Standard Biopsy Research Articles

The clinical and neuroimaging features of sporadic adult-onset neuronal intranuclear inclusion disease.

Neuronal intranuclear inclusion disease (NIID) is a rare slowly progressive neurodegenerative disorder that is characterized pathologically by the presence of eosinophilic intranuclear inclusions. NIID is a heterogeneous disease with diverse clinical manifestations, making diagnosis difficult. Here, we analyzed the clinical, pathological, and radiological features of Chinese NIID patients to improve our understanding of NIID. A total of 17 patients with sporadic NIID were recruited from the Ruijin Hospital Database between 2014 and 2021. Clinical patient information and brain MRI data were collected. All of the patients underwent standard skin biopsy procedures. The average age of onset for symptoms was 60.18 years, and the average duration of illness was 4.06 years. All patients were diagnosed with NIID due to the presence of intranuclear inclusions confirmed by skin biopsy. Tremor was the most common initial symptom. The average ages at onset and at diagnosis were both lower in patients with tremor than in patients without tremor. NIID may be a systemic disease that affects multiple organs, for one patient had a history of chronic renal insufficiency for more than 10 years. In addition to high-intensity U-fibers signals on diffusion-weighted imaging, there were several other MRI findings, such as focal leukoencephalopathy and cortical swelling. Encephalitic episodes followed by reversible leukoencephalopathy was another important imaging feature of NIID. The clinical manifestations of NIID are highly variable. Tremor may be the most common initial symptom in certain cohorts. Encephalitic episodes followed by reversible asymmetric leukoencephalopathy may also indicate this disease.

Nanoparticle-assisted axillary staging: an alternative approach after neoadjuvant chemotherapy in patients with pretreatment node-positive breast cancers.

In order to achieve an optimized method of axillary staging after neoadjuvant chemotherapy (NAC) in breast cancer patients with pretreatment positive axillary lymph nodes, we evaluated the feasibility and accuracy of nanoparticle-assisted axillary staging (NAAS) which combines carbon nanoparticles with standard sentinel lymph node biopsy (SLNB) with radioisotope and blue dye. Invasive breast cancer patients with pre-NAC positive axillary lymph nodes who converted to ycN0 and received surgeries from November 2020 to March 2021 were included. All patients underwent ipsilateral NAAS followed by axillary lymph node dissection. Detection rate (DR), false-negative rate (FNR), negative predictive value (NPV) and accuracy of axillary staging were calculated. Eighty of 136 (58.8%) breast cancer patients converted to ycN0 after NAC and received NAAS. The DR, NPV and accuracy was 95.0%, 93.3% and 97.4% for NAAS, respectively. And the FNR was 4.2% (2/48) for NAAS, which was lower than that of standard dual-tracer SLNB (SD-SLNB)(9.5%, 4/42). Pretreatment clinical T4 classification was a risk factor for detection failure in NAAS (p = 0.016). When patients with pretreatment inflammatory breast cancers were excluded from analysis, FNR dropped to 2.2% (1/45) for NAAS. NAAS revealed great performance in invasive breast cancer patients with pre-NAC positive axillary lymph nodes who converted to ycN0. The application of NAAS reached a better balance between more accurate axillary evaluation and less intervention. Trial registration Chictr.org.cn (ChiCTR2000039814). Registered Nov 11, 2020.

