Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS: Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
Bacteremia ; etiology ; Biopsy, Fine-Needle ; adverse effects ; instrumentation ; methods ; Case-Control Studies ; Feasibility Studies ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Retrospective Studies ; Sterilization ; methods ; Ultrasonography, Interventional ; Urinary Tract Infections ; prevention & control

OBJECTIVETo assess the accuracy of ultrasound-guided 16G and 18G core needle biopsy for detecting ultrasound visible breast lesions with different sonographic features.

METHODSA total of 955 sonographically detected breast lesions examined with ultrasound-guided core needle biopsy (US-CNB) and subsequently surgically excised from July 2005 to July 2012 were retrospectively reviewed. Histological findings of US-CNB and the surgical specimens were analyzed for agreements, sensitivities, false negative rates, and underestimate rates according to different sonographic features.

RESULTSThe pathological results of the US-CNB showed malignant lesions in 84.1%, high-risk lesions in 8.4%, and benign lesions in 7.5% of the samples. The overall agreement rates were 92.4% for 16G CNB and 92.8% for 18G CNB; their complete sensitivities and false negative rates were both 98.6% and 1.4%, respectively; the high-risk underestimate rates and DCIS underestimate rates were 48.0% and 46.2% for 16G CNB vs 53.3% and 41.2% for 18G CNB, showing no significant difference between the two groups (P>0.01). For both 16G and 18G CNB, the agreements were better for mass lesions than for non-mass lesions (P<0.01). For the mass lesions with a diameter no greater than 10 mm, the agreement rates were lower than the overall data (P<0.01). Calcification in the lesions did not affect the agreement rates (P>0.01).

CONCLUSIONUltrasound-guided 16G and 18G CNB are both accurate methods for evaluating ultrasound visible breast mass lesions with a diameter larger than 10 mm.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; instrumentation ; methods ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Female ; Humans ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography, Mammary ; Young Adult

OBJECTIVE: To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. MATERIALS AND METHODS: Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. RESULTS: MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. CONCLUSION: MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.
Adult ; Biopsy, Needle ; Breast Neoplasms/*pathology ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Feasibility Studies ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Magnetic Resonance Imaging/*instrumentation ; Magnetic Resonance Imaging, Interventional/*methods ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Vacuum

To meet the need of accurate positioning for biopsy gun in the breast biopsy operation, a new stereotactic biopsy guide device have been developed to adapt to the domestic mammary machine, which can help physician to carry out biopsy operation more accurately and effectively. The guide device has the motion model, measurement model and display model and can realize linear motion and display real-time displacement values in X, Y and Z direction. The experimental results showed that the guide device could be well fixed in the domestic mammary machine, and achieved good accuracy and repeatability in each direction. Depending on the displacement values, physician can change the space of biopsy gun accurately.
Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Equipment Design ; Female ; Humans ; Stereotaxic Techniques ; instrumentation

Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.
Biopsy, Needle/instrumentation/*methods ; Contrast Media/diagnostic use ; Equipment Design ; Fluoroscopy ; Humans ; Lung Diseases/*pathology/radiography ; Mediastinal Diseases/*pathology/radiography ; Patient Positioning ; Radiography, Interventional/*methods ; Radiography, Thoracic/*methods ; *Tomography, X-Ray Computed

OBJECTIVETo compare the effectiveness and accuracy of the use of vacuum-assisted biopsy (VAB) versus wire localization (WL) in the diagnosis of non-palpable breast lesions (NPBL).

METHODSNinety-seven consecutive women with NPBL were randomized into VAB group and WL group. All specimens were identified by mammography. The patients were requested to score the cosmetic appearance of their breast after operation, and a numerical rating scale was used to measure pain on the first postoperative day. Underestimation rates for atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were recorded if open surgical biopsy revealed DCIS and invasive cancer, respectively. Clear margins were also recorded in the two groups.

RESULTSVAB and WL located all the NPBL successfully. In the VAB group, the specimen volume was smaller than that of the WL group (2.3 cm(3) vs. 18.4 cm(3), P = 0.03). Underestimation rates of ADH and DCIS in the VAB group were 16.7% and 11.1%, respectively. The diagnostic accordance rate of VAB was 97.9%, the false negative rate was 2.1%, and there was no false positive case. The means of the numerical rating pain scale were different in both groups (1.7 for VAB vs. 2.5 for WL, P = 0.02). When cosmetic results were taken into account, 40 VAB patients had excellent outcomes and 8 good outcomes, compared with 25 excellent and 24 good for the WL group. There were better cosmetic outcomes with the VAB procedure (P < 0.05).

CONCLUSIONVAB is highly reliable and may avoid diagnostic open surgery in the majority of patients with benign lesions. However, because of the underestimation of histologic diagnosis and tumor margin involvement, VAB can not be used to completely substitute wire localization.

