Paediatric bone lesions: diagnostic accuracy of imaging correlation and CT-guided needle biopsy for differentiating benign from malignant lesions

2021 ◽  
pp. 20201234
Author(s):  
Alessandro Vidoni ◽  
Ian Pressney ◽  
Asif Saifuddin
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Bone Tumour ◽  
Final Diagnosis ◽  
Imaging Diagnosis ◽  
Ct Guided ◽  
Primary Bone Tumour ◽  
Primary Bone ◽  
Malignant Lesions ◽  
Sensitivity Specificity

Objective: To determine the sensitivity, specificity and accuracy of CT-guided needle biopsy (CT-NB) for distinguishing benign and malignant lesions in children with suspected primary bone tumours, and to assess the correlation between imaging diagnosis and final diagnosis. Methods: Retrospective review of children who underwent CT-NB of a suspected primary bone tumour between October 2016 and October 2019. Data collected included anatomical location, imaging diagnosis, type of needle, type of biopsy sample, CT-NB diagnosis, final diagnosis and post-procedural complications. The final diagnosis was established based on surgical histology or clinical/imaging follow-up. Results: 125 patients met the inclusion criteria (68M, 57F: mean age 11 years; range 10 months–18 years). Biopsy was performed using a 10 cm Jamshidi needle (10G n = 96; 13 G n = 8); 14G Tru-Cut needle (n = 18); 14G Temno needle (n = 3). The commonest anatomical locations were the femur (n = 40), tibia (n = 25) and humerus (n = 16), while the commonest diagnoses were osteosarcoma (n = 35), CRMO (n = 15) and LCH (n = 14). A benign tumour was correctly identified on imaging in 100% of cases, and a malignant tumour in 95.8%. Sensitivity, specificity and diagnostic accuracy of CT-NB for distinguishing malignant from benign lesions were 98%, 100 and 99%. Of 24 indeterminate biopsy results, all that had a non-aggressive radiological appearance were benign. No immediate complications were recorded. Conclusion: CT-NB represents a safe and very effective tool for differentiating benign and malignant lesions in children presenting with a suspected primary bone tumour. Suspected radiological diagnosis plays a pivotal role in the management of indeterminate biopsy results. Advances in knowledge: Paediatric bone tumours pose a significant diagnostic and therapeutic challenge. The interpretation of the imaging findings is essential for the successful management of indeterminate histological results.

scholarly journals Radioimaging Evaluation of Primary Bone Tumors and Tumor like Lesions

2020 ◽  
Vol 8 (1) ◽  
pp. 69-82
Author(s):  
Sunil K Vatukiya ◽  
Bhautik Kapadia
Keyword(s):  
Imaging Techniques ◽  
Bone Tumour ◽  
Pathologic Fracture ◽  
Malignant Tumour ◽  
Final Diagnosis ◽  
Matrix Mineralization ◽  
Primary Bone Tumors ◽  
Primary Bone ◽  
Malignant Lesions ◽  
Mri Characteristics

Background: Bone tumour is relatively rarely encountered by radiologist, so sometimes it creates diagnostic difficulty. Aim over study was   to determine the X-ray CT and MRI characteristics of different primary bone tumours and tumour like lesion and correlation of radiologic diagnosis with histopathologic diagnosis whenever possible. To understand the advantages and limitations of different radio-imaging techniques. Subjects and Methods: We have studied total 45 cases of primary bone tumour and tumour like lesions during study of 15 months duration in department of Radiodiagnosis, Baroda Medical College, Vadodara, Gujarat, India. First radiological diagnosis and differential diagnosis was given than histopathologic examination was done in all malignant and indeterminate lesions for final diagnosis. Results:  Out of 45 patients   21 (46.6%) were female and 24 (53.3%) were male. Benign and malignant lesions were 69% and 31% respectively. Multiple lesions were common with osteochondroma, hemangioma and multiple myeloma. Most common malignant tumour was osteosarcoma and benign tumour was osteochondroma. Pathologic fracture was seen in 6 patients but out of them 2 fractures were missed on radiograph. Skip lesions were seen in two malignant lesions which was missed on radiograph and CT but it was easily detected on MRI. Conclusion: Radiography is baseline investigation for evaluation of bone tumor and tumour like lesions. Pathological fracture and matrix mineralization can be better seen on CT. MR is superior in detection skip lesion, soft tissue and marrow extension.

scholarly journals CT-guided transthoracic needle biopsy of pulmonary lesions: comparison between the cutting needle and aspiration needle

2020 ◽  
pp. 20190930
Author(s):  
Zhen-guo Huang ◽  
Hong-liang Sun ◽  
Cun-li Wang ◽  
Bao-xiang Gao ◽  
He Chen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Needle Biopsy ◽  
Final Diagnosis ◽  
Benign Lesions ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Pulmonary Lesions ◽  
Severe Hemorrhage ◽  
Cutting Needle