Control of Indentation of a Needle into the Brain Phantom Tissue Using a Piezoelectric Drive

Currently, stereotaxic brain surgery is an actively developing branch of medicine. During these operations, a special needle is inserted into the brain through a hole in the skull. This needle is moved in the brain tissue so that its tip reaches a certain point, after which the necessary medical manipulation is performed (for example, taking a puncture). To ensure accurate positioning of the needle, it is advisable to monitor the process of such operations using the magnetic resonance imaging apparatus. This puts restrictions on the type of actuators that can be used to drive the needle. The paper considers the problem of controlling the penetration of a cylindrical needle into a phantom of the brain where the control force is generated using a piezoelectric drive (PED). To describe the interaction of the needle with the tissue, a phenomenological model is proposed, under which it is assumed that the phantom tissue is a viscoelastic and plastic material, and also demonstrates relaxation properties. When describing forces acting on the lateral surface of the needle from the side of the tissue, the presence of dry friction is taken into account. The proposed model contains a number of parameters that are identified based on experiments carried out at the NCKU (Taiwan). In these experiments, a standard biopsy needle was inserted into a phantom made from agar-agar solution, and the position of the needle and the force acting on it from the tissue were registered. It is shown that the experimental results are in good agreement with the calculations in the context of the model. An algorithm for controlling the needle by setting the frequency of excitation of the probe is proposed. The aim of the control is to introduce the needle to a given depth at a given constant speed, and then hold the needle at this depth. During the process, it is required to avoid overshooting in speed and position. Numerical simulation has been carried out. The effect of the feedback parameters on the nature of the process is investigated. It is shown that the proper choice of parameters allows for avoiding the overshooting.

Imaging of clinically silent rectoprostatic hematoma in MRI guided in-bore prostate biopsy

MR imaging provides awareness for rectoprostatic hematomas as a complication in prostate biopsy. We evaluated the frequency and size of clinically silent bleeding after in-bore MRI-guided prostate biopsy according to documentation in MRI. From 2007 until 2020 in-bore MRI-guided prostate biopsy was performed in 283 consecutive patients with suspected prostate cancer. Interventional image documentation was reviewed for rectoprostatic hematomas and rectal blood collections in this retrospective observational single-center study. Correlation to patient characteristics was analyzed using a multivariable logistic regression model. 283 consecutive patients with a mean age of 66 ± 8 years were included. We diagnosed bleeding complications in 41 (14.5%) of the patients. Significant rectoprostatic hematomas were found in 24 patients. Intra-rectal blood collections were observed in 16 patients and one patient showed bleeding in the urinary bladder. The volume of rectoprostatic hematomas was determined with a median of 7.5 ml (range 2–40 ml, IQR 11.25). We found no correlation between the presence of a rectoprostatic hematoma and malignant findings, patient position in biopsy, number of cores, age, prostate volume nor PSA density (p > 0.05). Rectoprostatic hematomas and rectal blood collections are rare complications after in-bore MR-guided prostate biopsy. MR imaging provides benefits not only for lesion detection in prostate biopsy but also for the control of bleeding complications, which can be overlooked in standard TRUS biopsy. Their significance in pain, erectile dysfunction, and urinary retention remains to be investigated.

A0455 - Target vs. target plus standard biopsy in naïve patients: Results of a prospective randomized controlled trial

A0455 - Target vs. target plus standard biopsy in naïve patients: Results of a prospective randomized controlled trial

A0358 - Prostate cancer screening: A novel risk prediction tool with standard biopsies vs. PSA with MRI-targeted biopsies

A0358 - Prostate cancer screening: A novel risk prediction tool with standard biopsies vs. PSA with MRI-targeted biopsies

A0279 - The additional role of Standard prostate biopsy combined to Target biopsy in biopsy naïve patients after radical prostatectomy: Results of a prospective randomized clinical trial

A0279 - The additional role of Standard prostate biopsy combined to Target biopsy in biopsy naïve patients after radical prostatectomy: Results of a prospective randomized clinical trial

Meta-Analysis of Non-Alcoholic Fatty Liver Disease and Electromechanical Reconstruction of Myocardium.

