Tru-cut Needle Research Articles

Enhanced Artificial Intelligence Methods for Liver Steatosis Assessment Using Machine Learning and Color Image Processing: Liver Color Project.

The use of livers with significant steatosis is associated with worse transplantation outcomes. Brain death donor liver acceptance is mostly based on subjective surgeon assessment of liver appearance, since steatotic livers acquire a yellowish tone. The aim of this study was to develop a rapid, robust, accurate, and cost-effective method to assess liver steatosis. From June 1, 2018, to November 30, 2023, photographs and tru-cut needle biopsies were taken from adult brain death donor livers at a single university hospital for the study. All the liver photographs were taken by smartphones then color calibrated, segmented, and divided into patches. Color and texture features were then extracted and used as input, and the machine learning method was applied. This is a collaborative project between Vall d'Hebron University Hospital and Barcelona MedTech, Pompeu Fabra University, and is referred to as LiverColor. A total of 192 livers (362 photographs and 7240 patches) were included. When setting a macrosteatosis threshold of 30%, the best results were obtained using the random forest classifier, achieving an AUROC = 0.74, with 85% accuracy. Machine learning coupled with liver texture and color analysis of photographs taken with smartphones provides excellent accuracy for determining liver steatosis.

Assessment of ultrasound-guided tru-cut needle pleural biopsy in the diagnosis of unexplained exudative pleural effusion compared to medical thoracoscopy

Background Ultrasound-guided needle biopsy (USGNB) allows for precise and immediate viewing of pleural lesions, effusions, and needle placement without ionizing radiation. This study aimed to assess the efficacy of US-guided tru-cut needle pleural biopsy in diagnosing unexplained exudative pleural effusion compared to medical thoracoscopy (MT), focusing on safety, accuracy, time, and cost of the treatment. Patients and methods This observational cross-sectional research was conducted on 40 patients over 18 years old, of both sexes, with unexplained exudative pleural effusion. The patients were randomly separated into two equal groups. The girst group is USGNB and the second group is MT. Results Group II exhibited substantially greater costs, sedation levels, procedure duration, biopsy site discomfort, surgical emphysema, lung expansion failure, and psychological distress compared to group I (P<0.05). There was no notable disparity between the two groups regarding radiological detection of pleural effusion, pleural fluid properties, procedural observations, histological results, and diagnostic effectiveness. The duration of hospitalization was considerably shorter in group I compared to group II, assessed from the day of the operation to the day of release (P=0.001). Conclusion USGNB is an important tool in the diagnosis of pleural effusion after failure of pleural fluid analysis, which is performed by a chest physician is an accurate, safer, lower in cost, and shorter in duration with fewer complications compared with MT.

Role of Core Needle Biopsy in Liver Metastases: A Histopathological and Immunohistochemical Approach

Abstract Background: The liver is the second most common organ involved by secondary neoplasms. Core needle biopsy of oncological patients requires an accurate histological diagnosis for the subsequent prescription of adequate management plans. Objectives: The aim of this study was to evaluate the diagnostic accuracy of core needle biopsy for suspected hepatic metastasis and to assess factors that influence the accuracy of the procedure. Materials and Methods: A cross-sectional study randomly enrolled 74 percutaneous ultrasound-guided core needle biopsies from patients with suspected hepatic neoplasm. A 16-gauge tru-cut biopsy needle was performed for all patients. Patient characteristics, procedure information, histopathology reports, and slides were collected from the Department of Histopathology at Al-Jamhorii Teaching Hospital, Mosul City, Iraq. All cases were analyzed using SPSS software, version 18.0. Results: Among 74 patients diagnosed with liver metastasis, the median age was 57 years (range 33–90 years) at the time of biopsy; of them, 61 patients (82.4%) reported a previous history of malignancy, P = 0.003. Histologically, metastatic adenocarcinoma was the most common neoplasm identified in 56 patients (75.7%), with the predominance of colorectal carcinoma. Forty-seven (63.5%) patients underwent two–five passes, which was statistically correlated with an increase in diagnostic accuracy (k = 0.21, 95% confidence interval [CI]= 0.038–1.189, P = 0.04). The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of tru-cut biopsies were 100%, 97.1%, 95.7%, 100%, and 98.2%, respectively. Conclusions: The core needle biopsy is a reliable and valid diagnostic option for the histological assessment of suspected liver metastasis, particularly when supplemented by ancillary immunohistochemistry.

