Is the Immediate Evaluation of Touch Imprint Cytology from CT-Guided Core Needle Biopsies of Mass Lesions Helpful?
P Gopal, SR Williams, AB O'Bannon, H Alatassi, S Sahoo. University of Louisville, Louisville, KY
Background: Computed Tomography guided core needle biopsy (CTCNB) is a minimally invasive, safe and effective manner of tissue sampling in many organs. Some institutions employ pathologists in the immediate evaluation of CTCNB using touch imprint cytology (TIC) to guide the radiologist in determining whether the biopsy needle is in the correct location and to ensure adequate tissue sampling. The aim of our study is to determine the impact of on-site evaluation of TIC to minimize the number of passes required to obtain adequate tissue for diagnosis.
Design: A retrospective review of all CTCNBs from 2004 to 2008, where a pathologist was present for on-site TIC evaluation was performed. The cases included CTCNBs from masses in various organs. Each case was evaluated for the number of passes required before TIC was interpreted as adequate for diagnosis.
Results: A total of 140 CTCNBs were included in the study (liver, lung, kidney, sacral, paraspinal, omental, splenic and adrenal masses). Of the 140 cases, 109 were diagnosed as malignant and 28 as benign. In 106 cases (75.7%), the biopsies were determined adequate by TIC on the first pass, 19 (13%) on the second pass and 7 cases (5%) on the third pass. Only in 5 cases (3.6%), more than 3 passes were required before diagnostic material was obtained. Three cases (2.14%) were interpreted as inadequate both on TIC and on the final diagnosis. Of the biopsies deemed adequate on the first pass, 71% resulted in either termination of the procedure, or only one additional pass was obtained. In 5 cases, based on the TIC evaluation, a portion of the sample was sent for either flow cytometric analysis or cytogenetics.
Conclusions: In the majority of cases, adequate material was obtained in the first pass of CTCNB, and once this was obtained, either no additional passes, or one additional pass was performed. This study demonstrates the utility of on-site evaluation in minimizing the number of passes required to obtain a sufficient amount of diagnostic tissue and for specimen triage for ancillary studies, which in turn decreases the risk to the patient and decreases costs.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 56, Wednesday Afternoon