In developed countries, non-alcoholic fatty liver disease (NAFLD), which results from obesity, has become endemic and kills many adults annually. Health research centers in most countries are looking to examine the relationship between metabolic syndrome (MetS) and metabolic biomarkers. A bleeding-prone standard liver biopsy or costly magnetic resonance imaging scan is used to diagnose NAFLD. The present study aimed to analyze medical databases using various scientific articles; moreover, this experiment analyzed medical databases using published scientific articles related to NAFLD, endovascular treatment, cardiac arrhythmias and conduction disorders, changes in the geometry of atria and ventricles, changes in myocardial mass volume as well as diastolic flow left and right ventricular systolic functions, coronary blood flow, analysis of the dependence of epicardial fat tissue (EFT) thickness, and the presence of chronic heart failure (CHF). It is demonstrated that the index of EFT in NAFLD positively correlated with the criteria of cardiovascular health, values of the carotid intima-media thickness, and calcification of the coronary arteries on the coronary artery calcium scale (P<0.0001). The index of per EFT significantly correlated with the factor of the age of the NAFLD patients (P=0.04), hemoglobin A1C level (P<0.001), systemic inflammatory index (P=0.02), the index of impaired glucose tolerance (P=0.03), and especially, the patient's diabetes factor (P<0.001). In addition, adiponectin levels were significantly lower in individuals with NAFLD (P=0.001) and patients with MetS (P=0.02). NAFLD in association with an increase in epicardial adipose tissue (EAT) is an independent risk factor for atherosclerosis, coronary heart disease, CHF, as well as structural and electrophysiological myocardial remodeling. The study of pathogenetic mechanisms in the context of the role of EAT and clinical monitoring of its condition are urgent problems of modern medicine.

Potential of Raman Spectroscopy for Blood-Based Biopsy

Blood is a rich source of potential biomarkers for disease screening, risk assessment, detection, and prognosis. It is comprised of free-floating erythrocytes, leukocytes, platelets, and a nutrient-rich fluid of plasma. Blood samples are readily accessible in a minimally invasive manner compared to solid tissue biopsies; this enables repeated monitoring of the health status of a patient. Components of blood that can alter based on disease include metabolites such as glucose and lactic acid, immune markers such as cytokines and antibodies, and ions such as calcium and phosphate. Changes in levels of these components can be indicative of tumor growth, infection, and/or organ malfunction [1]. It is hardly surprising, therefore, that liquid biopsy based on blood is rapidly emerging as a complementary diagnostic approach to standard imaging and solid tissue biopsy for disease detection [2]. Current blood diagnostic assays, however, typically detect single biomarkers (e.g., pH [3], prostate specific antigen (PSA) in prostate cancer, cancer antigen 125 (CA125) in ovarian cancer). This can be very limiting since the heterogeneous nature of most diseases may require measurements of multiple biomarkers to ensure high specificity of detection.

Questions of axillary region surgery in breast cancer patients after systemic neoadjuvant therapy

As a consequence of the advances in systemic neoadjuvant therapy of breast cancer is the de-escalation of surgical treatment. The study of a limited number of axillary lymph nodes after neoadjuvant therapy and refusal of lymphadenectomy in the absence of metastatic lesions is becoming more common. The published studies have proven the informativeness and safety of standard techniques of sentinel lymph node biopsy after neoadjuvant treatment for cN0 patients. For group cN1 and regression of metastases after neoadjuvant treatment, standard sentinel lymph node biopsy techniques have failed. The use of combined methods of double detection and an increase in the number of examined lymph nodes to 3 and more increased the detection rate of sentinel node biopsy after neoadjuvant therapy and reduced false-negative rate. Long-term results, questions of methodology lymph nodes evaluation, radiation therapy in this group of patients require further investigation.

Liquid biopsies in primary and secondary bone cancers.

