1
|
Kurian J, Loganathan A, Jacob T, Matthew L, Moses V, Nidugala Keshava S, Priscilla A. Efficacy of core needle biopsy in the diagnosis of pediatric extracranial solid malignancies: A 10-year study. J Indian Assoc Pediatr Surg 2022; 27:60-64. [PMID: 35261515 PMCID: PMC8853597 DOI: 10.4103/jiaps.jiaps_319_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/26/2020] [Accepted: 02/04/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Core needle biopsies of solid masses in children are a minimally invasive technique. It guides to a definitive diagnosis and facilitates management. Aims and Objectives: To determine the accuracy, sensitivity, and specificity of core needle biopsies in diagnosing pediatric solid masses. Materials and Methods: A retrospective analysis of 430 children, who underwent core needle biopsy for solid masses between January 2007 and December 2016 at CMC Vellore, was done. Results: Retroperitoneal and intra-abdominal masses constituted 66% of cases. Real-time image guidance was used in 44% of cases. An accurate diagnosis was obtained in 93.6% of cases, while results did not correlate with the final diagnosis in 3.4%. Three percent had inadequate or necrotic tissue. None of the children had postprocedure complications. Conclusion: Core needle biopsies serve as good diagnostic modality, with minimal risks, in making a conclusive diagnosis and deciding on the line of management.
Collapse
|
2
|
Numerical Simulation and Experimental Verification of Electric-Acoustic Conversion Property of Tangentially Polarized Thin Cylindrical Transducer. MICROMACHINES 2021; 12:mi12111333. [PMID: 34832745 PMCID: PMC8624405 DOI: 10.3390/mi12111333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Abstract
In solving piezoelectric equations of motion, we established an electric–acoustic equivalent circuit of tangentially polarized thin cylindrical transducers and derived analytical expressions of the electric-acoustic response from the harmonic driving-voltage excitation. To experimentally verify the findings, we manufactured a parallel electric-acoustic transmission network for transducers excited by multifrequency driving signals. We found that the tangentially polarized thin cylindrical transducers achieved a much higher electric-acoustic conversion efficiency than the radially polarized thin cylindrical transducers. The electric-acoustic impulse response of the transducers consisted of a direct-current damping with lower-frequency components, a damping oscillation with higher-frequency elements, and a higher resonant frequency of the transducer over its center frequency. The characteristics of radiated acoustic signals included contributions from the geometrical shape and size of the transducer, the physical parameters of piezoelectric material, the type of driving-voltage signals, and the polarization mode of the transducers. In comparison, our theoretical predictions are in good agreement with experimental observations. It is plausible that using the tangentially polarized thin cylindrical transducers as sensors in the acoustic-logging tool may significantly improve the signal-to-noise ratio of the measured acoustic-logging signals.
Collapse
|
3
|
Ultrasound-Guided Core Biopsy for Tissue Diagnosis in Pediatric Oncology: 16-Year Experience With 597 Biopsies. AJR Am J Roentgenol 2021; 216:1066-1073. [PMID: 33566633 DOI: 10.2214/ajr.20.23196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE. Percutaneous imaging-guided core needle biopsies (CNBs) for cancer diagnosis in pediatric patients are gaining interest because of their availability, lower rate of complications, and high diagnostic power compared with traditional surgical biopsies. Nevertheless, their precise role in the diagnostic algorithm of pediatric oncology is still unknown. The purpose of this study was to report our accumulated 16-year experience with CNB; discuss the availability, safety, and diagnostic accuracy of the procedure and the adequacy of ancillary testing; and compare our findings with the available literature. MATERIALS AND METHODS. Pediatric ultrasound-guided CNBs performed in our hospital between November 2003 and December 2019 were retrospectively studied. Data collection included demographics, clinical and procedural parameters, complications, and final diagnosis. RESULTS. A total of 597 biopsies were performed in 531 patients (132 performed in known oncologic patients and 465 performed to establish diagnosis). The median time between the biopsy request and the procedure was 1 day. Of 432 biopsies performed in patients with malignancies, 12 (2.8%) had false-negative results. In 165 cases of benign pathologic findings, all had true-negative results. Ancillary testing was adequate in all malignant cases. Overall sensitivity, specificity, and accuracy rates were 97.2%, 100%, and 98.0%, respectively. Five biopsies (0.8%) resulted in complications, including one major bleed and one track seeding. CONCLUSION. Our experience shows that ultrasound-guided CNB for suspected malignancy in pediatric patients has a high safety profile, availability, and accuracy rate compared with surgical biopsy. Our fast-track strategy enables early initiation of designated therapy and has the potential to become the procedure of choice.