Role of Ultrasound-guided Tru-cut Needle Biopsy in the Diagnosis of Suspicious Breast Masses at South Valley University Hospitals

Role of Ultrasound-guided Tru-cut Needle Biopsy in the Diagnosis of Suspicious Breast Masses at South Valley University Hospitals

An algorithmic approach to the management of peripheral nerve tumours.

This article reviews the pathology and management of peripheral nerve tumours, including a framework for investigation and decision-making. Most tumours are benign, including schwannomas and neurofibromas, but malignant peripheral nerve sheath tumours can occur. The risk of malignant change is remote for schwannomas but higher for neurofibromas, particularly in neurofibromatosis type 1. Magnetic resonance imaging is useful for defining the relationship of a swelling with adjacent nerves but is not definitive for tissue diagnosis. Increasing size, pain and neurological deficit suggest malignant change and TruCut needle biopsy is indicated, although there is a risk of sampling error. Excision biopsy preserving nerve function may be carried out for benign tumours to relieve symptoms. Malignant tumours require a multidisciplinary approach. Complete surgical excision with clear margins is the only curative treatment and may be supplemented with radiotherapy and chemotherapy. However, prognosis remains poor, particularly for patients with neurofibromatosis.

Histology profiling of lung tumors: tru-cut versus full-core system for CT-guided biopsies

PurposeWe aimed to compare the diagnostic yield and procedure-related complications of two different types of systems for percutaneous CT-guided lung biopsy.Material and methodsAll patients with a lung lesion who underwent a CT-guided lung biopsy at our institution, between January 2019 and 2021, were retrospectively analyzed. The inclusion criteria were: (a) Procedures performed using either a fully automated tru-cut or a semi-automated full-core biopsy needle, (b) CT images demonstrating the position of the needles within the lesion, (c) histopathological result of the biopsy and (d) clinical follow-up for at least 12 months and\\or surgical histopathological results. A total of 400 biopsy fulfilling the inclusion criteria were selected and enrolled in the study.ResultsOverall technical success was 100% and diagnostic accuracy was 84%. Tru-cut needles showed a significantly higher diagnostic accuracy when compared to full-core needles (91% vs. 77%, p = 0.0004) and a lower rate of pneumothorax (31% vs. 41%, p = 0.047). Due to the statistically significant different of nodules size between the two groups, we reiterated the statistical analysis splitting our population around the 20 mm cut-off for nodule size. We still observed a significant difference in diagnostic accuracy between tru-cut and full-core needles favoring the former for both smaller and larger lesions (81% vs. 71%, p = 0.025; and 92% vs. 81%; p = 0.01, respectively).ConclusionOur results demonstrated that the use of automated tru-cut needles is associated with higher histopathological diagnostic accuracy compared to semi-automated full-core needles for CTLB.

Pediatric mediastinal tumors.

Mediastinal tumors are the most common thoracic tumor in the pediatric population. They include a spectrum of tumors, and most are malignant. These lesions can be anatomically and radiologically classified by means of compartments; anterior, middle, and posterior. Symptoms, signs, localization of the tumor, age of the child, and tumor markers are key points of diagnosis. Surgical approaches are typically needed for diagnosis, but sometimes tru-cut needle biopsies may be sufficient. Mediastinoscopy, mediastinotomy, and video-assisted thoracoscopic surgery may be used in the diagnostic workup of mediastinal tumors in children as they are used in adults. Frequently, diagnosis and treatment are both established by means of surgery. Surgery remains the mainstay of treatment of most benign and malignant nonlymphoid tumors. Combined modality of treatment incorporating chemotherapy and radiotherapy is often required in malignant tumors and is associated with high survival rates in these patients.

