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Sampling error in diagnosing hyperparathyroid changes in bone in small needle biopsies.

V J Vigorita·V S Anand·T A Einhorn
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Abstract

Sampling error in diagnosing the effects of hyperparathyroidism on bone was studied retrospectively by subdividing large-core bone biopsy samples and evaluating them histologically. We used intratrabecular osteoclastic tunneling resorption as the diagnostic feature of secondary hyperparathyroidism in 10 hemodialysis patients. All biopsies were taken with a large-core bone biopsy instrument, resulting in a mean biopsy width of 5 mm. The processed tissue slides were divided into halves (mean width 2.5 mm) and subsequently into thirds (mean width 1.6 mm), mimicking smaller bone biopsy instruments such as the Jamshidi needle. In 30% of the cases the diagnosis of secondary hyperparathyroidism would have been missed if taken by a Jamshidi-type needle, and 60% if taken by a needle with a core diameter of 1.6 mm. Our findings emphasize the necessity of utilizing large-core bone biopsies in diagnosing certain metabolic bone diseases.

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Biopsy, NeedleBone ResorptionBone and BonesHumansHyperparathyroidism, SecondaryNeedlesRetrospective StudiesJournal Article

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BibTeXRIS

V J Vigorita, V S Anand, T A Einhorn. 1986. Sampling error in diagnosing hyperparathyroid changes in bone in small needle biopsies.. https://doi.org/10.1097/00000478-198602000-00007

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Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet.

PURPOSE: To report the accuracy of magnetic resonance imaging (MRI)-guided needle localization for diagnosis of MRI detected suspicious breast lesions located in difficult accessible regions of the breast, using the freehand method in a 3.0 T closed bore magnet. MATERIALS AND METHODS: In five patients with five MRI-only breast lesions underwent MRI-guided needle localization for histopathologic evaluation of the lesions. All interventional procedures were performed in a 3.0 T MRI system with the patient in prone position and by using a dedicated phased array breast coil. MRI-guided needle localizations were performed by using a freehand technique. In our study, the high-resolution scan allowed preprocedural localization of all lesions without use of contrast enhancement. In all cases contrast-enhanced MRI was performed after insertion of the wire to confirm the tip of the wire in direct contact with the enhancing lesion. RESULTS: Needle localizations were performed in five patients. Histopathologic evaluation of tissue after surgery excision biopsy revealed one lymph node, three invasive ductal carcinoma and one ductal carcinoma in situ. Lesion size varied from 6 to 30 mm. Mean duration time was 25 min. No complications occurred during the intervention method. In the patient with the benign lesion control MRI of the breast after 6 months confirmed lesion removal. CONCLUSIONS: MRI-guided needle localization by using a freehand technique in a 3.0 T closed bore magnet is a safe and accurate method for diagnosis of difficult accessible breast lesions only visible on MRI.

Biopsy, Needle↗