches and yet use cost-effective management strategies. It is essential that thought is applied to breast biopsy technique used where there is cost-consciousness as it significantly influences subsequent therapy. Less expensive strategies like fine needle aspiration cytology (FNAC) and core needle biopsy (CNB), when performed with particular attention to technique, handling, transportation and preparation of biopsy specimens allows a high level of accuracy and provides adequate information for the next steps in treatment. This mini-review discusses the variation in biopsy approaches among lower and higher income areas and offers suggestions for appropriate breast biopsy strategies in resource-limited countries.

Soft-tissue sarcoma biopsy: A safe and well-tolerated technique with a high diagnostic yield – A 5-year review of more than 800 cases

Objectives: The objectives of this study were to assess the diagnostic yield, accuracy, and complication rate of the US-guided core-needle biopsy technique for suspected soft-tissue sarcomas (STSs) and review this against other published practices. Material and Methods: A 5-year retrospective study was performed of consecutive US-guided percutaneous biopsy for suspected STSs, with 815 planned procedures in 799 patients (average age 57.8 years, [range 15–95] with 54.7% male). Diagnostic yield was recorded as positive for a sample that allowed differentiation of benign and malignant lesions. Diagnostic accuracy was defined as the correlation between biopsy and surgical specimen when excision was performed. Immediate and late complications were documented. The patient procedural experience was recorded by a departmental questionnaire. Results: Diagnostic yield was positive in 751/778 (96.5%) with no immediate, short- or long-term complications. Of 815 planned biopsies, 778 core biopsies were obtained. Of the 37 biopsy cases, where the tissue was not obtained, nine were not performed due to patient factors and a further 28 could not be obtained for other technical reasons (e.g., the lesion being too hard to penetrate or too painful to the core). 27/778 (3.5%) of biopsies were non-diagnostic (96.5%) and of these 27, nine patients were followed up clinically, 13 biopsies were repeated, and five cases were surgically excised without further biopsy attempts. Conclusion: The described soft-tissue mass US-guided percutaneous core-needle biopsy technique demonstrates a high diagnostic yield and accuracy with a low complication rate. The diagnostic yield appears comparable to data published by other institutions with more invasive techniques.

Modified percutaneous biopsy of the spine: improvement of the technique.

Biopsy of the spine can be performed by open surgery or percutaneous needle sampling. The first has the highest diagnostic yield while the second is a less invasive procedure with lower rate of complications and shorter hospitalization time. We described a modified technique of percutaneous biopsy using semi-rigid grasping forceps that may offer the advantages of both, open and minimally invasive surgery. Thirty consecutive patients with spinal lesions requiring biopsy were admitted to Neurosurgical Unit of Belcolle Hospital (Viterbo, Italy) from January 2017 to September 2021. There was a suspicion of spondylodiscitis in 25 cases and of tumor in 5 cases. Percutanous trans-pedicular spine biopsy has been performed using this new semi-rigid grasping forceps. Combining the opening width, jaw length and full 360° rotation, the device allows a wide and precise sampling. Sampling was sufficient in all cases (100%); tumors was observed in 5 cases (16.7%%) with a percentage of definitive histopathologic diagnosis of 100% (n = 5); among the remaining patients histological examination yielded a diagnosis of spinal infection in 25 cases (100%), and microbiologic culture provided an aetiologic diagnosis in 23 cases (92%). All procedures were well tolerated, and no postoperative complications were observed. Levels involved included: thoracic (T5-T9) in 8 cases, thoracolumbar junction (T10-L2) in 12 cases and lumbar (L3-L5) in 10 cases. Percutaneous biopsy with the semi-rigid grasping forceps is a safe and effective procedure that can be used for diagnosis of both infectious and tumor lesions of the spine. It allows to obtain a larger specimen volume and to use a multidirectional trajectory for sampling, resulting in a minimally invasive technique with strong ability to yield etiologic diagnosis.

Preoperative percutaneous needle lung biopsy techniques and ipsilateral pleural recurrence in stage I lung cancer.