Diagnostic yield of combined ultrasound-guided fine needle aspiration and core needle biopsy versus either technique alone in peripheral lung and pleural lesions

IntroductionUltrasound (US) has become an integral tool for chest assessment as it provides crucial information on pleural pathologies and peripherally located lung lesions.AimTo assess the diagnostic yield of combined fine needle aspiration (FNAB) and core needle biopsy (CNB) versus each technique ultrasound-guided in peripheral lung and pleural lesions.MethodologyThe present study enrolled 30 patients presenting to Alexandria Main University Hospital, with CT scans showing undiagnosed peripheral lung or parietal pleural lesions with or without effusion. A full ultrasound chest assessment was done covering 12 regions. Assessment of the lesion of interest, vascularity was assessed via color Doppler, locating the safest entry site. Real-time US-guided FNAB was done using a spinal needle 22 gauge. Then real-time US-guided CNB using 18 gauge Trucut needle in the same setting. Duration and complications of each procedure were reported. In FNAB, three smears were prepared, fixed in alcohol, and stained with hematoxylin and eosin stain. The remaining sample was fixed in formalin and centrifuged to prepare cell blocks. On the other hand, Trucut needle biopsy specimens were fixed in formalin and processed as paraffin-embedded blocks. Immunohistochemical staining was done. The results were classified into four categories (inadequate, negative, suspicious, and positive for malignancy.ResultsThe diagnostic yield of combined techniques was 96.7% versus 63.3% using FNAB and 96.7% using CNB. The sensitivity of FNAB was 86% while CNB was 95%. The specificity and positive predictive value of both methods were 100%. The negative predictive value of FNAB was 57% versus 80% for CNB in peripheral lung lesions. Duration of US-guided CNB was statistically significantly longer than that of FNAB in both peripheral lung and pleural lesions. No major complications were reported using either technique.ConclusionCombined FNAB and CNB were not superior to CNB alone regarding diagnostic yield but were superior to FNAB. Ultrasound-guided CNB has a superior diagnostic yield over FNAB, with no statistically significant difference regarding associated complications, both techniques are safe. FNAB provided sufficient material for ancillary molecular testing.

Diagnostic Usefulness of Tru-Cut Needle Biopsy in the Diagnosis of Palpable Breast Lump

Introduction: Tru-cut biopsy is now one of the useful means of obtaining early and accurate histopathological diagnosis. It is easy and can be performed on an outpatient basis. It also avoids unnecessary excisional biopsy. Objective: To correlate findings of trucut biopsy in Diagnosis of Palpable Breast Lesions. Material and Methods: A cross sectional, observational study of one years conducted in Dept. Of Surgery, Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh from January to December 2017. The study includes 100 patients of palpable breast lump. Trucut biopsy was performed using a Tru-Cut gun BARD MAX-CORE with an 18-gauge needle by means of 4 successive insertions with different angulations of the needle into the lesion’s core. Results: The study includes 100 patients, Trucut Biopsy findings correlated with the histopathological findings in 97 of 100 cases (97.2%), which included 27 of 28 (96.4%) of the benign lesions and 71 of 72 (98.6%) of the malignant lesions. Conclusion: The results of this study suggest that TCB is an accurate, reliable and a safe method of establishing the diagnosis of cancer in patients with breast lesions. Our results yielded a high sensitivity of 95.65% with 96.88% specificity when compared with FNAC in the diagnosis of breast cancer especially when radiology is not diagnostic. Thus, trucut biopsy should replace fine needle aspiration in the preoperative assessment of suspicious breast lumps.

