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Kim HJ, Kim JS. Ultrasound-guided core needle biopsy in salivary glands: A meta-analysis. Laryngoscope 2017; 128:118-125. [DOI: 10.1002/lary.26764] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Hee Joon Kim
- Department of Radiology; Presbyterian Medical Center; Jeonju Republic of Korea
| | - Jong Seung Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; College of Medicine, Chonbuk National University; Jeonju Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University; Biomedical Research Institute of Chonbuk National University Hospital; Jeonju Republic of Korea
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Haldar S, Mandalia U, Skelton E, Chow V, Turner SS, Ramesar K, Tighe D, Williams M, Howlett D. Diagnostic investigation of parotid neoplasms: a 16-year experience of freehand fine needle aspiration cytology and ultrasound-guided core needle biopsy. Int J Oral Maxillofac Surg 2014; 44:151-7. [PMID: 25457828 DOI: 10.1016/j.ijom.2014.09.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 07/25/2014] [Accepted: 09/30/2014] [Indexed: 01/12/2023]
Abstract
This study aimed to examine the diagnostic yield of fine needle aspiration cytology (FNAC) and ultrasound-guided core needle biopsy (USCB) in the diagnosis of parotid neoplasia. A 16-year retrospective analysis was performed of patients entered into our pathology database with a final diagnosis of parotid neoplasia. FNAC and USCB data were compared to surgical excision where available. One hundred and twenty FNAC, 313 USCB, and 259 surgical specimens were analyzed from 397 patients. Fifty-six percent of FNAC and 4% of USCB were non-diagnostic. One hundred and thirty-two (33%) patients had a final diagnosis made by USCB and did not undergo surgery. Surgery was performed in 257 (65%) patients, 226 (88%) of whom had a preoperative biopsy. Most lesions were benign, but there were 62 parotid and 13 haematological malignancies diagnosed; false-negative results were obtained in three FNAC and two USCB samples. The sensitivity and specificity of FNAC were 70% and 89%, respectively, and for USCB were 93% and 100%, respectively. This study represents the largest series of patients with a parotid neoplasm undergoing USCB for diagnosis. USCB is highly accurate with a low non-diagnostic rate and should be considered an integral part of parotid assessment.
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Affiliation(s)
- S Haldar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK.
| | - U Mandalia
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - E Skelton
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - V Chow
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - S S Turner
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - K Ramesar
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Tighe
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - M Williams
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
| | - D Howlett
- Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
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Yuen HY, Lee YYP, Bhatia K, Ahuja AT. A short review of basic head and neck interventional procedures in a general radiology department. Cancer Imaging 2013; 13:502-11. [PMID: 24334514 PMCID: PMC3864226 DOI: 10.1102/1470-7330.2013.0043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Image-guided interventional procedures provide a safe way to diagnose and treat a variety of head and neck abnormalities. The procedure time is usually short, and most procedures can be performed on an outpatient basis. Knowledge about strengths and weaknesses, efficacy, potential complications, and pitfalls of these procedures allows the best treatment to be chosen for a particular lesion type. This review discusses some of the commonly performed interventional radiology procedures in a general radiology department in the management of patients with neoplastic diseases in the head and neck region.
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Affiliation(s)
- H Y Yuen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - Y Y P Lee
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - K Bhatia
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
| | - A T Ahuja
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
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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
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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.
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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: 50] [Impact Index Per Article: 4.2] [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.
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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
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Yuen HY, Lee Y, Bhatia K, Wong KT, Ahuja AT. Use of end-cutting needles in ultrasound-guided biopsy of neck lesions. Eur Radiol 2011; 22:832-6. [PMID: 22080282 DOI: 10.1007/s00330-011-2323-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 09/28/2011] [Accepted: 10/20/2011] [Indexed: 12/20/2022]
Abstract
UNLABELLED The management of a neck mass is dictated by its nature, location and extent. Pathological diagnosis by fine needle aspiration cytology (FNAC) or core biopsy is often required before proceeding to definitive treatment. It is not uncommon for the cytology result to come back as inadequate for various reasons. The unique design of the end-cutting biopsy needle in our experience makes it a good choice for use in obtaining both transcutaneous and intraoral biopsy under ultrasound guidance of neck lesions and serves as a useful alternative or adjunct to FNAC. Although there is, as yet, only a limited evidence base about end-cutting in comparison to side-cutting needles, they carry several potential advantages. KEY POINTS End-cutting needles are safe to use for lesions close to vital structures. End-cutting needles yield sufficient tissue samples in a single pass. End-cutting biopsy needles are a useful adjunct to FNAC.