A recent meta-analysis of individual patient data revealed that preoperative percutaneous transthoracic needle lung biopsy (PTNB) was associated with an increased risk of ipsilateral pleural recurrence in stage I lung cancer. This study aimed to examine whether particular PTNB techniques reduced the risk of pleural recurrence. We retrospectively included 415 consecutive patients with stage I lung cancer who underwent preoperative PTNB and curative resection from 2009 through 2016. Detailed information was collected, including clinical, PTNB technique, radiologic, and pathologic characteristics of lung cancer. Cox regression analyses were performed to identify risk factors for pleural recurrence before and after propensity score matching. The overall follow-up period after PTNB was 62.1 ± 23.0months, and ipsilateral pleural recurrence occurred in 40 patients. Before propensity score matching, age (p = 0.063), microscopic pleural invasion (p = 0.065), and pathologic tumor size (p = 0.016) tended to be associated with pleural recurrence in univariate analyses and subsequently were matched using a propensity score. After propensity score matching, multivariate analysis revealed that ipsilateral pleural recurrence was associated with a larger target size on computed tomography (hazard ratio [HR] = 1.498; 95% CI, 1.506-2.125; p = 0.023) and microscopic lymphatic invasion (HR = 3.526; 95% CI, 1.491-8.341; p = 0.004). However, no PTNB techniques such as needle gauge, biopsy, or pleural passage numbers were associated with a reduced risk of recurrence. No particular PTNB techniques were associated with reduced pleural seeding after PTNB in stage I lung cancer. Regardless of the technique, PTNB needs to be cautiously applied when early lung cancer is suspected, followed by curative treatment. • Age, microscopic pleural invasion, and pathologic tumor size tended to be associated with pleural recurrence in stage I lung cancer before propensity matching. • After propensity matching, pre-biopsy CT target size and microscopic lymphatic invasion were associated with pleural recurrence. • No particular PTNB techniques were associated with reduced pleural seeding in stage I lung cancer before and after propensity matching.

An initial experience of computed tomography-guided trans superior vena caval biopsy: a novel approach for precarious mediastinal lesions.

PurposeAs interventional radiologists, we encounter precarious deep-seated mediastinal lesions in our day-to-day practice. The conventional technique of percutaneous transthoracic biopsy of these lesions carries significant intrinsic complications. Endovascular approaches for such lesions under fluoroscopic guidance have been described in previous literature but with significant technical constraints. In this article, we would like to describe the novel approach of computed tomography (CT)-guided trans superior vena caval biopsy, which we have performed in 3 consecutive precarious mediastinal lesions.Material and methodsWe placed a vascular sheath under ultrasound and fluoroscopic guidance considering the intended angle of needle puncture and length to reach the target lesion from the puncture site. With the sheath in situ, the trans superior vena caval biopsy was performed under CT guidance, and multiple cores of target tissue were safely and successfully obtained.ResultsWe have carefully and successfully employed this novel technique of CT-guided trans superior vena caval approach for 3 tricky deep-seated mediastinal lesions with very low risk of complications.ConclusionsThrough this article, we would like to enhance the importance of thought-provoking new techniques in tackling complex challenging referrals.

Percutaneous Image-guided Needle Biopsy of Musculoskeletal Tumors: Technical Tips.

With recent advances in imaging technology, the frequency of detecting musculoskeletal lesions has also increased. Percutaneous image-guided needle biopsy is occasionally required for the diagnosis of such lesions. Moreover, in the era of personalized cancer care, chances in histopathological diagnosis and the importance of histopathological diagnosis by percutaneous needle biopsy are increasing. However, as percutaneous needle biopsy is not a common procedure for musculoskeletal lesions, careful planning and the application of adequate techniques such as hydrodissection and the trans-osseous approach are occasionally required. In this review, we have summarized the indications and techniques for percutaneous image-guided needle biopsy for musculoskeletal lesions, including lymphatic lesions.

Approach-based techniques of CT-guided percutaneous vertebral biopsy.