Collapse
|
4
|
Soumya, Whitehorn A, Ooi EH, Lockwood C. Accuracy of core needle biopsy compared to fine needle biopsy for the diagnosis of neoplasm in patients with suspected head and neck cancers: a systematic review protocol of diagnostic test accuracy. JBI Evid Synth 2020; 18:1602-1608. [PMID: 32813401 DOI: 10.11124/jbisrir-d-19-00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The objective of this review is to determine the difference in diagnostic accuracy of core needle biopsy and fine needle aspiration for patients with a head and neck mass using surgical histopathology as a reference test. The risks and adverse events associated with each technique will also be compared. INTRODUCTION Tissue diagnosis is critical in evaluation of head and neck lesions to guide management. Options for tissue biopsy include surgical biopsy, fine needle aspiration and core needle biopsy. INCLUSION CRITERIA Studies that compare ultrasound-guided core needle biopsy and/or fine needle aspiration to investigate lumps in the thyroid, cervical lymph nodes, or salivary glands for malignancy in adult patients will be included. The comparator test will be definitive histology in form of surgical biopsy/excision. METHODS MEDLINE, Emcare, Embase, Web of Science and Cochrane Register of Diagnostic Accuracy Studies will be searched. Studies will be critically appraised by two independent reviewers for methodological quality, using the modified critical appraisal instrument QUADAS-2 and JBI SUMARI software. Two independent reviewers will extract data from papers included in the review using the standardized data extraction tool available in the JBI Reviewer's Manual. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020140005.
Collapse
Affiliation(s)
- Soumya
- 1Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Australia 2JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia 3Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Australia 4Department of Surgery, Flinders University, Bedford Park, Australia
| | | | | | | |
Collapse
|
5
|
Tabet P, Saydy N, Letourneau-Guillon L, Gologan O, Bissada É, Ayad T, Tabet JC, Guertin L, Nguyen-Tan PF, Christopoulos A. Cystic masses of the lateral neck: Diagnostic value comparison between fine-needle aspiration, core-needle biopsy, and frozen section. Head Neck 2019; 41:2696-2703. [PMID: 30945785 DOI: 10.1002/hed.25755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/09/2019] [Accepted: 03/12/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The usefulness of fine-needle aspiration (FNA), core-needle biopsy (CNB), and frozen section (FS) for assessing lateral cystic neck masses (LCNM) remains unclear. METHODS A retrospective review of patients presenting with a LCNM was undertaken. RESULTS In total, 135 patients were included. FNA had a lower sensitivity then CNB (59% vs 83%; P = .036) and FS (59% vs 93%; P = .01). FS had a better negative predictive value (NPV) when compared to FNA (92% vs 40%; P < .001) and CNB (92% vs 50%; P = .062). Positive predictive values (PPV) and sensitivities were similar among all groups. CONCLUSION Given its adequate PPV (92%), FNA should be used initially on LCNM. Because of its high sensitivity, CNB should be considered if FNA is not diagnostic of malignancy. FS should always follow a CNB indicative of malignancy, because of low NPV. A diagnosis of malignancy on FNA, CNB, or FS strongly indicates presence of malignancy.