Diagnostic Accuracy of Fine Needle Aspiration Cytology, Triple Test and Tru-cut Biopsy in the Detection of Breast Lesion

Background: The majority of breast illnesses manifest as a palpable mass. The vast majority of breast lesions are not malignant, and the vast majority of benign lesions do not progress to cancer; however, the accuracy of diagnosis can be improved by a combination of preoperative tests such as physical examination, mammography, fine-needle aspiration cytology (FNAC), and Trucut needle biopsy (TCNB) or core needle biopsy (CNB). FNAC has gained in popularity and is now the primary treatment performed after a history and clinical examination to diagnose solid and cystic breast masses. This study was designed to assess the accuracy of FNAC in comparison to Triple Test and TCNB for the diagnosis of breast masses. Methodology: From January 2023 through May 2023, this study was conducted in the Tezpur Medical College and Hospital. The research included all female patients over the age of 20 with clinically palpable lumps. Palpable breast lumps need a complete clinical breast examination, imaging, and tissue sample for a clear diagnosis to rule out cancer.The Ultrasonography/Mammography, FNAC and tru-cut biopsy procedures were performed concurrently in the same region, and the results were compared to final histopathology as the gold standard. Result: The majority of the patients in the study were in age group of > 60 years. In our study Left breast was involved in 41 (58.5%) patients and right breast in 29 (41.4%) patients. The most frequent site involved was upper outer quadrant in 38 (54.2%). The overall sensitivity of FNAC in our study was 93.75%, tru-cut biopsy is 100% and that of triple test is 100% and specificity for malignancy was 91.6%, 93.6 and 95.6% for FNAC, tru-cut biopsy and triple test respectively. Conclusion: All three techniques have advantages and disadvantages. Core Needle Biopsy cannot be used in place of FNAC, and it is not required to identify all breast lesions. It can be utilised as an adjuvant in circumstances when cytology is definitive and biomarker tests are required. triple test and trucut were more accurate than FNAC in our testing.Trucut biopsy was able to provide histological diagnosis, and the findings were 100% consistent with the final histopathology report.

Diagnostic Accuracy and Complications Rate of CT-guided Core Needle Lung Biopsy of Solid and Part-solid Lesion: A Single-institution Experience

Purpose: The aim of this study was to retrospectively analyze the diagnostic accuracy and risk factors of complications of percutaneous CT-guided transthoracic lung core needle biopsy (CT–TTLB) by stratifying pulmonary lesions by size and consistency. The secondary purpose of this study was to retrospectively evaluate the feasibility and safety of 1-hour patient discharge after (CT–TTLB). Methods: 170 lung biopsies were performed using a semi-automated true-cut needle. There were 116 (68.2%) male and 54 (31.8%) female patients, with a mean age of 60.9±14.24 years (19–91 years). The mean lesion's longest diameter was 6.08±3.33 cm. The lesions were stratified into solid and part-solid lesions. Diagnostic accuracy and adequacy were calculated for all biopsies and for each group separately, as well as the incidence of complications. Complications were stratified into early (discovered within the first hour after biopsy) and delayed (after 1 hour of biopsy) to assess the safety of 1 hour of patient discharge after (CT–TTLB). Results: The overall diagnostic accuracy was 80.6%, with no significant difference between small and large lesions, nor with solid and part-solid lesions. An adequate sample for NGS testing was obtained in 135 core biopsies (79.4%). The most frequent complication was perilesional intrapulmonary hemorrhage and the second most frequent complication was small pneumothorax; seen at a rate of 26% and 15.2% respectively. Large pneumothorax requiring chest tube placement occurred in one patient (1.1%). Most of the biopsy-related complications (98.9%) were discovered in the first hour of the biopsy with only two patients presenting to the ER with the delayed incidence of pneumothorax, which was treated conservatively. Conclusion: Diagnostic accuracy and adequacy were not affected by lesion characteristics or the number of samples. Larger gauge needles and smaller and deeply located nodules were found to have higher complication rates, compared to the larger size, solid, and peripherally located masses. Early discharge after CT-TTLB is associated with little morbidity and no mortality.