Magnetic resonance imaging (MRI) plays an important role in the characterization of vertebral lesions. Even if latest improvements in MRI permit to understand and suspect the nature of vertebral lesions and positron emission tomography computed tomography (PET-CT) gives information about lesion metabolism, biopsy is still needed in most cases. CT-guided percutaneous vertebral biopsy is a minimally invasive, safe and accurate procedure for definitive tissue diagnosis of a vertebral lesion. CT-guided vertebral biopsy is often the best alternative to a surgical biopsy. The purpose of this technical note is to discuss the approach-based techniques for CT-guided percutaneous vertebral biopsy.

3:36 PM Abstract No. 203 Safety and efficacy of percutaneous computed tomography–guided transplant pancreas biopsy

Percutaneous computed tomographic (CT)-guided biopsy is a minimally invasive alternative to open biopsy, not frequently described in the literature. The purpose is to describe and assess technique, complications, and diagnostic yield of CT-guided percutaneous transplant pancreas biopsy. This is a single institution retrospective review of 75 patients (47 women, 28 men, mean age 47) who underwent CT-guided transplant pancreas biopsy (n = 149) between April 2005 and October 2018.Three cases (2%) were aborted due to inadequate safe percutaneous approach. Biopsy results were classified based on final pathology as diagnostic (with the subcategory partially diagnostic used if the sample was adequate for the diagnosis of cell mediated rejection, but not humoral rejection) and nondiagnostic. Diagnostic yield and complication rates were evaluated. 149 percutaneous CT-guided biopsies of transplant pancreas were performed. 98% (n =143) of the biopsies used 17/18 Gauge coaxial core biopsy system, and 2% (n = 3) used a 19/20 Gauge coaxial device. On-site pathologic touch prep assessment was utilized for 91% of biopsies. Diagnostic tissue was obtained 94% of the time, of which 9% were considered partially diagnostic. 6% of the samples were deemed non-diagnostic. Of the diagnostic biopsies, 7 (51%) were positive for rejection (24% grade I, 16% grade II, 4% grade III, and 7% chronic) and 49% were negative for rejection. On-site pathologic touch prep did not appear to have an effect on sample adequacy (P = 0.9) nor did the number of cores (P =.28) or graft location (P = 1.0). The most common complication was minor bleeding (9%), pancreatitis (1%) and sedation related adverse events (1%); there was 1 moderate complication (hemorrhage requiring overnight observation), and no major complications. No significant difference in the INR (P = 0.68) or platelet count (P = 0.07) between patients who had bleeding complications and those who did not have bleeding complications. Image-guided percutaneous CT-guided transplant pancreas biopsies have high diagnostic yield with low complication rates.

Fine-Needle Aspiration Biopsy of Liver Lesions Yields Higher Tumor Fraction for Molecular Studies: A Direct Comparison With Concurrent Core Needle Biopsy.

This retrospective study evaluated and compared the diagnostic accuracy and suitability of tissue specimens for advanced molecular diagnostic testing obtained via 2 different techniques for percutaneous biopsy of primary and metastatic liver tumors. Samples from 137 patients with liver masses who underwent concurrent fine-needle aspiration biopsy with cell block (FNAB-CB) and core needle biopsy (CNB) at 2 hospitals were assessed for diagnostic accuracy, tumor fraction, and tumor cellularity. A subset of FNAB-CBs, that were deemed to have less or equal tumor cellularity compared with CNBs, had level sections performed and were reassessed for tumor cellularity. Diagnostic accuracy was 96% for FNAB and 93% for CNB (P=.267). In FNAB-CBs, tumor fraction was significantly higher than in CNB samples (67% vs 36%; P<.0001), whereas nontumor components were significantly lower (stromal component, 7% vs 29%; P<.0001; background benign hepatocytes, 25% vs 36%; P=.003). Additionally, in 44% of cases, FNAB-CB tumor cellularity was equal to or greater than that of the concurrent CNB. In the current age of personalized medicine, a minimally invasive, safe approach to obtaining adequate tissue for myriad molecular testing is paramount. We have shown that FNAB sampling is diagnostically accurate and produces higher tumor fractions than CNB. Thus, FNAB should be strongly considered as an initial sampling modality, especially for patients in whom molecular tests will determine management.