Collapse
Affiliation(s)
- Paul Tabet
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Nadim Saydy
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Laurent Letourneau-Guillon
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Olga Gologan
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Éric Bissada
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Tareck Ayad
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Jean-Claude Tabet
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Louis Guertin
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Phuc Félix Nguyen-Tan
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Apostolos Christopoulos
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| |
Collapse
|
6
|
Farndon S, Behjati S, Jonas N, Messahel B. How to use… lymph node biopsy in paediatrics. Arch Dis Child Educ Pract Ed 2017; 102:244-248. [PMID: 28468821 DOI: 10.1136/archdischild-2015-309634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/26/2022]
Abstract
Lymphadenopathy is a common finding in children. It often causes anxiety among parents and healthcare professionals because it can be a sign of cancer. There is limited high-quality evidence to guide clinicians as to which children should be referred for lymph node biopsy. The gold standard method for evaluating lymphadenopathy of unknown cause is an excision biopsy. In this Interpretation, we discuss the use of lymph node biopsy in children.
Collapse
Affiliation(s)
- Sarah Farndon
- Cancer Genome Project, Wellcome Trust Sanger Institute, Cambridge, UK.,Developmental Biology and Cancer Programme, University College London, Institute of Child Health, London, UK
| | - Sam Behjati
- Cancer Genome Project, Wellcome Trust Sanger Institute, Cambridge, UK.,Department of Paediatric Haematology/Oncology, Addenbrooke's Hospital, Cambridge, UK
| | - Nico Jonas
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Boo Messahel
- Department of Paediatric Haematology/Oncology, Addenbrooke's Hospital, Cambridge, UK
| |
Collapse
|
7
|
Li L, Chen BD, Zhu HF, Wu S, Wei D, Zhang JQ, Yu L. Comparison of pre-operation diagnosis of thyroid cancer with fine needle aspiration and core-needle biopsy: a meta-analysis. Asian Pac J Cancer Prev 2015; 15:7187-93. [PMID: 25227812 DOI: 10.7314/apjcp.2014.15.17.7187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. MATERIALS AND METHODS Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. RESULTS Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (± 0.030) for FNA and 0.745 (± 0.095) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. CONCLUSIONS FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.
Collapse
Affiliation(s)
- Lei Li
- Zhenjiang Key Laboratory of Molecular Endocrinology; Affiliated Hospital of Jiangsu University, Zhenjiang, China E-mail :
| | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
Locke R, Comfort R, Kubba H. When does an enlarged cervical lymph node in a child need excision? A systematic review. Int J Pediatr Otorhinolaryngol 2014; 78:393-401. [PMID: 24447684 DOI: 10.1016/j.ijporl.2013.12.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/08/2013] [Accepted: 12/10/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND Palpable cervical lymphadenopathy is very common in children. The clinician's job is to exclude malignancy as a cause and reach a diagnosis. In children selected for open biopsy, reactive hyperplasia and other inflammatory causes are far more common as a final diagnosis than malignancy. Furthermore complications can occur after open biopsy. OBJECTIVE To assess the diagnostic utility of clinical examination and investigations to exclude malignancy and other serious causes of paediatric cervical lymphadenopathy and minimise open biopsy. TYPE OF REVIEW A systematic review of the literature with defined search strategy. SEARCH STRATEGY A structured search of Medline, Embase, CINAHL and Cochrane databases. The references within standard paediatric ENT and head and neck textbooks were also examined. RESULTS The quality of evidence regarding predictors of malignancy is poor. Large lymph nodes and supraclavicular nodes are potential indicators of serious pathology. Fever, weight loss and organomegaly may be indicators but duration of symptoms and consistency are not. Abnormalities on chest X-ray are associated with serious causes but the diagnostic utility of routine chest X-ray is unknown. Ultrasound assessment of nodal architecture, margins, and shape (and possibly vascularity) shows considerable promise as a means of differentiating reactive hyperplasia from malignancy but further studies in children are required. Abnormalities in the full blood count (FBC) seem to be uncommon but when present are associated with serious causes of cervical lymphadenopathy, again the diagnostic utility is unclear. Serological testing may identify a specific cause and therefore avoid excision biopsy in around 10% of cases. Cutting needle biopsy requires further evaluation before it can be recommended. Fine needle aspiration cytology (FNAC) is very specific, but sensitivity varies in different studies to the extent that it cannot yet be relied upon to exclude malignancy. CONCLUSIONS Large and supraclavicular nodes should be biopsied. Ultrasound is likely to be useful but further study is required. FNAC cannot be relied upon to exclude malignancy in children. The diagnostic utility of chest X-ray and FBC are unclear. Work is required on multivariate predictive models.
