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Biopsy etc. Procedures and Bronchography.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
The needles commonly used include: simple fine needles - e.g. of lumbar puncture type,rough spiral tipped trochar (to fix the lesion) within a biopsy cannula (Rotex needle - slide the sheath over the end of the screw for taking the biopsy), and(c) various cutting needles (e.g. TruCut, Biopty and Temno type needles) to obtain a slice or 'core' of tissue - these are particularly valuable with diffuse lung diseases and also a 'core' may allow a more certain diagnosis of the type of tumour - e.g. small cell, type of lymphoma etc. Other needles which have been used include Vim-Silverman (Silverman, 1938 - a new biopsy needle- cannula with inner split needle), Turner (see Lieberman et al., 1982), Menghini (see TØrpPedersen et al, 1984), Franseen, etc.
Interventional radiology
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
The tract is infiltrated with local anesthetic down to the level of the renal capsule. A 16-gauge semi-automatic core biopsy needle is then inserted through a short stab incision (Figure 90.2b). If the child is able to cooperate, they are asked to stop breathing as the needle is advanced under real-time US guidance into the kidney and the biopsy is taken. A shallow or deep trajectory may be appropriate, depending on the size of the kidney and the relationship of its lower pole to the ribs. When the child is under GA, suspension of breathing is not required, and the anesthetist may prefer to allow the patient to breathe spontaneously. A pathology technician is present to examine the core and confirm that the sample contains sufficient glomeruli. If not, another core is taken. Using this method, a definitive histopathology report should be possible for 99% of biopsies.
Soft Tissue Sarcomas
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Thomas F. DeLaney, David C. Harmon, Karol Sikora, Francis J. Hornicek
Several comments are pertinent with regard to the use of the core biopsy technique. The needle path for biopsy should allow excision of the biopsy track at the time of definitive surgery to avoid potential needle track recurrence. Image guidance with ultrasound or CT can help direct and document placement of the biopsy needle. Sufficient material for cDNA arrays can be obtained by core biopsies. It is recommended that at least three cores of tumor be retrieved for pathologic analysis. Open biopsies can be reserved for patients in whom diagnostic material cannot be obtained by needle core biopsy.
Prognostic value of the 7-year protocol biopsy of adult kidney allografts: impact of mesangiosclerosis and proteinuria
Published in Renal Failure, 2023
Yoshihiro Itabashi, Hideyo Oguchi, Tetuo Mikami, Noriyuki Kounoue, Taichi Arai, Kazunobu Shinoda, Masaki Muramatsu, Seiichiro Shishido, Ken Sakai
The present study was a retrospective analysis of a cohort treated in a single center. We performed the 7-year protocol biopsy within 6–8 years after kidney transplantation. The process of patient selection is demonstrated in Figure 1. One-hundred-and-eighty-four patients received kidney transplantation from 2002 to 2008 in the Toho University Omori Medical Center. We excluded patients aged <20 years at transplantation (n = 24), those who did not undergo a 7-year biopsy (n = 66), and those who underwent a for-cause biopsy during the same period (n = 5). The final study cohort comprised 89 patients who underwent a protocol biopsy at 7 years after kidney transplantation. We used basiliximab for the induction therapy, and the maintenance oral immunosuppressants included calcineurin inhibitors (CNI) (tacrolimus or cyclosporine), methylprednisolone, and antimetabolites (mycophenolate mofetil or mizoribine). We routinely performed protocol biopsies at 1 h, 3 months, 1 year, 5 years, 7 years, and 10 years after kidney transplantation. The biopsy samples were collected using a 16 G biopsy needle.
Feasibility of genomic profiling with next-generation sequencing using specimens obtained by image-guided percutaneous needle biopsy
Published in Upsala Journal of Medical Sciences, 2019
Miyuki Sone, Yasuaki Arai, Shunsuke Sugawara, Takatoshi Kubo, Chihiro Itou, Tetsuya Hasegawa, Noriyuki Umakoshi, Noboru Yamamoto, Kumiko Sunami, Nobuyoshi Hiraoka, Takashi Kubo
The primary outcome was the rate of successful genomic analysis with specimens obtained by percutaneous needle biopsy. The secondary outcomes were profiling of genetic alterations, technical success rate of biopsy procedures, adverse events evaluated using the Common Terminology Criteria for Adverse Events v. 4.0, rate of success in pathological diagnosis, and cause of failed genomic analysis. Technical success of the biopsy procedure was defined as obtaining tissue sections with imaging confirmation of the biopsy needle within the target. Successful NGS analysis was defined as the ability to perform genomic analysis by NGS using DNA extracted from the specimen. The causes of failed NGS analysis were categorized as: (i) failure of the puncture of the target site (sampling error); (ii) unprocessed for DNA extraction due to insufficient specimen volume; (iii) insufficient DNA volume; and (iv) deteriorated DNA quality. We also calculated the rate of successful genomic analysis excluding NGS analysis that failed due to reasons unrelated to the biopsy procedures, i.e. reasons (ii) and (iv).
Transthoracic ultrasound-guided biopsy in the hands of chest physicians – a stepwise approach
Published in European Clinical Respiratory Journal, 2019
Ida Skovgaard Christiansen, Paul Frost Clementsen, Uffe Bodtger, Therese Maria Henriette Naur, Pia Iben Pietersen, Christian B Laursen
Generally, a single-needle technique is used for ultrasound-guided biopsies. The procedure can be performed using both aspiration needles as well as core biopsy needles (Figure 2). Whether an aspiration needle or a core biopsy needle is chosen for a procedure will depend on the suspected diagnosis (e.g. carcinoma, malignant mesothelioma, lymphoma, infection), lesion characteristics (e.g. size, placement, mobility) and patient characteristics (e.g. comorbidities, medication). The advantage of the core biopsy is the amount of obtained tissue whereas the aspiration needle is less invasive and often easier to use when the lesion is small and mobile. If doubt exists whether a core biopsy needle can be used, or the procedure should be limited to aspiration, a pragmatic approach is to initially perform aspiration biopsies using aspiration needles. If this can be easily performed, core biopsies can be performed subsequently. Such an approach can also be combined with rapid on-site evaluation (ROSE) is available [7].