Liquid biopsies are a powerful tool to non-invasively analyze tumor phenotype and progression as well as drug resistance. In the bone oncology field, liquid biopsies would be particularly important to develop, since standard biopsies can be very painful, dangerous (e.g., when found in proximity to the spinal cord), and hard to collect. In this review, we explore the recent advances in liquid biopsies in both primary (osteosarcoma and Ewing sarcoma) and secondary bone cancers (breast, prostate, and lung cancer-induced bone metastases), presenting their current role and highlighting their unexpressed potential, as well as the barriers limiting their possible adoption, including costs, scalability, reproducibility, and isolation methods. We discuss the use of circulating tumor cells, cell-free circulating tumor DNA, and extracellular vesicles for the purpose of improving diagnosis, prognosis, evaluation of therapy resistance, and driving therapy decisions in both primary and secondary bone malignancies.

Endoscopic characteristics and management of Subepithelial Lesions in Video-Gastascopie

Background: Subepithelial lesions (SELs) are incidental findings on endoscopies. Some have evil potential. Aim: Assess the prevalence, endoscopic characteristics, and diagnostic/therapeutic management of Sub-epithelial lesions (SELs) in video-gastroscopies (VGC). Materials and methods: All VGC for January 2011-June to 2020 were included, and cases with missing data were excluded. The following was recorded where a SELS was identified: indication, age, sex, size, location and histology, findings from endoscopic ultrasonography (EUS), fine needle aspiration (FNA), and surgical resection. Results: 55 SELS were evidenced in 7,983 patients (0.7%). 72% were women, and the most common indication was dyspepsia (26%). The most frequent location was in the stomach (74%). The mean size was 16 mm (5-50 mm), and half were smaller than 10 mm. Seven presented ulcerated mucous, four were located in the gastric body, and 86% were referred for gastrointestinal bleeding/anemia. In 26 cases, 55 (48%) standard biopsies were performed, and 6 of the 55 (11%) biopsies on biopsies, with no diagnostic yield. EUS was performed in 11% of them, all larger than 10 mm: 2 ectopic pancreases, one lesion-compatible leiomyoma, two lesions of the muscularis propria (leiomyoma / GIST), and one extrinsic compression. No FNA was performed. All LSEs were managed conservatively. Conclusions: This is the first national study on the prevalence of SELS in the upper gastrointestinal tract and was comparable to other series. The diagnostic yield of the biopsy was null. In most cases, the lesions were managed according to the recommendations of international guidelines.

Should Targeted Biopsy be Performed in Patients Who Have Only Pi-rads 3 Lesions?

To determine whether clinical or radiological parameters can predict clinically significant prostate cancer (csPC) in patients with the Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions.Data were obtained from 247 patients with PI-RADS 3 lesions on mpMRI and who had received a software guided transperineal/transrectal MRI/transrectal ultrasonography (MRI/TRUS) fusion prostate biopsy with concomitant standard systematic 12-core biopsy following mpMRI in the prostate cancer and prostate biopsy database of Turkish Urooncology Association, between 2016 and 2020. The cut-off values of clinical parameters were determined using receiver operating characteristic (ROC) curve analysis. Simple and multiple logistic regression analyses were performed to determine the clinical parameters in predicting csPC.A total of 56 patients (22.6%) had prostate cancer, 23 (9.3%) of whom had csPC. In the lesion- based analysis, cancer detection rates (CDRs) of each lesion in targeted biopsy were found to be 6% and 5% for ISUP GG 1 and ISUP GG ≥ 2, respectively. In the patient-based analysis, clinically insignificant CDRs were significantly higher in systematic biopsy compared with targeted biopsy, whereas no significant difference was found in terms of clinically significant CDRs (p = 0.020 and p=0.422, respectively). The cut-off values were determined as 48.3 mL (AUC [95% CI] = 0.68 [0.53-0.82]) for prostate volume, and 0.213 ng/mL/mL (AUC [95% CI] = 0.64 (0.51-0.77]) for PSAD in predicting csPC. In the multiple logistic regression analysis, only PSAD was found to be an independent risk factor in predicting csPC (OR [95% CI]: 3.56 [1.15-10.91], p = 0.024).Since PSAD > 0.20 ng/mL/mL was found to be positive independent risk factor in predicting csPC, in the absence of advanced radiological parameters, PSAD could be used for the biopsy decision in patients with PI-RADS 3 lesions.