Collapse
Affiliation(s)
- Richard Locke
- Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, Scotland, United Kingdom.
| | - Rachael Comfort
- Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, Scotland, United Kingdom
| | - Haytham Kubba
- Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, Scotland, United Kingdom
| |
Collapse
|
10
|
Pedersen OM, Aarstad HJ, Løkeland T, Bostad L. Diagnostic yield of biopsies of cervical lymph nodes using a large (14-gauge) core biopsy needle. APMIS 2013; 121:1119-30. [DOI: 10.1111/apm.12058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 01/22/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Ole M. Pedersen
- Department of Heart Disease; Institute of Medicine; Haukeland University Hospital; Bergen Norway
| | - Hans J. Aarstad
- Department of Otolaryngology and Head and Neck Surgery; Haukeland University Hospital; Bergen Norway
| | - Turid Løkeland
- Department of Oncology and Medical Physics; Haukeland University Hospital; Bergen Norway
| | - Leif Bostad
- Department of Pathology; Haukeland University Hospital; Bergen Norway
- The Gade Institute Section for Pathology; Haukeland University Hospital; Bergen Norway
| |
Collapse
|
11
|
Diagnostic utility of freehand core-needle biopsy in head and neck masses. The Journal of Laryngology & Otology 2012; 127:175-80. [PMID: 23249679 DOI: 10.1017/s0022215112002915] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To review our experience with freehand core-needle biopsy in the assessment of unexplained head and neck masses. METHODS A total of 770 patients with head and neck masses (referred over a 22-month period) were evaluated. A retrospective chart review was performed on 53 of those patients who underwent core-needle biopsy for an unexplained mass. RESULTS Correct sampling of the target tissue was achieved in all 53 patients (100 per cent) using a freehand core-needle biopsy technique. The diagnostic accuracy for providing adequate tissue samples for histopathological diagnosis was 96 per cent; the test sensitivity was 92 per cent. Four patients (7 per cent) required open surgical biopsy prior to commencing definitive treatment. CONCLUSION Out-patient freehand core-needle biopsy can be carried out safely on select patients with head and neck masses, and provides high quality histopathology specimens with high diagnostic utility.
Collapse
|
12
|
Douville NJ, Bradford CR. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions. Head Neck 2012; 35:1657-61. [PMID: 23109044 DOI: 10.1002/hed.23193] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2012] [Indexed: 12/14/2022] Open
Abstract
Ultrasound-guided core biopsy provides many benefits compared with fine-needle aspiration cytology and has begun to emerge as part of the diagnostic work-up for a salivary gland lesion. Although the increased potential for tumor-seeding and capsule rupture has been extensively discussed, the safety of this procedure is widely accepted based on infrequent reports of tumor-seeding. In fact, a review of the literature shows only 2 cases of salivary tumor seeding following biopsy with larger-gauge needle characteristics, with 2 reported cases of salivary tumor seeding following fine-needle aspiration cytology. However, the follow-up interval of such studies (<7 years) is substantially less than the 20-year follow-up typically necessary to detect remote recurrence. Studies on tumor recurrence of pleomorphic adenoma, the most common salivary gland lesion, suggest that as many as 16% of tumor recurrences occur at least 10 years following initial surgery, with average time to recurrence ranging anywhere from 6.1 to 11.8 years postoperatively. Despite the benefits of ultrasound-guided core biopsy over fine-needle aspiration biopsy, which include both improved consistency and diagnostic accuracy, current studies lack adequate patient numbers and follow-up duration to confirm comparable safety profile to currently accepted fine-needle aspiration cytology. In this report we: (1) compare the relative benefits of each procedure, (2) review evidence regarding tumor seeding in each procedure, (3) discuss time course and patient numbers necessary to detect tumor recurrence, and (4) describe how these uncertainties should be factored into clinical considerations.
