Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Minimally invasive solid tumor biopsy may replace surgery to get diagnostic specimens

22.07.2005


Core-needle biopsy guided by CT scans or ultrasound appears to be an effective way to obtain tumor samples diagnosis of pediatric solid tumors, say St. Jude Children’s Research Hospital researchers



Inserting biopsy needles through the skin appears to be a safe and reliable alternative to surgery for obtaining diagnostic samples of a suspected solid tumor in children, according to results of a study by investigators at St. Jude Children’s Research Hospital. The technique, called percutaneous ("through the skin") core-needle biopsy, provides samples of tissue suitable for accurate initial diagnosis of a solid tumor, the researchers say.

In addition, the findings contradict the belief of many pediatric surgeons that this technique is more likely than surgery to dislodge cells from the tumor and cause the cancer to spread. A report on the findings of this study appears in the August 1 issue of Cancer. The St. Jude findings are based on a retrospective ("look back") study of the medical records.


Substituting percutaneous core biopsy for surgery would eliminate the need for children to recover from an operation, which delays chemotherapy for their cancer, according to Fredric A. Hoffer, MD, a member of the Department of Radiological Sciences. And it would eliminate potential complications from surgery, such as infections, he says. "This technique is already commonly used to diagnose solid tumors in adults," says Hoffer. "Our own study now shows that this technique appears to be suitable for children as well." Hoffer is senior author of the Cancer paper.

Hoffer performed the biopsies guided usually by ultrasound or CT scans to obtain images inside the patient as he inserted and manipulated the hollow biopsy needles in order to obtain cores of tumor samples.

The biopsy samples were analyzed using histopathologic techniques (studying the tissue under a microscope and using antibody-based techniques to enhance determination of tumor type), as well as by cytogenetics or molecular pathology (identifying abnormalities in chromosomes).

Obtaining sufficient amounts of fresh specimens for study is essential for the success of this technique, says Hoffer. Biopsies obtained only for cytology studies (studying cell structure) aren’t usually sufficient to diagnose childhood cancers, according to Christine Fuller, MD, an assistant member of the Department of Pathology at St. Jude. Having a laboratory available to process fresh tissue for cytogenetics and molecular pathology is also a key to success, she notes. Fuller is a co-author of the paper.

Patients ranged from less than one year in age to 33 years. Adults were included in this study because of suspected recurrence or metastasis (spread) from previously diagnosed childhood cancers. The researchers determined the accuracy of their results by comparing their diagnoses to the diagnoses that were subsequently made using specimens that had been obtained by surgery.

The St. Jude team first analyzed the clinical data obtained from 202 percutaneous core-needle biopsies of solid tumors over 5.5 years (1997 to 2003) in order to determine how many of the individual biopsy samples lead to the correct identification of a cancer. This would demonstrate how likely individual biopsy specimens provided suitable tissue for laboratory analysis, according to Hoffer.

Among the tumors correctly identified using biopsy samples obtained percutaneously were 13 neuroblastomas (a tumor of the nervous system), eight hepatoblastomas (a cancer of the liver), seven Wilms tumors (a cancer that originates in the kidney), four rhabdomyosarcomas (a cancer of the soft tissues), and three osteosarcomas (cancers of the bone), according to Hoffer.

Attempts to diagnose initial cancer for each of the 103 patients produced 62 "true positive" diagnoses out of 64 results that had been judged to be positive for cancer. This meant the sensitivity of this procedure for making initial diagnoses was 97%, according to the report. The technique also correctly identified all 39 patients who were later found to be negative following laboratory examination of tissues removed surgically--or by clinical follow-up--a specificity of 100%. These "false tumors" were caused by inflammatory or infectious processes rather than cancer, the researchers say. In addition, examination of biopsy samples obtained percutaneously led to the incorrect diagnosis of "no cancer" in only two thyroid carcinoma cases, for an accuracy of 98%.

The researchers also determined the ability of percutaneous biopsy to correctly identify cancer in 99 patients who were suspected of having a recurrence of a previously treated cancer. The results showed that percutaneous biopsy was less reliable than for initial diagnosis. Specifically, the sensitivity was 83%; specificity was 100%; and accuracy was 88%.

The follow-up studies of patients medical records provided no evidence that the cancer had spread due to dislodging cells during percutaneous biopsy, the researchers report.

"Overall, our study demonstrated that percutaneous biopsy is useful in diagnosing pediatric solid tumors," Hoffer says. "And this technique is especially useful for sampling tumors that are not easy to access using surgery--for instance in a patient with a large retroperitoneal neuroblastoma that may not be able to be removed surgically until the tumor shrinks from chemotherapy," he adds. "This technique might also be useful for those cases in which new chemotherapy agents are used for suspected recurrent tumor." Retroperitoneal refers to the membrane lining the abdomen that covers the internal organs.

The only disadvantage to this technique is that there is only a small amount of tissue remaining for tumor banking (saving the tumor for future studies) after allocating enough for laboratory analysis, Hoffer says.

Kelly Perry | EurekAlert!
Further information:
http://www.stjude.org

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

Im Focus: Autonomous 3D scanner supports individual manufacturing processes

Let’s say the armrest is broken in your vintage car. As things stand, you would need a lot of luck and persistence to find the right spare part. But in the world of Industrie 4.0 and production with batch sizes of one, you can simply scan the armrest and print it out. This is made possible by the first ever 3D scanner capable of working autonomously and in real time. The autonomous scanning system will be on display at the Hannover Messe Preview on February 6 and at the Hannover Messe proper from April 23 to 27, 2018 (Hall 6, Booth A30).

Part of the charm of vintage cars is that they stopped making them long ago, so it is special when you do see one out on the roads. If something breaks or...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Fingerprints of quantum entanglement

16.02.2018 | Information Technology

'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers

16.02.2018 | Health and Medicine

Hubble sees Neptune's mysterious shrinking storm

16.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>