Adult ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma in Situ ; diagnosis ; pathology ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Fibroadenoma ; diagnosis ; pathology ; Humans ; Hyperplasia ; Middle Aged ; Precancerous Conditions ; diagnosis ; pathology ; Stereotaxic Techniques ; instrumentation ; Vacuum

Adolescent ; Adult ; Biopsy, Needle ; methods ; Contrast Media ; Female ; Humans ; Hyaluronic Acid ; blood ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis ; blood ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Platelet Count ; Predictive Value of Tests ; Sensitivity and Specificity ; Severity of Illness Index ; Ultrasonography ; instrumentation ; methods ; Young Adult ; gamma-Glutamyltransferase ; blood

OBJECTIVEStudy on the diagnostic accuracy of fine needle aspiration biopsy of cervical lymph nodes and to discuss the reasons of making a misdiagnosis.

METHODSFive hundred and eighty cases of cervical lymph node fine needle aspiration biopsy were reviewed retrospectively. Among them, histologic findings were available in 161 cases. The cytologic and histologic diagnoses were compared.

RESULTSThere were altogether 226 cases of reactive lymphoid hyperplasia, 202 cases of specific inflammation, 45 cases of malignant lymphoma and 107 cases of metastatic carcinoma. The concordance rate between the cytologic and corresponding histologic diagnoses was 94.4%. The primary foci of most cases with metastatic carcinoma could be delineated by reviewing the clinical and pathologic finding. Inadequate cellularity was the main reason of making misdiagnosis and useful diagnostic clues might be obtained by careful study of the clinical findings.

CONCLUSIONSFine needle aspiration biopsy of cervical lymph node carries a high diagnostic accuracy. It provides important clues in guiding subsequent clinical management. However, for detailed subtyping of certain disease entities such as malignant lymphoma, surgical biopsy for histologic and immunohistochemical studies are required.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Biopsy, Fine-Needle ; methods ; Biopsy, Needle ; adverse effects ; instrumentation ; Child ; Diagnosis ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma ; diagnosis ; pathology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo evaluate the accuracy and utility of ultrasound-guided core needle biopsy (CNB) in the diagnoses of breast lesions.

METHODSThe clinical data of 2152 consecutive breast lesions examined by CNB were reviewed. The histological agreement between core pathology and subsequent excision pathology was studied. The benign diseases without repeat biopsy were followed up.

RESULTSThere were 1461 cancers in final diagnosis among 2152 breast lesions, 1339 cancers were diagnosed by CNB. The false-negative rate of CNB was 3.5% (51/1461), and the underestimation rate was 4.9% (71/1461). In the repeat biopsy, carcinoma was found in 17 (50.0%) of 34 atypical ductal hyperplasia lesions and 25 (46.3%) of 54 papillary lesions. In 1461 cancers, the false-negative rate of ultrasound-guided CNB (2.1%, 22/1068) was significantly lower than that of free-hand-guided CNB (7.4%, 29/393) (P < 0.05). The false-negative rate of two special doctors for CNB (1.2%, 8/681) was significantly lower than that of other doctors (5.5%, 43/780) (P < 0.05). In 738 of benign lesions, 417 cases were excised and 50 malignant lesions were found, 205 cases were followed up by 2 - 29 months (median, 10.2 months), and one malignant lesion was found.

CONCLUSIONSUltrasound-guided core needle biopsy with histopathological assessment is an accurate method in diagnosis of breast lesions. Excisional biopsy is required to the high-risk lesions in CNB.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Mammary

OBJECTIVETo evaluate fine needle localized biopsy under mammography-guiding and skin incision selection by hookwire under ultrasound-guiding for patients with breast microcalcification.

METHODSBreast microcalcification of 178 patients treated from May 2000 to November 2006 were resected after localized with fine needle under X-ray mammography-guiding. Among them, 62 patients received the selection of hookwire under ultrasound-guiding.

RESULTSBreast cancer was detected in 58 patients (32.6%). Among them, 32 (55.1%) cases were carcinoma in situ, 11 (19.0%) intraductal carcinoma with early infiltration, 15 (25.9%) infiltrative ductal carcinoma, and 4 infiltrative ductal carcinoma with lymph node metastasis. The overall 5-year survival rate was 100%. Compared with that in needle guided group, the acceptable rate of cosmetic results was higher in hookwire group (P = 0.022).

CONCLUSIONSFor breast microcalcification, mammography guided needle biopsy with ultrasound selected skin incision is an effective and accurate diagnostic method.

Adult ; Aged ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Diseases ; pathology ; Breast Neoplasms ; pathology ; Calcinosis ; diagnosis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Mammography ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Stereotaxic Techniques ; Ultrasonography, Mammary