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Yang H, Xiao M, Zheng W, Wang J, Lin Q, Lin X, Zhou J, Yang A, Guo Z, Han F. Ultrasound-guided core needle biopsy for accessing laryngeal masses with unsatisfactory laryngoscopy and biopsy results. Am J Otolaryngol 2023; 44:103716. [PMID: 36774812 DOI: 10.1016/j.amjoto.2022.103716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Laryngoscopy and biopsy is the standard techniques to sample and diagnose laryngeal neoplasms, but not all patients with laryngeal neoplasm are eligible for biopsy via laryngoscopy (e.g., submucosal neoplasms). PURPOSE This study was conducted to evaluate the feasibility and diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) for submucosal laryngeal neoplasms with unsatisfactory laryngoscopy and biopsy results. METHODS We retrospectively reviewed the medical records of 24 patients with unsatisfactory laryngoscopy and biopsy results who were referred to our center for US-CNB from January 2017 to November 2021. For all enrolled patients, we assessed consistency between the laryngoscopic biopsy, US-CNB, and final results. The final results were determined from the surgical biopsy results or clinical follow-up information (at least 3 month). Differences between biopsy techniques were compared using the Fisher's exact test. A P value less than 0.05 indicated statistical significance. RESULTS Twenty-four patients (median [range] age: 60.6 [41-76] years, 20 men) were included in our study. Among the 24 patients, 12 were eligible for laryngoscopic biopsy. In total, 24 patients underwent 26 US-CNB. Two patients underwent a repeat US-CNB for conformation of a benign histological result or due to inadequate specimen collection. The results of laryngoscopic biopsy and US-CNB were compared with the final result. The overall accuracy of US-CNB for differentiating benign from malignant lesions was 95.8 % (23/24), and this procedure had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2 %, 100 %, 100 %, and 75 %, respectively. The results of US-CNB are significantly better than those of laryngoscopic biopsy. CONCLUSIONS US-CNB is a safe, effective, and feasible technique for investigating suspicious submucosal laryngeal neoplasms and can serve as a complementary method for early and timely diagnosis of those neoplasms.
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Affiliation(s)
- Hao Yang
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Meiqin Xiao
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Wei Zheng
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Jianwei Wang
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Qingguang Lin
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Xi Lin
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Jianhua Zhou
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Ankui Yang
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Zhixing Guo
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China
| | - Feng Han
- Department of Ultrasound, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, People's Republic of China.
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Xu W, Wen Q, Zhang X, Pan M, Liu C, Zha L, Huang P. The Application of Contrast Enhanced Ultrasound for Core Needle Biopsy of Subpleural Pulmonary Lesions: Retrospective Analysis in 92 Patients. Ultrasound Med Biol 2021; 47:1253-1260. [PMID: 33546923 DOI: 10.1016/j.ultrasmedbio.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/17/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to investigate the role of contrast-enhanced ultrasound (CEUS) in determining the viable target area in patients with subpleural pulmonary lesions before ultrasound-guided transthoracic core biopsy. In this retrospective study, we analyzed 92 patients with subpleural pulmonary lesions (63 males and 29 females; mean age: 65.17 ± 11.72 y). All patients underwent B-mode ultrasound, color Doppler and CEUS. Color Doppler was performed to identify the major vessels. The time to enhancement of the contrast agents, homogeneity of enhancement and the presence of areas without enhancement were recorded after administration of the contrast agents. The viable target areas were defined as regions showing enhancement relative to those without enhancement and regions showing delayed enhancement in reference to peripheral lung tissues showing early enhancement. Afterward, real-time ultrasound-guided transthoracic core needle (18 gauge) biopsies were performed and the complication rate, success rate and diagnostic accuracy were calculated. With CEUS, the needle pathways of these lesions were readjusted the biopsy strategy in 40/92 patients (43.5%). It was determined that the satisfactory rate of the subsequent biopsy specimen was 100%. The histologic diagnostic accuracy of the biopsy was 97.83%. No serious complications occurred during the biopsy. In conclusion, the application of CEUS before biopsy was able to depict the viable target areas of the lesion to readjust the biopsy routes. With the help of CEUS, ultrasound-guided core biopsy could obtain adequate samples, improve the diagnostic accuracy and reduce the complication rates of biopsies.
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Affiliation(s)
- Wen Xu
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Qing Wen
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xinjian Zhang
- Department of Vascular Surgery, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - MinQiang Pan
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Chunmei Liu
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Lijing Zha
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Pintong Huang
- Department of Ultrasound, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
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Tan A, Rajakulasingam R, Saifuddin A. Diagnostic concordance between ultrasound-guided core needle biopsy and surgical resection specimens for histological grading of extremity and trunk soft tissue sarcoma. Skeletal Radiol 2021; 50:43-50. [PMID: 32514582 DOI: 10.1007/s00256-020-03496-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Determination of accurate histological grade impacts on management for soft tissue sarcomas (STSs). Although ultrasound-guided core needle biopsy (US-CNB) accurately establishes tumour subtype compared with surgical specimens, the concordance for tumour grade is uncertain. The aim of this study was to assess the concordance between US-CNB and surgical resection specimens for tumour grade in trunk and extremity STS. MATERIALS AND METHODS Retrospective review of consecutive patients presenting with extremity/trunk STS. Data collected included patient age, gender, lesion location, US-CNB diagnosis and grade, and surgical histology and grade. The histological diagnosis and tumour grade from US-CNB was compared with surgical resection histology. RESULTS A total of 118 patients were included, 76 males and 42 females with a mean age of 54 years (range 10 months-90 years old). STS size ranged from 26 to 350 mm (mean 89.5 mm). All US-CNB procedures were performed with a 14G biopsy needle with a mean number of 5 passes. First US-CNB was diagnostic for STS in all patients, and provided adequate tissue for tumour grading in all but one patient. Histological tumour subtype on US-CNB matched surgical specimens in all cases, with 25 (21.2%) STS being low grade and 93 (78.8%) high grade. The concordance for tumour grade was 96.6%, with no difference between low- and high-grade STSs (p > 0.05). The 4 cases of mismatch were considered low grade on US-CNB, but subsequently high grade on surgical resection. CONCLUSION US-CNB of STS can reliably predict histological tumour grade compared with surgical resection specimens, thus allowing confident treatment decisions to be made.
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