Objectives: To compare CT-guided transthoracic cutting needle biopsy (TCNB) with transthoracic aspiration needle biopsy (TANB) for pulmonary lesions with respect to the diagnostic accuracy and complication rate. Methods: Of the 859 cases that underwent consecutive CT-guided biopsy of pulmonary lesions, 713 cases confirmed by surgical pathology or clinical follow-up were enrolled. Of these, the first consecutive 275 cases underwent TANB, and the remaining 438 received TCNB. The final diagnosis determined the accuracy of biopsy. Based on the post-biopsy CT and clinical medical records, the presence or absence of biopsy-related complications was determined. The χ2 test was used to compare the differences between TCNB and TANB in terms of diagnostic accuracy and complication rate. Results: Among the 713 biopsy lesions, the final diagnosis was malignant in 411 cases and benign in 302 cases. As compared to TANB, the diagnostic accuracy of TCNB (98.9% vs 93.8%, χ2 = 14.35, p < 0.01), sensitivity to malignant lesions (97.8% vs 90.6%, χ2 = 10.58, p < 0.01), negative predictive value (97.6% vs 84.8%, χ2 = 19.03, p < 0.01), and specific diagnostic rate for benign lesions (73.4% vs 57.9%, χ2 = 7.29, p < 0.01) were improved. On the other hand, a statistical difference was detected between TCNB and TANB with respect to the incidence of pneumothorax (20.6% vs 13.1%, χ2 = 6.46, p = 0.01), hemorrhage (32.2% vs 13.1%, χ2 = 33.03, p < 0.01), and hemoptysis (8.2% vs 3.3%, χ2 = 6.87, p < 0.01). One patient died just several minutes after TCNB due to severe hemorrhage with hemoptysis. Conclusions: Compared to TANB, CT-guided TCNB improves the diagnostic accuracy of pulmonary lesions, but complication rate increases significantly. Advances in knowledge: In general, TCNB should be recommended, especially for highly suspicious benign lesions. For patients with small lesions adjacent to vessels or vessels within the lesion, TANB should be considered.

Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Results of 612 consecutive procedures

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18022-18022
Author(s):  
U. Ricardi ◽  
A. M. Priola ◽  
S. M. Priola ◽  
S. Novello ◽  
A. Cataldi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Inflammatory Cells ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Lesion Size ◽  
Maximum Diameter ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions

18022 Background: CT-guided transthoracic needle biopsy (TNB) is commonly used in diagnostic work-up of lung lesions. The availability of a on-site pathologist at the time of the procedure ameliorate its sensitivity, reduce the number of biopsies and false negatives. Methods: 612 procedures (608 patients with a CT-documented central or peripheral pulmonary lesion) performed at S. Luigi Hospital between November 2002 and August 2005 were prospectively analyzed; 66% males, median age was 66 years (range 29–87). Ineligibility criteria for the procedure included severe coagulopathy, previous contralateral pneumonectomy, lesions with a maximum diameter less than 5 mm or the impossibility to understand the procedure or to maintain the clinostatism for the time of the procedure. The on-site pathologist assigned to each specimen a semiquantitative score: 0 for bloody sample without other cells, 1 for aspecific benign or inflammatory cells, 2 for malignant cells without histotype characterization and 3 for well established benign or malignant histotype. Results: Most of the procedures was performed by fine needle aspiration biopsy, while in a minority of cases a tru-cut biopsy was requested. In 57.2% of the cases a single transthoracic access (range 1–4) was used and in 31% the procedure was repeated on the basis of the radiologist/pathologist judgment. In 154 patients a surgical resection was subsequently performed, while 454 were patients non-surgical. A score of 3 was obtained in 71% of cases (88% malignancies), 2 in 12.5%, 1 in 7.5% and 0 in 9%. A definitive diagnosis was made in 83.5% of procedures, while a score of 0–1 was assigned in 101 cases. Among 458 malignancies there were 411 lung cancer, 7 non-epithelial cancers and 40 metastases with only 1 false positive. The diagnostic accuracy for benign and malignant lesions was 67% and 92%, respectively (Pearson’s test p<0.005) with overall diagnostic accuracy of 83.3%. The variables affecting diagnostic accuracy were final diagnosis (benign 67%, malignant 92%, p<0.001) and lesion size (lesion 5 cm 78%, p<0.05). The presence of cavitation or necrotic areas and location of the lesion didn’t affect the diagnostic accuracy. Conclusion: In consecutive cases of CT-guided TNB final diagnosis and lesion size affect diagnostic accuracy. No significant financial relationships to disclose.

