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 Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

nachricht NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

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: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Closing the carbon loop

08.12.2016 | Life Sciences

Applicability of dynamic facilitation theory to binary hard disk systems

08.12.2016 | Physics and Astronomy

Scientists track chemical and structural evolution of catalytic nanoparticles in 3-D

08.12.2016 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>