Collapse
Affiliation(s)
- Nicholas J Douville
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan; Medical Scientist Training Program, University of Michigan, Ann Arbor, Michigan
| | | |
Collapse
|
13
|
Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck 2011; 34:1497-503. [PMID: 22127851 DOI: 10.1002/hed.21821] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2011] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Core-needle biopsy (CNB) has occasionally been used in the work-up of head and neck lesions. However, no systematic review of this simple, minimally invasive method has yet been performed. METHODS A systematic review of the literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1291 cervical lesions in 1267 patients were examined by CNB. This resulted in 1232 adequate samples, from which 554 were subsequently confirmed by excisional biopsy. RESULTS CNB was able to identify true neoplasms and detect malignancy in head and neck lesions with an overall accuracy of 94% and 96%, respectively, even though there was a significant difference between the histologically verified and all adequate samples. CNB provided a correct specific diagnosis in 87% of cases without major complications and achieved a higher accuracy than that of fine-needle aspiration in detecting malignancy. CONCLUSIONS This meta-analysis confirms that CNB is an excellent method in the assessment of salivary gland lesions and lymphadenopathies inclusive of malignant lymphoma, but it is not ideal for evaluating thyroid lesions.
Collapse
Affiliation(s)
- Eva Novoa
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital AG, Aarau, Switzerland.
| | | | | | | |
Collapse
|
14
|
Pfeiffer J, Ridder GJ. How safe is the use of ultrasound-guided cutting needle biopsy in the head and neck? Eur Radiol 2010; 20:2933-8. [DOI: 10.1007/s00330-010-1871-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 05/14/2010] [Indexed: 11/24/2022]
|
15
|
Pfeiffer J, Kayser G, Ridder GJ. Sonography-assisted cutting needle biopsy in the head and neck for the diagnosis of lymphoma: Can it replace lymph node extirpation? Laryngoscope 2009; 119:689-95. [DOI: 10.1002/lary.20110] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
16
|
Diagnostic effectiveness of sonography-assisted cutting needle biopsy in uncommon cervicofacial lesions. ACTA ACUST UNITED AC 2009; 107:173-9. [DOI: 10.1016/j.tripleo.2008.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 06/06/2008] [Accepted: 06/25/2008] [Indexed: 11/24/2022]
|
17
|
Pfeiffer J, Kayser L, Ridder GJ. Minimal-invasive core needle biopsy of head and neck malignancies: Clinical evaluation for radiation oncology. Radiother Oncol 2009; 90:202-7. [DOI: 10.1016/j.radonc.2008.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 10/09/2008] [Accepted: 10/23/2008] [Indexed: 10/21/2022]
|
18
|
Carbone A, Ferlito A, Devaney KO, Rinaldo A. Ultrasound-guided core-needle biopsy: is it effective in the diagnosis of suspected lymphomas presenting in the head and neck? J Surg Oncol 2008; 98:4-5. [PMID: 18338333 DOI: 10.1002/jso.21003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
19
|
Pfeiffer J, Kayser G, Technau-Ihling K, Boedeker CC, Ridder GJ. Ultrasound-guided core-needle biopsy in the diagnosis of head and neck masses: Indications, technique, and results. Head Neck 2007; 29:1033-40. [PMID: 17525968 DOI: 10.1002/hed.20620] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Unclear cervicofacial masses are common presentations that often require tissue sampling to guide therapy. While open biopsy is invasive, fine-needle aspiration cytology includes a high rate of nondiagnostic samples. METHODS A retrospective analysis on 181 core-needle biopsies in 88 patients was performed to determine the diagnostic efficacy of ultrasound-guided core-needle biopsies in the head and neck. RESULTS We experienced 100% success in obtaining high-quality histopathologic specimens. The target tissue was correctly sampled in 80 of 88 patients. In these patients the sensitivity, specificity, and accuracy rate of core-needle biopsies in differentiating benign from malignant cervicofacial lesions was 98.1%, 100%, and 98.8%, respectively. CONCLUSIONS Ultrasound-guided core-needle biopsies can be recommended as a safe and reliable technique in the diagnosis of cervicofacial masses with a high diagnostic yield. It obtains tissue samples of high quality and represents a sufficient alternative to open biopsy even in the diagnosis of lymphoma.