Immunoglobulin E and G Levels in Predicting Minimal Change Disease before Renal Biopsy.

Purpose The diagnosis of minimal change disease in adults relies mainly on renal biopsy, but this procedure is not without complications. Despite the advancements in technique of percutaneous renal biopsy, biopsy-related complications still occur. Bleeding is one of the major complications, which may lead to hemodynamic instability and, sometimes, even death. Thus, we developed a model to predict MCD for high-risk patients unsuitable for renal biopsy. Methods We enrolled 142 patients with nephrotic syndrome who received renal biopsy between October 2007 and April 2011 at one tertiary medical center in this study. Demographic, clinical, and prebiopsy laboratory variables were retrospectively recorded and analyzed. Results The overall prevalence of MCD was 26.8%. Age, hemoglobin levels, 24-hour urine protein, immunoglobulin (Ig) G, and IgE differed significantly between the MCD and non-MCD groups. Logistic regression analysis showed a significant increase in the risk of developing MCD as the number of Ig risk factors, namely, IgG < 450 mg/dl and IgE > 110 mg/dl, increased. Having both risk factors significantly increased the chances of receiving a diagnosis of MCD (by 31.84-fold, P =.007) compared with having neither. Combining the aforementioned clinical model and the 2 Ig risk factors was the best in predicting the diagnosis of MCD, with the area under a receiver-operating characteristic curve of 0.91. Conclusions Combining clinical model and this 2 Ig risk factors provides physicians simple and valuable clinical markers to diagnose MCD.

Percutaneous Renal Biopsy: Comparison of Blind and Real-time Ultrasound Guided Technique

Percutaneous renal biopsy is performed for diagnosis and prediction of prognosis of renal diseases. Adequacy of tissue and clinically significant bleeding are the main issues of the procedure. We aimed to compare these issues in renal biopsy by blind and real time ultrasound guided technique. It was a cross sectional, randomized study conducted between June 2016 to December 2016. In blind technique, marking for biopsy was done by ultrasound. Two attempts were performed for all and more if tissue was inadequate. Patients kept in bed rest for 24 hours, observed for post procedure hematuria and ultrasound done at 6 hours and 24 hours to diagnose perinephric hematoma. Total 75 biopsies (blind = 37 and Ultrasound -guided = 38) were evaluated. Blind and Ultrasound-guided technique had significant difference of number of attempt (mean±SD) 2.4±0.6 and 2.1±0.3 (p<0.01) respectively with no difference of number of glomeruli in light microscopy. Bleeding complications were macroscopic hematuria (11(30%)vs15(40%)) and perinephric hematoma ( 5(13.5%)vs3(7.9%)) in blind and Ultrasound-guided technique respectively with no significant difference. Those patients who developed perinephric hematoma was observed in all at 6 hours. Ultrasound-guided technique of percutaneous renal biopsy is superior with fewer attempts and equivalent in adequacy of tissue and bleeding complication than blind technique.

La ponction biopsie rénale: indications, complications et résultats

La ponction biopsie rénale (PBR) est une technique indispensable au diagnostic des maladies rénales. Ce geste demeure invasif avec diverses complications, essentiellement hémorragiques. L'objectif de notre travail était d'étudier notre pratique de la PBR, mettre le point sur la technique de la biopsie rénale transcutanée, évaluer ses complications, et déterminer les néphropathies diagnostiquées dans notre région. Il s'agit d'une étude rétrospective, menée entre Janvier 2015 et Juin 2017. Nous avons inclus 69 patients du service de Néphrologie du CHU Mohamed VI, Oujda, Maroc ayant bénéficié d'une biopsie de reins natifs. L'âge moyen des patients au moment de la PBR était de 38,16 ±13 ans (12-77 ans), le sexe ratio (H/F) était de 0,86. Le syndrome néphrotique était l'indication la plus fréquente tout âge confondu. Les néphropathies glomérulaires représentaient 81% des maladies rénales, réparties comme suit: la glomérulonéphrite extra-membraneuse retrouvée chez 19% des patients, la hyalinose segmentaire et focale chez 18%, la glomérulonéphrite lupique chez 11%, les glomérulonéphrites chroniques diagnostiquées dans 11% des cas, la glomérulonéphrite membrano-proliférative chez 7%, la glomérulonéphrite extra-capillaire chez 5% à part égale avec l'amylose rénale. Quatre pour cent (4%) des PBR étaient en faveur d'une néphropathie diabétique. Avec un taux estimé à 2% chacune, l'étude histopathologique avait retrouvé la glomérulonéphrite aigue post-infectieuse, la lésion glomérulaire minime, la néphropathie à IgA, les vascularites, les néphropathies tubulo-interstitielles ainsi que la microangiopathie thrombotique. Cinq pour cent (5%) des PBR étaient aglomérulaires. L'hématurie macroscopique était la principale complication observée dans notre série avec une fréquence de 2,8%. La PBR reste le gold standard du diagnostic de la maladie rénale, cependant le diagnostic syndromique permet au clinicien d'identifier la maladie rénale la plus probable et de guider les thérapeutiques urgentes.