The best prostate biopsy sampling system-fusion and systematic biopsy: A single center experience.

Prostate cancer is the second most commonly diagnosed cancer in men. The diagnostic accuracy in prostate cancer can be increased by employing a preliminary multiparametric MRI followed by a fusion-targeted biopsy. To compare the diagnostic accuracy of fusion-targeted biopsy with the standard systematic biopsy in prostate cancer patients, we enrolled 139 patients on which we performed 139 prostate biopsies consisting of three targeted samples followed by 12 regular systematic samples. Based on histology, we analyzed the diagnostic performance of the two methods. Both methods were equally good at detecting clinically significant cancer (83.3%, 50/60), while systematic biopsy detected more clinically insignificant cancers. However, the best diagnostic performance is obtained by combining the two methods. The two methods are best seen as synergistic, and the addition of fusion biopsy can be used to detect more clinically significant prostate cancers than systematic biopsy alone.

O-OGC07 Endoscopically derived oesophageal adenocarcinoma organoids to assess potential response to neo-adjuvant therapy and virotherapy

Abstract Background Organoids are 3D models that retain the architecture and function of the organ from which they are derived. Culture of oesophageal adenocarcinoma organoids from individual’s standard endoscopic biopsies to assess response to therapy could dramatically alter the neo-adjuvant treatment paradigm, giving clarity over who will benefit from therapy, including novel treatment methodologies. Immune checkpoint blockade (ICB) has been shown to be effective in oesophageal adenocarcinoma. Combining Oncolytic Virotherapy with ICB could enhance the action of ICB alone, through selective infection of tumour cells accompanied by immunogenic cell death, with release of neo-tumour antigens and alteration of the tumour microenvironment. Methods This study uses organoids derived from endoscopic biopsies to assess the viability of an oncolytic herpes simplex virus in the treatment of oesophageal adenocarcinoma. Samples were taken at staging endoscopy using standard biopsy forceps. Tissue specimens were dissociated using the Miltenyi tumour dissociation kit before being suspended in Matrigel in conditioned media. Media was changed every 48 hours with domes being split every 7-10 days. After &amp;gt;6 passages organoids were incubated with an oncolytic herpes simplex virus lacking ICP 34.5 and 47. Growth was monitored, and green fluorescence protein expression measured using the Incucyte SX5 Live Cell Analysis system. Results Organoids were successfully established and cultured beyond 6 passages for patients with oesophageal adenocarcinoma. Organoids incubated with an oncolytic herpes simplex virus demonstrated significantly reduced growth compared to untreated organoids with increased expression of green fluorescence protein indicating viral infection. Conclusions We have demonstrated a successful methodology to culture Oesophageal adenocarcinoma organoids from endoscopic biopsies. Further work to determine their responses to standard chemotherapy used in the perioperative phase will help to assess their potential for providing bespoke therapy in the future. Oncolytic herpes simplex virus is able to infect and cause lysis of OAC organoids supporting its potential use in driving an increased inflammatory tumour microenvironment which could be combined with immune checkpoint blockade to induce durable responses for patients.

Epigenetic imprinting alterations as effective diagnostic biomarkers for early-stage lung cancer and small pulmonary nodules