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Affiliation(s)
- H Y Yuen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR
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Dos Santos JAR, Capella DL, Rozza RE, Ferreira SJ, Berti-Couto SDA, Sant'ana-Filho M, de Lima AAS, Westphalen FH, Couto-Souza PH. Histological diagnosis of oral lesions with cutting needle biopsy: a pilot study. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2011; 2:e3. [PMID: 24421990 PMCID: PMC3886060 DOI: 10.5037/jomr.2011.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 04/18/2011] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this pilot study was to evaluate the effectiveness of cutting
needle biopsy in the diagnosis of solid oral lesions. Material and Methods The biopsies were carried out on seven patients who presented with solid oral
lesions with sizes ranging from 2 to 6 cm. Specimens were obtained from each
lesion before conventional biopsies using a cutting needle with 18-gauge x 9
cm (MD TECH, Gainesville, FL, USA). A total of 64 specimens processed by
hematoxylin-eosin staining method, were obtained. Afterwards, the analysis
was performed by an oral pathologist, in two different stages, with and
without the clinical history of each lesion. Then, these answers were
compared with the final histological diagnosis. Results Results presented by the descriptive analysis showed that the correct
diagnosis using cutting needle biopsy without the clinical history of
lesions was registered in 37.5% of cases, while with the clinical history in
76.6%. Conclusions Despite the promising results as a potential technique for biopsies and
histological diagnosis of oral lesions, the cutting needle biopsy should be
analyzed carefully in those cases.
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Affiliation(s)
| | - Diogo Lenzi Capella
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil
| | - Rafaela Elvira Rozza
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil
| | | | | | - Manoel Sant'ana-Filho
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul Brazil. ; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul Brazil
| | | | - Fernando Henrique Westphalen
- Department of Stomatology, School of Dentistry, Pontifical Catholic University of Paraná Brazil. ; Department of Stomatology, School of Dentistry, Federal University of Paraná Brazil
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Kraft M, Laeng H, Schmuziger N, Arnoux A, Gürtler N. Comparison of ultrasound-guided core-needle biopsy and fine-needle aspiration in the assessment of head and neck lesions. Head Neck 2008; 30:1457-63. [DOI: 10.1002/hed.20891] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Ultrasound-guided core needle biopsy of parotid gland swellings. The Journal of Laryngology & Otology 2008; 123:449-52. [DOI: 10.1017/s0022215108003563] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To determine whether ultrasound-guided core needle biopsy is a safe and reliable investigation in cases of parotid swelling in which fine needle aspiration cytology has failed to give a definitive diagnosis.Design:Analysis of 66 ultrasound-guided core biopsy specimens of the parotid gland (the largest series reported thus far) sample number refers to histological samples throughout the paper.Subjects:All the 184 cases of parotid surgery with a histological diagnosis were included.Main outcome measures:The sensitivity, positive predictive value and diagnostic accuracy of fine needle aspiration cytology and ultrasound-guided core needle biopsy, as compared with the final histological analysis.Results:Of a total of 184 patients, 89.1 per cent (164/184) had benign parotid lesions excised. The sensitivity, positive predictive value and diagnostic accuracy of fine needle aspiration cytology for benign lesions were 76.2, 84.2 and 87.5 per cent, respectively, and those of ultrasound-guided core needle biopsy were 91.7, 98.2 and 96.4 per cent, respectively. Twenty of 184 patients (10.9 per cent) had malignant lesions. The sensitivity, positive predictive value and diagnostic accuracy of fine needle aspiration cytology for detection of malignant lesions were 60, 75 and 75 per cent, respectively, while those of ultrasound-guided core biopsy were 89, 100 and 100 per cent, respectively. Non-diagnostic rates were 25.8 per cent for fine needle aspiration cytology and 4.5 per cent for ultrasound-guided core biopsy. Only one case of complications (a sub-clinical haematoma) occurred in the ultrasound-guided core biopsy group.Conclusion:We propose ultrasound-guided core needle biopsy as a very safe and effective tool in cases of parotid swelling in which fine needle aspiration cytology has failed to give a definitive diagnosis.