Percutaneous transcatheter biopsy for intracardiac mass diagnosis.

The differential diagnosis of intracardiac masses (ICM) is wide. While imaging modalities can suggest a diagnosis, clinical decision making usually requires histopathologic diagnosis. The aim of this study was to describe the procedural technique, safety outcomes, diagnostic accuracy and clinical utility of percutaneous transcatheter biopsy (TCB) for histopathologic diagnosis of ICM. The records of all patients undergoing TCB of ICM at the Mayo Clinic catheterisation laboratories in Rochester, Minnesota, between 2002 and 2017 were retrieved and reviewed. TCB of ICM to establish histopathologic diagnosis was performed in 29 patients. Masses were located in the right-sided chambers in 93% of cases. Echocardiographic guidance was used. Ventricular arrhythmias requiring immediate cardioversion occurred in 7% of patients. No other complications were noted. The average number of samples retrieved per procedure was 7±3.6. A histopathologic diagnosis was made by TCB in 72% and altered clinical decision making in 52% of patients overall. Eleven patients (38%) who would otherwise have required excisional biopsy were able to avoid cardiovascular surgery. Each additional biopsy sample was associated with an increase in the likelihood of making a histopathologic diagnosis (OR 1.74, 95% CI: 1.05-2.87, p=0.032). Echo-guided percutaneous TCB of ICM provides an accurate diagnosis and alters clinical management in the majority of cases. The procedural complication rate is low. An increase in the number of samples retrieved markedly improves the ability to render a diagnosis. TCB may therefore be considered as a first-line approach for the histopathologic diagnosis of ICM.

Development and Complications of Blind and Ultrasound-Guided Percutaneous Liver Biopsy Techniques in Donkeys (Equus asinus)

The present study was designed to develop blind (BL) and ultrasound-guided (UG) liver biopsy (LB) techniques in donkeys (Equus asinus) and assess the complication rates of both techniques. Forty donkeys were included in this study. Based on the LB technique and biopsy site, the animals were allocated into four groups as BL biopsy at the 13th intercostal space (ICS) (BL13, n = 10), BL14 (n = 10), UG13 (n = 10), and UG14 (n = 10). All animals underwent liver ultrasonography prior to the biopsy procedure and then kept for 2-day observation period postbiopsy. The ultrasonographic thickness of the liver was higher at the 13th and 14th ICSs than the 12th and 15th ICSs (P < .05). The liver was partially covered by the lung at the most upper part of the 13th ICS. No mortality or major complications were observed. Follow-up ultrasonography revealed no serious complications, except a case in BL13 group exhibited a subcutaneous hematoma. The mean values of erythrocytic count and packed cell volume were significantly lowered in the BL13 group in comparison with their prebiopsy values (P < .05). All the biopsy specimens (40/40) were adequate for histopathological assessment. Mean specimen length and tissue fragmentation were significantly higher in the BL groups than UG ones (P < .001). In conclusion, percutaneous UG LB is a safe and accurate procedure and can be performed easily in donkeys. Blind LB at the 13th ICS is not recommended; however, it can be done safely at the 14th ICS.