CT-guided core-needle biopsy in omental pathology

1997 ◽  
Vol 38 (6) ◽  
pp. 978-981 ◽  
Author(s):  
F. Pombo ◽  
E. Rodriguez ◽  
R. Martin ◽  
M. Lago
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Percutaneous Biopsy ◽  
Final Diagnosis ◽  
Endoscopic Biopsy ◽  
Ct Guided ◽  
Core Needle ◽  
Laparoscopic Biopsy ◽  
Ct Guided Biopsy ◽  
Sensitivity Specificity

Purpose: to assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). the final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. the CT-guided biopsies were performed with 1.0–1.8-mm Surecut core-needles Results: in 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). in the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. in differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology

Does ProCore fine needle biopsy really improve the clinical outcome of endoscopic ultrasound-guided sampling of pancreatic masses?

2021 ◽  
Author(s):  
Gabriele Delconte ◽  
Federica Cavalcoli ◽  
Andrea Magarotto ◽  
Giovanni Centonze ◽  
Cristina Bezzio ◽  
...  
Keyword(s):  
Adverse Events ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Clinical Performance ◽  
Negative Likelihood Ratio ◽  
Fine Needle Biopsy ◽  
Fine Needle ◽  
Sensitivity Specificity

Introduction: Fine Needle Biopsy (FNB) has been suggested to provide better histological samples as compared to endoscopic ultrasound fine needle aspiration (EUS-FNA). However, studies comparing EUS-FNA and EUS-FNB for pancreatic lesions reported contrasting results. The aim of this study was to compare the clinical performance of EUS-FNA versus EUS-FNB with ProCore needle for the investigation of pancreatic lesions. Methods: We reviewed all patients undergoing EUS for the investigation of pancreatic lesions from August 2012 to September 2018. From August 2012 to January 2015 all procedures were performed with standard needles, whereas from February 2015 to September 2018 the use of ProCore needles had been introduced. Data on diagnostic accuracy, number of needle passes and/or adverse events were collected. Results: 324 patients were retrospectively evaluated: 190 (58.6%) underwent EUS-FNA and 134 (41.4%) EUS-FNB. Both EUS-FNA and EUS-FNB showed high diagnostic accuracy for malignancy [94% (CI 95%:89-97%) vs 94% (CI 95%:89-98%)]. Notable, there were no differences between EUS-FNA and EUS-FNB in terms of sensitivity, specificity, positive and negative likelihood ratio, histological core tissue retrieval, adverse events or number of needle passes. However, subgroup analysis noted a higher diagnostic accuracy for 25G EUS-FNB as compared to 25G EUS-FNA (85,7% vs 55,5%; *p=0.023). Conclusion: EUS-FNB with ProCore needle is safe and feasible in pancreatic lesions. ProCore needle did not provide any advantage in terms of diagnostic accuracy, sensitivity, specificity, positive and/or negative likelihood ratio, or acquisition of core specimen, therefore its routine application is not

scholarly journals Growth in the Lower Limb Following Chemotherapy for a Malignant Primary Bone Tumour: A Straight-Line Graph

Sarcoma ◽  
1997 ◽  
Vol 1 (2) ◽  
pp. 75-77 ◽  
Author(s):  
Paul Cool ◽  
Mark Davies ◽  
Rob J. Grimer ◽  
Simon R. Carter ◽  
Roger M. Tillman
Keyword(s):  
Lower Limb ◽  
Line Graph ◽  
Bone Tumour ◽  
Straight Line ◽  
Primary Bone Tumour ◽  
Primary Bone

scholarly journals Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

2019 ◽  
Vol 8 (6) ◽  
pp. 821 ◽  
Author(s):  
June Hong Ahn ◽  
Jong Geol Jang
Keyword(s):  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Safe Procedure ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Percutaneous Transthoracic Needle Biopsy

In the diagnosis of lung lesions, computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) has a high diagnostic yield and a low complication rate. The procedure is usually performed by interventional radiologists, but the diagnostic yield and safety of CT-guided PTNB when performed by pulmonologists have not been evaluated. A retrospective study of 239 patients who underwent CT-guided PTNB at Yeungnam University Hospital between March 2017 and April 2018 was conducted. A pulmonologist performed the procedure using a co-axial technique with a 20-gauge needle. Then diagnostic yield and safety were assessed. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 96.1% (171/178), 100% (46/46), 100% (171/171), and 86.8% (46/53), respectively. The diagnostic accuracy was 96.9% (217/224) and the overall complication rate was 33.1% (82/248). Pneumothorax, hemoptysis, and hemothorax occurred in 27.0% (67/248), 5.2% (13/248), and 0.8% (2/248) of the patients, respectively. Univariate analyses revealed that pneumothorax requiring chest tube insertion was a significant risk factor (odds ratio, 25.0; p < 0.001) for diagnostic failure. CT-guided PTNB is a safe procedure with a high diagnostic accuracy, even when performed by an inexperienced pulmonologist. The results were similar to those achieved by interventional radiologists as reported in previously published studies.

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