Diagnostic Evaluation of Solid Pancreatic Lesions: Endoscopic Ultrasound-Guided Fine Needle Aspiration Versus Percutaneous Ultrasound-Guided Core Needle Biopsy.

The main objective of the present study is to compare the safety, technical success and diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus ultrasound-guided percutaneous core-needle biopsy (US-CNB) in patients with solid pancreatic lesions. This is a retrospective study that involved all patients with a solid pancreatic lesion who underwent EUS-FNA or US-CNB between November 2019 and February 2021. Of all patients, 69 (84.1%) had inoperable malignancy, whereas 13 (15.9%) had chronic pancreatitis. Resectability status was ascertained by computed tomography. All core needle biopsies were performed by the same interventional radiologist via ultrasound guidance with an 18-gauge semi-automatic tru-cut needle. All EUS-FNA procedures were performed by the same gastroenterologist with a 27-gauge EUS-FNA needle. Technical success is defined as if the region of interest is reached and specimen taken from the pancreatic lesion. Diagnostic yield is defined as the procurement of sufficient tissue for pathological examination. Overall, 52 patients (mean age 58.5 ± 9.8years) who underwent EUS-FNA and 30 patients (60.1 ± 12.1years) who underwent US-CNB were included. Solid lesions were most commonly (61.5% in EUS-FNA and 50.0% in US-CNB groups) located in pancreatic head in both groups. Mean size of the lesions was comparable in both groups as well. The technical success was 100% in both groups. In 12 (14.6%) patients, pathology results revealed inadequate sampling (11 × in the EUS-FNA and 1 × in the US-CNB group). The diagnostic yield was significantly higher in US-CNB group than in EUS-FNA group (96.7% vs. 78.8%, respectively, p = 0.048). Of 11 patients in the EUS-FNA with inadequate sampling, pancreatic lesions were located in the pancreatic head in 7 (63.6%). No major complications were observed in neither of the groups. As a minor complication, one case of slight abdominal pain was detected in the EUS-FNA group. Based on the results of the present study, both US-CNB and EUS-FNA appeared safe; however, diagnostic yield in the US-CNB group was significantly higher.

Quality of Tissue Samples Obtained by Endoscopic Ultrasound-Guided Liver Biopsy: A Randomized, Controlled Clinical Trial.

Liver biopsy (LB) remains essential for the diagnosis and staging of parenchymal liver diseases. Endoscopic ultrasound-guided LB (EUS-LB) has emerged as an attractive alternative to percutaneous and transjugular routes. We aimed at comparing the adequacy of samples obtained by EUS-LB with percutaneous LB. A single-center, randomized, controlled clinical trial was designed. Patients undergoing LB were randomly assigned to EUS-LB or percutaneous LB groups. EUS-LB was performed with a 19-gauge Franseen core needle through a transduodenal and transgastric route. Percutaneous LB was performed with a 16-gauge Tru-Cut needle. The main outcome was the percentage of adequate samples obtained. Secondary outcomes were the percentage of accurate histologic diagnosis, number of complete portal tracts (CPT), total and longest specimen length (TSL and LSL), sample fragmentation, adverse events, and patients' satisfaction. An adequate specimen was defined as TSL ≥20 mm and including ≥11 CPT. Ninety patients were randomized (44 to EUS-LB and 46 to percutaneous LB) and included in the analysis. The percentage of adequate tissue samples was 32.6% and 70.4% for percutaneous LB and EUS-LB, respectively (P < 0.001). A final histologic diagnosis was provided in all cases but one. TSL was longer after EUS-LB (23.5 vs 17.5 mm, P = 0.01), whereas the number of CPT was similar in both groups. Sample fragmentation occurred more often after EUS-LB (P < 0.001). No differences in adverse events were found. Satisfaction reported with both procedures was high. EUS-LB is safe and accurate and may be considered an alternative to percutaneous LB for the evaluation of parenchymal liver diseases.