Collapse
Affiliation(s)
- Jens Pfeiffer
- Department of Otorhinolaryngology-Head and Neck Surgery, Freiburg Medical School, Freiburg, Germany
| | | | | | | | | |
Collapse
|
20
|
Song JY, Cheong HJ, Kee SY, Lee J, Sohn JW, Kim MJ, Seo SIL, Kim IS, Kim WJ. Disease spectrum of cervical lymphadenitis: Analysis based on ultrasound-guided core-needle gun biopsy. J Infect 2007; 55:310-6. [PMID: 17697715 DOI: 10.1016/j.jinf.2007.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 06/12/2007] [Accepted: 06/13/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Despite the high frequency of cervical lymphadenopathy in the outpatient clinics, there was no published data on the disease spectrum of cervical lymphadenopathy among adult outpatients. We are evaluating the disease spectrum of cervical lymphadenitis in the outpatient setting. METHODS As for the patients with cervical lymphadenitis, ultrasound-guided core-needle gun biopsy has been performed in Korea University Hospital. We reviewed medical records of adult outpatients with cervical lymphadenitis between January 2004 and April 2006, and compared the clinical, laboratory and radiological differences among them. RESULTS The study included 147 patients with the mean age of 33.7 years. Histopathological diagnoses were obtained from 137 (93.2%) cases: Kikuchi's disease (34.7%), tuberculous lymphadenitis (22.4%), non-specific lymphadenitis (22.4%), lymphoma (6.1%), metastatic carcinoma (3.4%), etc. Overall, clinical manifestations were indistinguishable among tuberculous lymphadenitis, Kikuchi's disease and non-specific lymphadenitis. Leucopenia was characteristic of Kikuchi's disease, while anemia, thrombocytosis and pulmonary tuberculosis (irrespective of activity) were more common in the tuberculous lymphadenitis. CONCLUSION Kikuchi's disease and tuberculosis were the most common and clinically important causes of cervical lymphadenitis. Complete blood count, chest X-ray and ultrasound-guided core-needle gun biopsy would be helpful in the differential diagnosis of cervical lymphadenitis, especially between Kikuchi's disease and tuberculous lymphadenitis.
Collapse
Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Ridder GJ, Pfeiffer J. Usefulness of cutting needle biopsy in recurrent and advanced staged head and neck malignancies in a palliative setting. Support Care Cancer 2007; 15:1301. [PMID: 17375341 DOI: 10.1007/s00520-007-0237-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 02/15/2007] [Indexed: 11/26/2022]
Abstract
GOAL OF WORK Advanced staged and recurrent head and neck malignancies require histological confirmation before planning further treatment. The purpose of this article is to focus on the clinical usefulness of cutting needle biopsies in the head and neck as a minimal invasive procedure to establish a tissue diagnosis in a palliative setting. MATERIALS AND METHODS A retrospective analysis on 74 core needle biopsies in 32 patients with recurrent and advanced staged head and neck malignancies was performed to determine the advantages of ultrasound-guided cutting needle biopsies compared to open biopsy and fine-needle aspiration cytology in palliative cancer treatment. MAIN RESULTS We experienced 100% success in obtaining high-quality histopathologic specimens. In 93.8% of the patients, a tissue core of the target organ was successfully obtained. All of the patients tolerated the procedure well without any minor or major complications. CONCLUSIONS Cutting needle biopsy in the head and neck is a safe and minimal-invasive procedure that can be performed in local anaesthesia on an outpatient basis. In a palliative setting, it can be recommended as an attractive alternative to both fine needle aspiration and open biopsy. It represents a simple and fast device for obtaining a tissue diagnosis with high diagnostic yield and accuracy and low morbidity.