Multi-quadrant biopsy technique improves diagnostic ability in large heterogeneous renal masses. Abel EJ, Heckman JE, Hinshaw L, Best S, Lubner M, Jarrard DF, Downs TM, Nakada SY, Lee FT Jr, Huang W, Ziemlewicz T.J Urol. 2015 Oct;194(4):886-91. [Epub 2015 Mar 30]. doi: 10.1016/j.juro.2015.03.106.

PurposePercutaneous biopsy obtained from a single location is prone to sampling error in large heterogeneous renal masses, leading to nondiagnostic results or failure to detect poor prognostic features. We evaluated the accuracy of percutaneous biopsy for large renal masses using a modified multi-quadrant technique vs. a standard biopsy technique. Materials and methodsClinical and pathological data for all patients with cT2 or greater renal masses who underwent percutaneous biopsy from 2009 to 2014 were reviewed. The multi-quadrant technique was defined as multiple core biopsies from at least 4 separate solid enhancing areas in the tumor. The incidence of nondiagnostic findings, sarcomatoid features and procedural complications was recorded, and concordance between biopsy specimens and nephrectomy pathology was compared. ResultsA total of 122 biopsies were performed for 117 tumors in 116 patients (46 using the standard biopsy technique and 76 using the multi-quadrant technique). Median tumor size was 10cm (IQR: 8–12). Biopsy was nondiagnostic in 5 of 46 (10.9%) standard and 0 of 76 (0%) multi-quadrant biopsies (P = 0.007). Renal cell carcinoma was identified in 96 of 115 (82.0%) tumors and nonrenal cell carcinoma tumors were identified in 21 (18.0%). One complication occurred using the standard biopsy technique and no complications were reported using the multi-quadrant technique. Sarcomatoid features were present in 23 of 96 (23.9%) large renal cell carcinomas studied. Sensitivity for identifying sarcomatoid features was higher using the multi-quadrant technique compared to the standard biopsy technique at 13 of 15 (86.7%) vs. 2 of 8 (25.0%) (P = 0.0062). ConclusionsThe multi-quadrant percutaneous biopsy technique increases the ability to identify aggressive pathological features in large renal tumors and decreases nondiagnostic biopsy rates.

Composição miofibrilar do glúteo médio de equinos de concurso completo de equitação na fase inicial do treinamento

The studies of myofibrillar composition in athletic horses make it possible to best direct them according to their specific fitness and certainly saves time and resources in the preparation of these athletic animals. Through the technique of percutaneous muscle biopsy and different enzyme-histochemical techniques have been possible to classify these fibers in three different types, type I, IIA and IIX. This information can be applied in the selection of those horses and to the possibility the proper conduct of training protocols. In order to evaluate the myofibrillar composition of Gluteus Medius to the selected mode of Eventing by Army Riding School -RJ, thirteen horses, crossbred breeds of Hanoverian, Thoroughbred and Brazilian Equestrian, in the age range 6-12 years, were used. All animals were submitted to a percutaneous muscle biopsy procedure and the fragments subjected to enzyme-histochemical techniques for distinguishing the three different types of muscle fibers by assessing the reactivity of the enzyme adenosine triphosphate miosinica ( mATPase ) and succinate dehydrogenase ( SDH). The animals used had an average relative distribution of different types of muscle fibers apparently quite homogeneous, with 25.9 %, 35.7 % and 38.4 % of fibers of type I, IIA and IIX, respectively, but lying statistically significant difference , with a higher proportion of type II fibers compared to type I , suggesting that it was a direct genetic influence of the training squad races of the Brazilian Army .

Evaluation of Muscle Fiber Types in German Shepherd Dogs of Different Ages.

