S Feuerbach1, J Gmeinwieser, P Gerhardt
1Institut für Röntgendiagnostik, Technische Universität München, Klinikum rechts der Isar.
This study compared diagnostic success rates of different biopsy tools during CT-guided procedures. Researchers evaluated 14- and 18-gauge needles versus a 0.95 mm cutting cannula in 350 patients. Larger needles achieved a success rate of 82.7%, while cannulas reached 66.2%. The main issue with large needles was poor positioning, while cannulas often failed due to insufficient tissue. Five patients had minor complications that did not require treatment. These findings suggest larger needles may be more effective for diagnostic biopsies. The study helps guide clinical decisions about which tools to use based on device performance and diagnostic goals.
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Area of Science:
Background:
Diagnostic accuracy remains a central challenge in percutaneous biopsy procedures. Prior research has shown that larger gauge needles tend to yield more tissue material than smaller ones. It was already known that needle positioning significantly influences biopsy outcomes. That uncertainty drove this investigation into how different needle sizes affect diagnostic success rates. No prior work had resolved whether cutting cannulas could match the performance of traditional needles. This gap motivated a comparative analysis of 14- and 18-gauge needles versus a 0.95 mm cutting cannula. The study aimed to clarify how device choice affects tissue acquisition and diagnostic yield. These findings could help guide clinical decisions about biopsy tool selection.
Purpose Of The Study:
The researchers sought to compare diagnostic success rates across different biopsy instruments. They focused on 14- and 18-gauge needles versus a 0.95 mm cutting cannula. The specific problem addressed was the variability in tissue sampling effectiveness. Motivation came from the need to optimize biopsy procedures for accuracy and safety. The study aimed to determine which device type provided the highest sensitivity. It also sought to identify the most frequent causes of failed biopsies. The goal was to inform clinical practice about optimal biopsy tool selection. This work could help reduce the need for repeat procedures and improve diagnostic confidence.
The study found 14- and 18-gauge needles achieved 82.7% sensitivity, while 0.95 mm cannulas reached 66.2%.
A successful biopsy was defined as one that produced a definitive histological diagnosis.
The cannulas provided inadequate tissue samples, unlike larger needles that failed due to poor positioning.
Five patients experienced complications, but none required treatment.
The study involved 350 patients undergoing percutaneous CT-guided biopsies.
Main Methods:
The study involved 350 patients undergoing percutaneous CT-guided biopsies. A total of 291 procedures used 14- or 18-gauge needles. Fifty-nine procedures employed a 0.95 mm cutting cannula. Histological success was defined as a definitive diagnosis. Needle placement was guided using computed tomography imaging. Tissue samples were analyzed for diagnostic adequacy. Complication rates were recorded and categorized. The primary outcome was sensitivity for each device type. Secondary outcomes included procedural success and adverse event frequency.
Main Results:
Using 14- and 18-gauge needles, a histological diagnosis was achieved in 191 of 233 cases. This produced a sensitivity of 82.7% for larger needles. The 0.95 mm cannulas yielded successful diagnoses in 39 of 59 cases. This resulted in a lower sensitivity of 66.2% for the cutting cannula. The most frequent issue with large needles was improper needle placement. Small needles often failed due to insufficient tissue sampling. Five patients experienced complications, but all were asymptomatic and untreated. These findings suggest device type significantly influences diagnostic yield.
Conclusions:
The authors propose that larger gauge needles provide higher diagnostic sensitivity than cutting cannulas. They suggest that needle positioning is a critical factor in biopsy success. The data indicate that 14- and 18-gauge needles outperform 0.95 mm cannulas in diagnostic yield. The researchers propose that cannulas may be less suitable for challenging cases. They suggest that cannulas may be appropriate in select scenarios where tissue volume is less critical. The findings imply that device choice should align with diagnostic goals. The authors propose that clinicians consider needle size when planning biopsies. These results may inform procedural decisions to optimize diagnostic outcomes.
The authors suggest clinicians consider needle size to optimize biopsy diagnostic yield.