BackgroundEarly lung cancer detection remains a clinical challenge for standard diagnostic biopsies due to insufficient tumor morphological evidence. As epigenetic alterations precede morphological changes, expression alterations of certain imprinted genes could serve as actionable diagnostic biomarkers for malignant lung lesions.ResultsUsing the previously established quantitative chromogenic imprinted gene in situ hybridization (QCIGISH) method, elevated aberrant allelic expression of imprinted genes GNAS, GRB10, SNRPN and HM13 was observed in lung cancers over benign lesions and normal controls, which were pathologically confirmed among histologically stained normal, paracancerous and malignant tissue sections. Based on the differential imprinting signatures, a diagnostic grading model was built on 246 formalin-fixed and paraffin-embedded (FFPE) surgically resected lung tissue specimens, tested against 30 lung cytology and small biopsy specimens, and blindly validated in an independent cohort of 155 patients. The QCIGISH diagnostic model demonstrated 99.1% sensitivity (95% CI 97.5–100.0%) and 92.1% specificity (95% CI 83.5–100.0%) in the blinded validation set. Of particular importance, QCIGISH achieved 97.1% sensitivity (95% CI 91.6–100.0%) for carcinoma in situ to stage IB cancers with 100% sensitivity and 91.7% specificity (95% CI 76.0–100.0%) noted for pulmonary nodules with diameters ≤ 2 cm.ConclusionsOur findings demonstrated the diagnostic value of epigenetic imprinting alterations as highly accurate translational biomarkers for a more definitive diagnosis of suspicious lung lesions.

Neonatal Cholestasis: Updates on Diagnostics, Therapeutics, and Prevention.

Cholestatic jaundice is a common presenting feature of hepatobiliary and/or metabolic dysfunction in the newborn and young infant. Timely detection of cholestasis, followed by rapid step-wise evaluation to determine the etiology, is crucial to identify those causes that are amenable to medical or surgical intervention and to optimize outcomes for all infants. In the past 2 decades, genetic etiologies have been elucidated for many cholestatic diseases, and next-generation sequencing, whole-exome sequencing, and whole-genome sequencing now allow for relatively rapid and cost-effective diagnosis of conditions not previously identifiable via standard blood tests and/or liver biopsy. Advances have also been made in our understanding of risk factors for parenteral nutrition-associated cholestasis/liver disease. New lipid emulsion formulations, coupled with preventive measures to decrease central line-associated bloodstream infections, have resulted in lower rates of cholestasis and liver disease in infants and children receiving long-term parental nutrition. Unfortunately, little progress has been made in determining the exact cause of biliary atresia. The median age at the time of the hepatoportoenterostomy procedure is still greater than 60 days; consequently, biliary atresia remains the primary indication for pediatric liver transplantation. Several emerging therapies may reduce the bile acid load to the liver and improve outcomes in some neonatal cholestatic disorders. The goal of this article is to review the etiologies, diagnostic algorithms, and current and future management strategies for infants with cholestasis.

12-year review of MRI-detected breast cancers. How often was a diagnosis of malignancy established using targeted ultrasound and standard 14-gauge core biopsy?

