Evaluation of Image Guided Core Biopsies by Touch-Prep: Utility and Limitations
Joseph Byers, Roshan Patel, Luis Samayoa, Michael Cibull, Yolanda Brill. University of Kentucky, Lexington, KT; Veterans Affairs Hosptial, Lexington, KT
Background: Touch-Prep (TP) on image guided core biopsies has the potential to avoid non-diagnostic sampling and allow for immediate triage of specimens. This potential, in turn, is dependent upon the congruence in cytologic and histologic interpretations. We reviewed TP and core biopsy diagnoses and identified factors that are likely to cause discordant interpretations. In an era of increasing reliance on smaller specimens, effective triage and efficient utilization of material is crucial.
Design: We performed a one year (2010) retrospective analysis of all image guided core biopsies with TP. 214 cases were identified, of which 78 (36%) were lung, 40 (19%) liver and 96 (44%) other (lymph node, bone, mediastinum, intraabdominal, etc.). TP cases were categorized as positive, negative or atypical and compared to the histologic diagnoses. Discrepant cases were reviewed and the medical record was consulted for follow-up in cases without subsequent biopsy.
Results: See Tables 1 - 3
Conclusions: Touch-Prep on core biopsies is very accurate and contributes to a more efficient and effective use of very small specimens. Discordance between TP and core biopsy is often due to necrosis, obscuring blood or tumor characteristics such as marked fibrosis with few tumor cells. When correlated with the corresponding definitive specimen, TP identified more positive specimens than core biopsies. The presence of tumor cells in the TP should not be ignored when absent on the core biopsy. Until ancillary tests are adapted to cytologic material, cytopathologists should encourage radiologists to obtain sufficient viable and cellular material to perform such tests.
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 79, Wednesday Afternoon