Primary pancreatic lymphoma and metastatic lymphoma cases diagnosed with ultrasonography guided tru-cut needle biopsy; Two case reports

Secondary pancreatic involvement can be seen up to 30% of advance staged non-Hodgkin’s lymphoma cases, but primary pancreatic lymphomas constitute only 1% of extranodal lymphomas. Furthermore, 0.2% of the pancreatic space-occupying lesions are primary pancreatic lymphomas, which usually present as a mass in the head of the pancreas with nonspecific symptoms. Therefore, primary pancreatic lymphomas should be considered as differential diagnosis of pancreatic solid lesions. Herein, we report two cases with different clinical presentation and different course of disease resulting in the diagnosis of primary and metastatic pancreatic lymphoma.

Compliance of thyroid nodules through ultrasound-guided trucut/core needle biopsy with Thyroid imaging, reporting, and data system score and surgical pathology

Background and Aim The ultrasound-guided trucut/core needle biopsy (CNB) has been effectively used as a supplemental approach for the assessment of thyroid nodules. We aimed to evaluate the diagnostic value of the ultrasound-guided trucut needle biopsy of thyroid nodules in correlation with Thyroid imaging, reporting, and data system (TIRADS score). Patient and methods Between November 2020 and November 2021, this prospective study had been carried out at Al-Azhar University Hospital, Assiut, in the department of general surgery and diagnostic and interventional radiology. There were 50 patients in this study, All of them had clinically suspected thyroid nodules. Results The mean age of patients involved in the current research was 43.9±11.7 years. Females represented 92% of the study groups, while males made up just 8%. There was no considerable variation in the prevalence of diabetes mellitus (DM) or hypertension among the study groups. The most prevalent diagnosis in the normocalcemic group (39.63%) was simple goiter, while in the hypocalcemic group was malignancy (44.44%). In terms of preoperative diagnosis, there was a substantial diversity among the 2 groups. Conclusion Thyroid CNB used as an alternative choice for cases with a previous non-diagnostic or indeterminate diagnosis, but is presently being recommended as a first-line method for identification of thyroid nodules in selected cases. Accuracy of CNB in thyroid nodules is high with low rate of drastic effects.

Comparison of the number and content of pathology laboratory samples before and after the COVID-19 pandemic.

Coronavirus disease 2019 (COVID-19) has caused respiratory system diseases and affected people's access to healthcare services for diseases other than COVID-19. After theCOVID-19 pandemic, changes occurred in thenumber and content ofpathology laboratory samples, related to measures such as reducing thenumber ofoutpatient clinics in hospitals, postponing elective surgery, and restricting cancer screening. All samples sent to thepathology laboratory between 2019 and 2020 were included in our study. Biopsy, cytology, histochemical, and immunohistochemical staining and biopsies for malignant cases were evaluated. Changes in sample number and content caused by thepandemic were examined. Thenumber ofbiopsies was 24312 in 2019 and 13208 in 2020. On comparison, adecrease was observed in all parameters. Thelargest (78.5%) and smallest (11.02%) decreases were observed in examinations oftheincoming preparations for consultation (214-46) and Trucut needle biopsies (726-646), respectively. Cases such as appendectomies that require urgent intervention and malignancies that require further examination and diagnosis are theleast affected. However, whether thedecrease in cancer screening will affect theearly diagnosis and treatment ofmalignancies and create apublic health problem in thefuture remains to be established.

Plugged percutaneous liver biopsy using Tru-cut needle and coils: A retrospective study.