This retrospective study aimed to determine the percentage of MRI-detected breast cancers diagnosed using targeted ultrasound and standard 14-gauge (14g) biopsy in the setting of an Australian breast MRI service. This is of clinical relevance because malignancies not identifiable on mammography or by ultrasound may then require more invasive, technically demanding and costly MRI-guided interventional procedures, usually by large-core vacuum-assisted biopsy (VAB) or hook-wire localisation with open surgical biopsy. On review of the 12-year period 2006-2018, we identified 67 new breast cancer events in 64 women where the diagnosis was made on the basis of the MRI scan findings either alone (n = 60) or in combination with a concurrent mammogram (n = 7), with no recorded clinical abnormality. The percentage in which malignancy was confirmed on histopathology using targeted ultrasound in combination with 14g biopsy was determined versus other biopsy methods, for both invasive cancer and insitu disease. Ultrasound-guided 14g biopsy was successful in establishing the presence of malignancy in 42/46 (91%) of events with a final diagnosis of invasive cancer, with 2 more proven by MRI-guided interventional procedures (1 VAB and 1 hook-wire) and 1 by open surgical biopsy. In the final case, a 5 mm focus on MRI with no sonographic correlate at the initial presentation was only identified and biopsied by ultrasound at 12-month follow-up. For events with a final diagnosis of DCIS/pLCIS (pleomorphic LCIS, n = 2), US-guided 14g biopsy was successful in 10/21 (48%), while 4/7 events with corresponding mammographic microcalcifications were proven by x-ray stereotactic interventions. A further 5 events had MRI-guided interventions (3 VAB and 2 hook-wires) and 1 an open surgical biopsy to confirm malignancy. In the final case (a woman with a 30 × 20 mm focal area of non-mass enhancement with corresponding microcalcifications consistent with DCIS), a pathologic diagnosis was not made until the patient presented 5 years later with invasive disease. There were also 3 instances of upgrades to invasion on final surgical pathology, one from pLCIS to microinvasion and 2 others from DCIS to IDC. Among the DCIS/pLCIS events, semi-random 14g core biopsy (sampling at the expected location of the MRI abnormality without a specific sonographic correlate) proved to be successful in 3 women. Ultrasound-guided 14g core biopsy established a malignant diagnosis in 91% of invasive cancers and in 48% of DCIS/pLCIS cases. This relatively non-invasive, technically easy to perform and low-cost biopsy procedure can be used immediately when targeted ultrasound shows a correlate for a suspicious MRI scan finding. Careful imaging-pathologic correlation is required after 14g biopsy, and a discordant result will usually prompt recourse to an MRI-guided VAB or hook-wire localisation.

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.&#x0D; Aim. To clarify the information content of ultrasound bronchoscopy using a modified technique.&#x0D; 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.&#x0D; Results. The period of examination of patients when using this technique does not increase. The technique replaces more invasive diagnostic procedures.&#x0D; 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.

The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy in clinically significant prostate cancer detection in patients with biopsy-naïve men according to PSA levels: Apropensity score matching analysis.

ObjectivesTo evaluate the detection rate of clinically significant prostate cancer (csPCa) in Magnetic resonance imaging and ultrasonography (MRI/US) fusion biopsy in patients with biopsy-naïve men for varying prostate-specific antigen (PSA) levels. Since MRI can efficiently detect csPCa compared to standard transrectal ultrasound (TRUS) guided biopsy; however, the optimal PSA threshold for its use is unclear.Materials and methodsWe retrospectively reviewed those who underwent MRI/US-fusion and standard biopsy from January 2016 to June 2018. Patients were divided into three groups: PSA <4, 4–10, >10 ng/mL. Propensity scoring was performed to balance the characteristics of the different biopsy groups, and the detection rate of csPCa was compared.ResultsData from a total of 670 males were included in the analysis (standard TRUS, n = 333; MRI/US fusion, n = 337). Prior to matching, patients who received MRI/US-fusion biopsy had lower prostate volume. Propensity score matching balanced this characteristic and generated a cohort comprising 195 patients from each group. In the matched cohort, patients with PSA 4–10 ng/mL had a significantly increased risk of csPCa by MRI/US-fusion vs. standard biopsy (35.0% vs. 26.6%, P = 0.033). However, patients with PSA <4 ng/mL had csPCa found by MRI/US-fusion versus standard biopsy (12.0% vs. 16.0%, P = 0.342), whereas, patients with PSA >10 ng/mL had csPCa found by MRI/US-fusion versus standard biopsy (78.0% vs. 80.0%, P = 0.596). In multivariate logistic analysis among patients with PSA 4-10 ng/mL, MRI/US-fusion biopsy (odds ratio: 2.46, 95% confidence interval = 1.31–4.60, P = 0.005) were significantly associated with a detection of csPCa.ConclusionsDetection of csPCa by MRI/US-fusion biopsy is more efficient in patients with biopsy-naïve men with PSA 4–10 ng/mL. However, standard TRUS biopsy may identify csPCa in patients with PSA <4 ng/mL and ≥10 ng/mL, emphasizing the importance of performing a standard biopsy in conjunction with MRI/US-fusion biopsy in such populations.