The objective of this study was to determine and confirm the percentage of type I and type II muscle fibers that comprise the Gluteus Medius muscle in male and female canines of the German Shepherd breed, with standardized care, in different age groups, using the enzyme histochemical method. Muscle samples were collected from the Gluteus Medius muscles of forty clinically healthy dogs of the German Shepherd breed using the technique of percutaneous needle muscle biopsy. The samples were evaluated using histological and enzyme histochemical methods. The percentages of type I and II fibers and the ratio between the quantity of type I fibers/quantity of type II fibers were evaluated using the parameters of weight, age group, correlation between sex and age group, and between the sexes. It was found that there was no significant difference in relation to the types of fibers for the parameters of weight, age group, and age of the females. The correlation between the ages of the males suggested an increase in the percentage of type I fibers, a decrease in the percentage of type II fibers, or an increase in the ratio during the aging process. It was concluded that there was a decrease in the percentage of type II fibers with advancing age in male dogs, but without significant difference in the percentage of type I and type II fibers in relation to the weight. Anat Rec, 299:1540-1547, 2016. © 2016 Wiley Periodicals, Inc.

Novel technique for percutaneous biopsy of a peri-acetabular lesion.

Novel technique for percutaneous biopsy of a peri-acetabular lesion.

Mitochondrial Bioenergetics and Fiber Type Assessments in Microbiopsy vs. Bergstrom Percutaneous Sampling of Human Skeletal Muscle.

Microbiopsies of human skeletal muscle are increasingly adopted by physiologists for a variety of experimental assays given the reduced invasiveness of this procedure compared to the classic Bergstrom percutaneous biopsy technique. However, a recent report demonstrated lower mitochondrial respiration in saponin-permeabilized muscle fiber bundles (PmFB) prepared from microbiopsies vs. Bergstrom biopsies. We hypothesized that ADP-induced contraction (rigor) of smaller length microbiopsy PmFB causes a greater reduction in maximal respiration vs. Bergstrom, such that respiration could be increased by a myosin II ATPase-inhibitor (Blebbistatin; BLEB). Eleven males and females each received a 2 mm diameter percutaneous microbiopsy and a 5 mm diameter Bergstrom percutaneous biopsy in opposite legs. Glutamate/malate (5/0.5 mM)—supported respiration in microbiopsy PmFB was lower than Bergstrom at submaximal concentrations of ADP. 5 μM BLEB reduced this impairment such that there were no differences relative to Bergstrom ± BLEB. Surprisingly, pyruvate (5 mM)-supported respiration was not different between either biopsy technique ±BLEB, whereas BLEB increased succinate-supported respiration in Bergstrom only. H2O2 emission was lower in microbiopsy PmFB compared to Bergstrom PmFB in the presence of BLEB. Microbiopsies contained fewer type I fibers (37 vs. 47%) and more type IIX fibers (20 vs. 8%) compared to Bergstrom possibly due to sampling site depth and/or longitudinal location. These findings suggest that smaller diameter percutaneous biopsies yield lower glutamate-supported mitochondrial respiratory kinetics which is increased by preventing ADP-induced rigor with myosin inhibition. Microbiopsies of human skeletal muscle can be utilized for assessing mitochondrial respiratory kinetics in PmFB when assay conditions are supplemented with BLEB, but fiber type differences with this method should be considered.

PET/CT-guided percutaneous biopsy for diagnosis of MPNST in Neufibromatosis Type 1 (NF1).

e21513 Background: MPNST (Malignant Peripheral Nerve Sheath Tumor) is one of the most frequent causes of death in patients (pts) with NF1. Early detection is crucial, as complete surgical resection is the only curative treatment. However, diagnosis between BPNST (Benign Peripheral Nerve Sheath Tumor) and MPNST by clinical symptoms or conventional CT and MRI (including whole-body MRI protocol) is difficult. PET/CT, with a T/L (Tumor/Liver) SUVmax ratio > 1.5, provides a high negative predictive value but it is not specific enough for NF1-related MPNST diagnosis. Thus, a formal proof of malignant transformation by histological analysis is necessary before surgical excision, which could be mutilating. We aimed to investigate the effectiveness and complications of PET/CT-guided percutaneous biopsy (PET/CT GPB) technique for MPNST NF1-related diagnosis. Methods: PET/CT GPB procedures performed on 26 NF1 pts with a clinical suspicion of MPNST and a suspect lesion on PET/CT (T/L SUVmaxratio > 1.5) were retrospec...