Plugged percutaneousliver biopsy, though has been in use for many years, is being used more frequently in patients in whom percutaneous liver biopsy is contraindicated due to proven or probable bleeding tendencies. We report our experience with this procedure, its indications, efficacy, and complications in Indian population over 2 years. A retrospective study of 127 consecutive patients who had undergone plug liver biopsy from April 2017 to May 2019 was done from the database maintained in our department. The indications, technical success, complications, and impact of histological diagnosis on the management of those patients were evaluated. A total of 127 biopsies were performed of which 68 were males and 59 were females, aged between 7 and 73 years. No procedures were abandoned; however, 13 cases needed ultrasonography (USG)guidance because of small size of the liver or presence of right perihepatic fluid. Out of 127 biopsies, none of the samples was inadequate and yielded adequate tissue for histopathological diagnosis. Seven patients required repeat study only because underlying liver disease was suspected clinically and the previous biopsy report had turned out to be normal. Histopathological examination in our study showed autoimmune hepatitis in 61, cirrhotic changes either hepatitis B virus (HBV)or hepatitis C virus (HCV) related in 40, veno-occlusive disease in 3, cholestatic disease in 2, and Wilson's disease in 2 patients. The remaining 19 were normal. Complications occurred in 3 patients - arterioportal fistula, pneumothorax, and inadequate coiling causing mild hemoperitoneum. Percutaneous liver biopsy followed by plugging of the tract with coils is a safe, easy, and effective method in patients with underlying bleeding tendencies, minimal ascites, and small liver.

Retroperitoneal laparoscopic renal biopsy: an 8year experience at a single centre.

To present our experience and outcome of consecutive laparoscopic renal biopsy (LRB) in a series of Chinese patients over an 8year period. Between January 1, 2013, and December 31, 2020, 104 patients (M/F 71/33, age 43.6 ± 16.0years) were enrolled. All patients underwent LRB for various indications, e.g., dialysis dependence (33.7%), serum levels of creatinine ≥ 442μmol/L (20.2%), morbid obesity (18.3%), uncontrolled severe hypertension (14.4%), aberrant renal anatomy (5.8%), solitary kidney (2.9%), deaf-mutes (2.9%), failed percutaneous biopsy (1.0%) and patient choice (1.0%). The kidney was approached via the laparoscopic retroperitoneal route using a three-port technique. Then, 16-gauge true-cut needle biopsy was performed and haemostasis was achieved by compression. Topical collagen mesh was used if necessary. Renal tissue was obtained in all cases. The operative time and amount of blood loss were significantly (P < 0.05) lower in 2017-2020 than 2013-2016 [42.6 ± 1.5min and 9.6 ± 0.7mL, respectively (n = 61) vs. 51.2 ± 1.3min and 14.4 ± 0.9mL, respectively (n = 43)], while the hospital stay was not significantly different between the two periods. The rate of tissue adequacy and median number of glomeruli were significantly higher in 2017-2020 than 2013-2016 [100% and 52 (IQR 24-94), respectively vs. 93% and 35 (IQR 6-98), respectively). Two postoperative complications occurred in the first 4years: disseminated intravascular coagulation (DIC) during the operation and injury at the hilum of the kidney (n = 1 each). The renal pathological diagnoses were also complex: 70.2% of the cases were independent pathological types, including IgA nephropathy (IgAN) (13.5%), Henoch-Schönlein purpura nephritis (HSPN) (2.9%), focal segmental glomerulosclerosis (FSGS) (9.6%), membranous glomerulonephritis (MN) (1.9%), lupus nephritis (LN) (3.8%), crescentic glomerulonephritis (CreGN) (7.7%), diabetic nephropathy (DN) (10.6%), tubulointerstitial nephritis (TIN) (11.5%) and malignant hypertensive nephropathy (MHTN) (8.7%). However, the rates of combinations of two and three pathological types were 25.0% and 4.8%, respectively. Retroperitoneal LRB is a safe, reliable, minimally invasive alternative for patients in whom PRB in not feasible. As a helpful supplement to PRB, it may be necessary to use this technique more often in the future.