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Pitman MB, Abele J, Ali SZ, Duick D, Elsheikh TM, Jeffrey RB, Powers CN, Randolph G, Renshaw A, Scoutt L. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008; 36:407-24. [PMID: 18478608 DOI: 10.1002/dc.20829] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The National Cancer Institute (NCI) sponsored the NCI Thyroid fine-needle aspiration (FNA) State of the Science Conference on October 22-23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational website and several on-line discussion periods between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document summarizes matters addressing manual and ultrasound guided FNA technique and related issues. Specific topics covered include details regarding aspiration needles, devices, and methods, including the use of core needle biopsy; the pros and cons of anesthesia; the influence of thyroid lesion location, size, and characteristics on technique; the role of ultrasound in the FNA of a palpable thyroid nodule; the advantages and disadvantages of various specialists performing a biopsy; the optimal number of passes and tissue preparation methods; sample adequacy criteria for solid and cystic nodules, and management of adverse reactions from the procedure. (http://thyroidfna.cancer.gov/pages/info/agenda/)
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Affiliation(s)
- Martha Bishop Pitman
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, Abati A. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal 2008; 5:6. [PMID: 18394201 PMCID: PMC2365970 DOI: 10.1186/1742-6413-5-6] [Citation(s) in RCA: 286] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Accepted: 04/07/2008] [Indexed: 12/16/2022] Open
Affiliation(s)
- Zubair W Baloch
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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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.
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Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea
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Fine-Needle Aspiration Cytology Versus Core Needle Biopsy in the Evaluation of Thyroid and Salivary Gland Lesions. AJSP-REVIEWS AND REPORTS 2007. [DOI: 10.1097/01.pcr.0000252856.19283.3f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Taki S, Yamamoto T, Kawai A, Terahata S, Kinuya K, Tonami H. Sonographically guided core biopsy of the salivary gland masses. Clin Imaging 2005; 29:189-94. [PMID: 15855064 DOI: 10.1016/j.clinimag.2004.06.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2004] [Accepted: 06/20/2004] [Indexed: 11/25/2022]
Abstract
Over an 8-year period, we performed ultrasonography (US)-guided core biopsy of the salivary gland in 37 patients using an 1l-mm-throw 18-gauge automated biopsy system. The biopsy results were retrospectively compared with the findings of surgical pathology (n=18) or more than 6 months of clinical follow-up (n=19). The sensitivity, specificity, and accuracy of US-guided core biopsy for the diagnosis of malignancy were 75.0%, 96.6%, and 91.9%, respectively. No immediate or delayed complications occurred.
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Affiliation(s)
- Suzuka Taki
- Department of Radiology, Kanazawa Medical University, Uchinada-cho, Kahoku 920-0293, Japan.
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Kumaran M, Benamore RE, Vaidhyanath R, Muller S, Richards CJ, Peake MD, Entwisle JJ. Ultrasound guided cytological aspiration of supraclavicular lymph nodes in patients with suspected lung cancer. Thorax 2005; 60:229-33. [PMID: 15741441 PMCID: PMC1747328 DOI: 10.1136/thx.2004.029223] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Lung cancer is the leading cause of death from cancer in the UK. Pathological diagnosis traditionally requires invasive procedures such as bronchoscopy, mediastinoscopy, or image guided biopsy. Ultrasound of the neck with fine needle aspiration cytology (FNAC) of enlarged but impalpable supraclavicular nodes has been used in patients with suspected lung cancer who have N2 or N3 disease on staging computed tomography (CT). If positive, this technique helps to both stage the patient and provide a cytological diagnosis. METHODS 101 patients were enrolled prospectively over a 1 year period. FNAC was performed on all supraclavicular nodes over 5 mm in size using the capillary aspiration technique. RESULTS Sixty one of the 101 patients had enlarged supraclavicular nodes and underwent FNAC. The overall malignant yield was 45.5% of patients scanned and 75.4% of patients sampled. As a result of FNAC, 43 patients (42.6%) avoided more invasive procedures. CONCLUSION Ultrasound guided FNAC is a promising, relatively non-invasive technique for the staging and diagnosis of patients with lung cancer.
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Affiliation(s)
- M Kumaran
- Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
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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.
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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.
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Affiliation(s)
- Nicholas J Screaton
- Department of Radiology, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 2QQ, England.
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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.
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Affiliation(s)
- Nicholas J Screaton
- Department of Radiology, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 2QQ, England.
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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.
