• Clinical Endoscopy
• /
• v.51 no.6
• /
• pp.600-601
• /
• 2018

• Journal of the Korean Society of Radiology
• /
• v.84 no.2
• /
• pp.345-360
• /
• 2023

In Korea, the number of institutions providing breast MRI, as well as the number of breast MRIs, has recently increased. However, MRI-guided procedures, including biopsy and needle localization, are rarely performed compared to ultrasound-guided or stereotactic biopsy. As breast MRI has high sensitivity but limited specificity, lesions detected only on MRI require pathologic confirmation through MRI-guided biopsy or surgical excision with MRI-guided needle localization. Thus, we aimed to review MRI-guided procedures, including their indications, techniques, procedural considerations, and limitations.

• Clinical Endoscopy
• /
• v.56 no.2
• /
• pp.221-228
• /
• 2023

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting. Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively. Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375). Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

• Journal of the Korean Society of Radiology
• /
• v.84 no.6
• /
• pp.1220-1232
• /
• 2023

The prostate cancer diagnosis has traditionally been based on a systematic biopsy method in which tissue samples are randomly obtained from the prostate 10-12 sites. However, there are concerns as the method can fail to diagnose all prostate cancers or lead to over-detection of clinically insignificant cancers. MRI-guided prostate targeted biopsy has been proposed to address these shortcomings. This method involves identifying suspicious lesions using MRI and performing targeted biopsies under ultrasound or MRI guidance. We review the methods of MRI-based targeted biopsy and discuss recent guidelines and trends in prostate cancer diagnosis.

• Korean Journal of Head & Neck Oncology
• /
• v.31 no.1
• /
• pp.1-4
• /
• 2015

Fine needle aspiration cytology(FNAC) holds a main role in assessing thyroid nodules. But nonnegligible rate of thyroid cytology is reported as uncertain, indeterminate or inadequate for diagnosis. Recently, the microhistologic evaluation by core needle biopsy(CNB) under ultrasound sonographical guidance has been reported to show high accuracy for the diagnose of thyroid nodules. Aim of this review was to furnish the state of the art of this topic by summarizing previous published data about indication, diagnostic performance, and complication of CNB in thyroid lesions compared with FNAC

• The Journal of the Korean bone and joint tumor society
• /
• v.10 no.2
• /
• pp.113-119
• /
• 2004

Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4689-4692
• /
• 2013

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

• Korean Journal of Radiology
• /
• v.22 no.4
• /
• pp.596-603
• /
• 2021

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

• Journal of Biomedical Engineering Research
• /
• v.41 no.5
• /
• pp.195-202
• /
• 2020

Needle detection in ultrasound images is sometimes difficult due to obstruction of fat tissues. Accurate needle detection using continuous ultrasound (CUS) images is a vital stage of treatment planning for tissue biopsy and brachytherapy. The main goal of the study is classified into two categories. First, new detection model, i.e. D-Attention Unet, is developed by combining the context information of 3D medical data and CUS images. Second, the D-Attention Unet model was compared with other models to verify its usefulness for needle detection in continuous ultrasound images. The continuous needle images taken with ultrasonic waves were converted into still images for dataset to evaluate the performance of the D-Attention Unet. The dataset was used for training and testing. Based on the results, the proposed D-Attention Unet model showed the better performance than other 3 models (Unet, D-Unet and Attention Unet), with Dice Similarity Coefficient (DSC), Recall and Precision at 71.9%, 70.6% and 73.7%, respectively. In conclusion, the D-Attention Unet model provides accurate needle detection for US-guided biopsy or brachytherapy, facilitating the clinical workflow. Especially, this kind of research is enthusiastically being performed on how to add image processing techniques to learning techniques. Thus, the proposed method is applied in this manner, it will be more effective technique than before.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.7
• /
• pp.3087-3091
• /
• 2014

Purpose: To determine the utility of digital rectal examination (DRE), serum total prostate specific antigen (tPSA) estimation, and transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) in men with lower urinary tract symptoms (LUTS). Materials and Methods: All patients with abnormal DRE, TRUS, or serum tPSA >4ng/ml, in any combination, underwent TRUS-guided needle biopsy. Eight cores of prostatic tissue were obtained from different areas of the peripheral prostate and examined histopathologically for the nature of the pathology. Results: PCa was detected in 151 (50.3%) patients, remaining 149 (49.7%) showed benign changes with or without active prostatitis. PCa was detected in 13 (56.5%), 9 (19.1%), 26 (28.3%), and 103 (74.6%) of patients with tPSA <4 ng/ml, 4-10 ng/ml, 10-20 ng/ml and >20 ng/ml respectively. Only 13 patients with PCa had abnormal DRE and TRUS with serum PSA <4 ng/ml. The detection rate was highest in patients with tPSA >20 ng/ml. The association between tPSA level and cancer detection was statistically significant (p<0.01). Among 209 patients with abnormal DRE and raised serum PSA, PCa was detected in 128 (61.2%). Conclusions: The incidence of PCa increases with increasing serum level of tPSA. The overall screening and detection rate can be further improved by using DRE, TRUS and TRUS-guided prostate needle biopsies.