Targeted prostate biopsy: 68Ga-PSMA PET/CT vs. mpMRI in the diagnosis of prostate cancer.

To evaluate the diagnostic accuracy of 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomog-raphy (PET/CT) vs. multiparametric magnetic resonance imaging (mpMRI) targeted biopsy (TPBx) in the diagnosis of clinical-ly significant prostate cancer (csPCa: Grade Group ≥ 2). From January 2021 to June 2022, 100 patients (median age: 66 years) with negative digital rectal examination underwent transperineal prostate biopsy for abnor-mal PSA values (median 7.5 ng/ml). Before prostate biopsy, all patients underwent mpMRI and 68Ga-PET/CT examinations and mpMRI (PI-RADS version 2 ≥ 3) or 68Ga-PET/CT index lesions suspicious for cancer (SUVmax > 5 g/ml) underwent cognitive targeted cores (mpMRI-TPBx and PSMA-TPBx: four cores) combined with extended systematic prostate biopsy (eSPBx: median 18 cores). The procedure was performed transperineally using a tru-cut 18-gauge needle under sedation and antibiotic prophylaxis. PCa was found in 58/100 (58.0%) men; in detail, 44/58 (75.9%) were csPCa; mpMRI and 68Ga-PSMA showed 66/100 (66%) and 62/100 (60%) lesions suspicious for PCa, respectively. 68Ga-PSMA-TPBx vs. mpMRI-TPBx vs. eSPBx diagnosed 42 (95.4%) vs. 36 (81.8%) vs. 30 (68.2%) csPCa, respectively; mpMRI-TPBx vs. 68Ga-PSMA-TPBx showed a diagnostic accuracy of 76.9% vs. 84.9% in diagnosing csPCa. 68GaPSMA PET/CT TPBx demonstrated good accuracy in the diagnosis of csPCa, which was not inferior to mpMRI TPBx (84.9% vs. 76.9%) improving the detection rate for cancer of systematic biopsy.

A Retroprospective Clinicopathological Study of Prostatic Lesions in Surgical Specimens

Abstract Background Prostatic diseases such as inflammation, benign prostatic hyperplasia, and tumors are prime causes of mortality and morbidity in males. The prevalence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide. Aim The present study was undertaken with the aim of studying the clinicopathological characteristics of prostate lesions in surgical specimens Methods The present study was a retroprospective study. A total of 212 prostate surgical specimens were included. Information provided in the requisition form regarding age, type of prostatic biopsy and clinical presentation, and histopathological diagnosis was taken into consideration and recorded. All specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with hematoxylin and eosin stain (H&amp;E stain). Relevant clinical data including age, the presenting complaints, and S.PSA values were recorded. Data were collected and analyzed using simple statistical methods with Microsoft Excel 2016. Results Out of 212 cases analyzed, 161 (76%) were transurethral resection of prostate (TURP) TUPR specimens, 38 (18%) were trucut needle biopsies, and 13 (6%) were open prostatectomy specimens. The youngest patient was 48 years old while the oldest patient was 90 years old with a mean of 71.7 ± 8.2 years. Of the total 212 surgical specimens, 174 (82%) cases were of benign prostatic hyperplasia (BHP), and 38 (18%) were prostatic adenocarcinoma (PAC). Also, 94 (44.3%) of BPH and carcinoma of the prostate cases were most common in the seventh decade of life (61-70 years). Difficulty in micturition was the most common presentation 82 (39%). A maximum number of the BPH cases 81 (46.5%) had the prostate-specific antigen range of 0 to 4 ng/mL. The highest value of serum PSA was noted among the PAC patients in the range of &gt; 80 ng/mL. Out of 38 cases of prostatic adenocarcinoma, moderately differentiated (Gleason scores 7) was the most common core and was seen in 42.1% of the PAC cases. Conclusion The present study showed that the most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61 to 70 years. The PAC was common among males of more than 60 years. Histopathological examination is the best diagnostic tool for PAC