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Screaton NJ, Berman LH, Bearcroft PW, Grant JW. Does a joint ultrasound guided cytology clinic optimize the cytological evaluation of head and neck masses? Clin Radiol 2000; 55:327-8. [PMID: 10767200 DOI: 10.1053/crad.1999.0270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Reply to screaton. Clin Radiol 2000; 55:327. [PMID: 10767201 DOI: 10.1053/crad.1999.0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Feld R, Nazarian LN, Needleman L, Lev-Toaff AS, Segal SR, Rao VM, Bibbo M, Lowry LD. Clinical Impact of Sonographically Guided Biopsy of Salivary Gland Masses and Surrounding Lymph Nodes. EAR, NOSE & THROAT JOURNAL 1999. [DOI: 10.1177/014556139907801208] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although fine-needle aspiration biopsy of salivary gland masses has been reported in the otolaryngology literature, the use of sonography to guide the biopsy of nonpalpable masses and masses seen on other cross-sectional imaging studies has not been described. Our goal was to evaluate sonographically guided biopsy of masses and lymph nodes related to the salivary glands. We analyzed the records of 18 patients who had undergone fine-needle aspiration biopsy of a salivary gland mass or lymph node with a 25-, 22-, or 20-gauge needle. A definitive cytologic diagnosis was made for 13 of the 18 patients (72%); cytology was suggestive but not definitive in three patients (17%) and insufficient in two (11%). Definitive diagnoses were made in three cases of reactive lymph node, in two cases each of lymph node metastasis and Warthin's tumor, and in one case each of pleomorphic adenoma, adenoid-cystic carcinoma, schwannoma-neurofibroma, parotid metastasis, parotid lymphoma, and Sjögren ‘s-related lymphoid-epithelial lesion. Sonographically guided biopsy allows for confident needle placement in masses seen on computed tomography and magnetic resonance imaging. Sonography can usually distinguish a perisalivary lymph node from true intrasalivary masses, and it can help the surgeon avoid the pitfall of a nondiagnostic aspiration of the cystic component of masses. We conclude that sonographically guided biopsy of salivary gland masses can provide a tissue diagnosis that can have a direct impact on clinical decision making.
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Affiliation(s)
- Rick Feld
- Division of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Levon N. Nazarian
- Division of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Laurence Needleman
- Division of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Anna S. Lev-Toaff
- Division of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Sharon R. Segal
- Division of Diagnostic Ultrasound, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Vijay M. Rao
- Division of Head and Neck Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Marluce Bibbo
- Department of Radiology; the Division of Cytopathology, Department of Pathology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
| | - Louis D. Lowry
- Department of Otolaryngology–Head and Neck Surgery, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia
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Buckland JR, Manjaly G, Violaris N, Howlett DC. Ultrasound-guided cutting-needle biopsy of the parotid gland. J Laryngol Otol 1999; 113:988-92. [PMID: 10696376 DOI: 10.1017/s0022215100145785] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We describe the technique of ultrasound-guided 18 gauge (1.2 mm) needle biopsy in 16 patients with parotid gland lesions. This provides material suitable for histological analysis and can be performed quickly and safely under local anaesthesia. Thirteen of the patients had non-diagnostic blind fine-needle aspiration cytology (FNAC) with a 21 gauge (0.8 mm) needle prior to biopsy. Initial ultrasound was found to be superior to clinical examination in 31 per cent of cases. The ultrasound-guided technique provided a diagnostic specimen in 100 per cent of patients and was helpful where FNAC had been inconclusive. There was a diagnostic accuracy of 100 per cent in the patients who underwent subsequent surgery. This method should be considered when FNAC is non-diagnostic and surgical treatment is being considered. It is particularly useful in patients with diffuse enlargement of the gland and does provide a core of material for accurate assessment of tissue architecture. In this series, nine patients avoided unnecessary surgery.
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Affiliation(s)
- J R Buckland
- Department of Ear, Nose and Throat Surgery, Eastbourne District General Hospital, East Sussex, UK
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Yoshida H, Yusa H, Ueno E, Tohno E, Tsunoda-Shimizu H. Ultrasonographic evaluation of small cervical lymph nodes in head and neck cancer. ULTRASOUND IN MEDICINE & BIOLOGY 1998; 24:621-629. [PMID: 9695264 DOI: 10.1016/s0301-5629(98)00025-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To establish sonographic criteria for differentiating metastasis and nonmetastasis in small cervical lymph nodes, correlations between sonographic parameters and histological diagnosis were statistically examined in 117 lymph nodes with maximal diameter of up to 10 mm in the sonographic findings, consisting of 26 metastatic and 91 nonmetastatic nodes. The equations obtained with logistic regression analysis showed lambda predictive values of -1.5 and 0.5 as effective cutoff-point criteria, and were considered to be a reliable indicator for differentiating small nodes with predictive values outside of -1.5 < lambda < 0.5. The sensitivity, specificity and accuracy with predictive values outside of -1.5 < lambda < 0.5 were 83%, 97% and 95%, respectively.
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Affiliation(s)
- H Yoshida
- Department of Oral and Maxillofacial Surgery, University of Tsukuba, Japan.
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