Automated biopsy devices: significance and safety

Article Abstract:

It has become standard practice to use imaging techniques to guide needles used in obtaining tissue biopsies. Smaller-gauge needles are generally used, although some proof exists that larger-gauge needles can provide more information. Users fear that the larger needles cause more damage and are harder to use, but the evidence is not clear that this is so. Automated biopsy devices have recently been developed, but the use and safety of these devices are not yet clear. Four articles in the September 1990 issue of Radiology discuss the use of these devices. Hopper et al. show that using automated devices generally increases quality and quantity of tissue obtained. The devices may help standardize biopsy procedures enough to increase the quality of results obtained by all but the most experienced practitioners. These devices appear to be most useful in the tissues and organs that are most difficult to biopsy. The article by Poster et al. indicates automated devices are well suited for biopsy of difficult tissues such as pediatric kidney, because they act quickly with minimal organ or needle movement. This also increases safety since the number of needle passes may be reduced. Two other articles examine the use of automated devices in other tissues. Elvin et al. show how it is possible to safely obtain samples from the pancreas with a larger gauge needle than is normally used. Incidence of pancreatitis (inflammation of pancreatic tissue) as a complication appears to be minimized using this procedure. The article by Parker et al. looks at biopsy of the breast. They found that automated devices, because they could get larger samples, could reduce the number of false results. This procedure also does not produce a scar and complications were not found to increase. Automated biopsy devices appear to be safe and effective and are useful additions to the practitioner's set of diagnostic tools. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Equipment and supplies, Diagnostic specimens, editorial

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Biopsy of the pancreas with a biopsy gun

Article Abstract:

Suspected tumors of the pancreas are mainly diagnosed by using needle biopsy techniques to obtain tissue samples. Fine-needle aspiration biopsy (FNAB) is the most commonly used technique because it is effective and causes few complications. The main drawback of this technique is the small amount of tissue that it can withdraw. This is because it is performed manually and therefore requires the use of a small needle. It also requires an experienced practitioner to obtain the sample. This study examined the use of an automatic sampling device (biopsy gun) to obtain tissue samples for biopsy. The gun uses a larger gauge needle and requires less technical proficiency. Accuracy and incidence of complications were compared with those associated with FNAB. The results of 50 pancreatic biopsies obtained from 47 patients using a biopsy gun were evaluated. Pancreatic tumors were found in 39 of the 47 patients as a final diagnosis. Biopsy using the biopsy gun was diagnostic for 36 of the 39. Two of these were correctly diagnosed on a second pancreatic biopsy. Five of the patients reported minor complications, including mild pain and small drops in blood pressure. No signs of bleeding as a result of the biopsies were seen, nor was inflammation of the pancreas (pancreatitis) a complication for any of the patients. The results show this technique to be highly accurate, perhaps more so than FNAB. It was able to obtain more tissue than FNAB, and the complication rates appear similar, although in this study follow-up to detect complications was not formal. The use of a biopsy gun to obtain pancreatic biopsies is both useful and safe. (Consumer Summary produced by Reliance Medical Information, Inc.)

Tumors, Pancreatic diseases

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Percutaneous pediatric renal biopsy: use of the biopsy gun

Article Abstract:

Tissues obtained by biopsy are crucial in diagnosing diseases of renal (kidney) cells. The traditional method involves the manual insertion of a needle. A new technique that uses a biopsy gun was evaluated for its ability to obtain tissue samples from the kidneys of children. The gun was guided using ultrasound. The needle used was 18 gauge in size, which is smaller than the needles used in manual biopsy. The technique was performed on seven patients between 3 and 14 years old. At least 10 glomeruli (small filtering structures of the kidney) were obtained in six of the seven samples, and seven were obtained in the other. This indicates the biopsy was successful in obtaining enough tissue to diagnose any kidney disease. Disease was found in five of the seven patients. Only one minor complication (trace hematuria, blood in the urine) occurred and it was a common one with renal biopsy. The results demonstrate the effectiveness of this technique. Traditional manual methods are often unsatisfactory in obtaining samples from the smaller kidneys of pediatric patients. The larger needle used in manual techniques can cause major complications. The use of the biopsy gun also made the procedure quicker and easier to perform. (Consumer Summary produced by Reliance Medical Information, Inc.)

Kidney diseases

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