Collapse
Affiliation(s)
- G J Ridder
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical School Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
| | - J Pfeiffer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical School Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| |
Collapse
|
22
|
Sebire NJ, Roebuck DJ. Pathological diagnosis of paediatric tumours from image-guided needle core biopsies: a systematic review. Pediatr Radiol 2006; 36:426-31. [PMID: 16532346 DOI: 10.1007/s00247-006-0123-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2005] [Accepted: 01/13/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND Image-guided core needle biopsy is widely used in paediatric oncology, but many protocols continue to discourage this practice. No published randomized studies compare image-guided needle biopsy with surgical techniques. OBJECTIVE To perform a systematic review of the literature on image-guided core needle biopsy in paediatric oncology. MATERIALS AND METHODS Several computerized databases were searched using the terms [(needle OR core) AND (biops*[ti]) AND (paediatric OR pediatric OR child OR children OR childhood OR boy OR girl)[ti]] to identify series of more than five cases of needle core biopsy for tumour diagnosis in children. Data from included studies were combined to calculate pooled estimates of adequacy, accuracy and complication rates. RESULTS Thirteen studies fulfilled the inclusion criteria. Overall biopsy adequacy rate (defined as sufficient to make a diagnosis) was 94% (95% CI 92-96%). The diagnostic accuracy rate in cases with adequate material (defined as achieving the correct specific diagnosis) was 94% (95% CI 92-96%). Complications requiring treatment occurred in 1%. CONCLUSIONS Available pooled data suggest that about 95% of image-guided needle core biopsies provide an adequate sample for diagnosis of malignant disease in childhood. In such cases, the pathological diagnosis is correct in about 95%. Complications are rare.
Collapse
Affiliation(s)
- Neil J Sebire
- Department of Paediatric Histopathology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
| | | |
Collapse
|
23
|
Ridder GJ, Technau-Ihling K, Boedeker CC. Ultrasound-Guided Cutting Needle Biopsy in the Diagnosis of Head and Neck Masses. Laryngoscope 2005; 115:376-7. [PMID: 15689771 DOI: 10.1097/01.mlg.0000154750.09303.36] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gerd Jürgen Ridder
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, 79106 Freiburg, Germany.
| | | | | |
Collapse
|
24
|
Abstract
PURPOSE To evaluate safety, yield, and accuracy of ultrasonography (US)-guided core-needle biopsy of the thyroid gland. MATERIALS AND METHODS Findings at 209 consecutive core-needle biopsies of lesions of the thyroid gland in 198 patients (median age, 48 years; age range, 14-80 years) were retrospectively reviewed. In 138 (66%), findings at previous fine-needle aspiration cytologic (FNAC) analysis were nondiagnostic on one to five occasions. Biopsy was performed as an outpatient procedure with direct US guidance by using nonadvancing 16-18-gauge core needles. Hospital records were reviewed 6 months to 5 years following biopsy to determine final diagnosis, delayed complications, and influence of biopsy findings on subsequent patient treatment. Final diagnoses were determined on the basis of findings at excisional histologic analysis, clinical course, or other laboratory values. The sensitivity, specificity, and accuracy of US-guided core-needle biopsy were calculated. RESULTS One hundred ninety-nine (95%) specimens were adequate for histologic diagnosis. The sensitivity, specificity, and accuracy of core biopsy in differentiating neoplastic (malignant and benign) from nonneoplastic lesions of the thyroid gland were 96% (74 of 77), 89% (109 of 122), and 92% (183 of 199), respectively. The sensitivity, specificity, and accuracy of core-needle biopsy in the detection of malignant neoplasms were 61% (11 of 18), 100% (181 of 181), and 96% (192 of 199), respectively. After US-guided core-needle biopsy, 115 (58%) of 198 patients were treated conservatively, and no evidence of missed tumor manifested during the follow-up period. In the 83 patients who underwent surgical resection, biopsy was performed for therapeutic reasons in 76 (92%) and for diagnostic reasons in seven (8%). There were three cases of small postbiopsy hematomas and one of minor hemoptysis, but none required hospital admission. There were no major complications. CONCLUSION US-guided core-needle biopsy of the thyroid gland is a safe outpatient procedure with a high diagnostic yield and accuracy, and frequently it obviates surgery in patients in whom findings at FNAC analysis are recurrently nondiagnostic.
Collapse
Affiliation(s)
- Nicholas J Screaton
- Department of Radiology, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 2QQ, England.
| | | | | |
Collapse
|
25
|
Affiliation(s)
- N Umpathy
- Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham B1 1PC
| | - R De
- Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham B1 1PC
| | - I Donaldson
- Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham B1 1PC
| |
Collapse
|
26
|
Screaton NJ, Berman LH, Grant JW. Head and neck lymphadenopathy: evaluation with US-guided cutting-needle biopsy. Radiology 2002; 224:75-81. [PMID: 12091664 DOI: 10.1148/radiol.2241010602] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate ultrasonography (US)-guided core biopsy in the assessment of 247 patients with cervicofacial lymphadenopathy. MATERIALS AND METHODS Two hundred sixty US-guided core biopsies were performed in 247 patients with cervicofacial lymphadenopathy. The age of the patients ranged from 1 to 91 years (mean, 50 years). Seventy-four (30%) had a history of malignancy. Biopsies were performed as outpatient procedures with direct US guidance and non-advancing 16-18-gauge core needles. Hospital records were reviewed 6 months to 5 years after biopsy. Final diagnoses were rendered based on results of histologic examination of excised specimens, clinical course, or results of other laboratory studies. RESULTS Two hundred thirty-eight (92%) core biopsies yielded adequate material. In 28 (11%) patients, the histologic diagnosis was considered highly probable. In the 210 patients in whom adequate material was obtained and an unequivocal histologic diagnosis was given, the sensitivity, specificity, and accuracy of US-guided core needle biopsy in differentiating benign from malignant lymphadenopathy were 98.1%, 100%, and 98.7%, respectively. Seventy biopsies were performed in 66 patients with lymphoma. Sensitivity, specificity, and accuracy in differentiating lymphoma from reactive lymphadenopathy were 98.5%, 100%, and 98.7%, respectively. In 53 patients (80%) with lymphoma as a final diagnosis, histologic subclassification was sufficient to guide treatment without the need for surgical biopsy. There were no major complications and only three minor post-biopsy hematomas. CONCLUSION US-guided core biopsy in patients with head and neck lymphadenopathy is a safe outpatient procedure that has a high diagnostic yield and accuracy and frequently obviates surgery.
Collapse
Affiliation(s)
- Nicholas J Screaton
- Department of Radiology, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 2QQ, England.
| | | | | |
Collapse
|
27
|
Yamashita Y, Kurokawa H, Takeda S, Fukuyama H, Takahashi T. Preoperative histologic assessment of head and neck lesions using cutting needle biopsy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:528-33. [PMID: 12075200 DOI: 10.1067/moe.2002.123867] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study assessed the clinical utility of cutting needle biopsy in which a newly developed Monopty biopsy instrument (MBI) (Monopty, Bard Urologic Division; Covington, Ga) was used in the preoperative assessment of head and neck lesions. STUDY DESIGN Needle biopsies were performed with the MBI in 16 cases of head and neck lesions that included lesions in lymph nodes, salivary glands, palate, and soft tissue. RESULTS High-quality histopathologic specimens were obtained without complications in all biopsies performed, and the diagnostic target tissue was obtained in 15 of 16 cases. Diagnoses made from MBI needle biopsy specimens were consistent with the final diagnoses made from subsequent surgical materials in 14 cases, and the accuracy rate was 88%. None of the samples demonstrated significant rush artifacts or obscuring blood, both of which are problems commonly associated with manual biopsy techniques. CONCLUSIONS This technique offers a safe and effective means of obtaining adequate tissue for the histological assessment of head and neck lesions.
Collapse
|