Fluoroscopic percutaneous brush cytology, forceps biopsy and both in tandem for diagnosis of malignant biliary obstruction.
Objectives: To evaluate percutaneous brush cytology, forceps biopsy and a tandem procedure consisting of both, in the diagnosis of malignant biliary obstruction.Methods: A retrospective review of consecutive patients who underwent biliary brush cytology and/or forceps biopsy between 01/2010 and 09/2...
| Publicado en: | European Radiology Vol. 28; no. 2; pp. 522 - 530 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Feb2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126970464&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126970464 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Feb2018 vid: 28 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 126970464 126970464 144028859 NLM28779396 10.1007/s00330-017-4987-5 NLM28779396 126970464 ppf: 522 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Fluoroscopic percutaneous brush cytology, forceps biopsy and both in tandem for diagnosis of malignant biliary obstruction. aug: au: Boos, Johannes Yoo, Raphael J. Steinkeler, Jennifer Ayata, Gamze Ahmed, Muneeb Sarwar, Ammar Weinstein, Jeffrey Faintuch, Salomao Brook, Olga R. affil: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, 02215, Boston, MA, USA sug: subj: Bile Duct Neoplasms Complications Fluoroscopy Methods Biopsy Methods Cholestasis Diagnosis Aged, 80 and Over Cholestasis Etiology Retrospective Design ROC Curve Female Aged Bile Duct Neoplasms Diagnosis Adult Middle Age Male Scales Aged, 80 & over Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Objectives: To evaluate percutaneous brush cytology, forceps biopsy and a tandem procedure consisting of both, in the diagnosis of malignant biliary obstruction.Methods: A retrospective review of consecutive patients who underwent biliary brush cytology and/or forceps biopsy between 01/2010 and 09/2014 was performed. The cytology and pathology results were compared to the composite outcome (including radiological, pathological and clinical data). Cost for tandem procedure compared to brush cytology and forceps biopsy alone was calculated.Results: A total of 232 interventions in 129 patients (70.8 ± 11.0 years) were included. Composite outcome showed malignancy in 94/129 (72.9%) patients. Sensitivity for brush cytology, forceps biopsy and tandem procedure was 40.6% (95% CI 32.6-48.7%), 42.7% (32.4-53.0%) and 55.8% (44.7-66.9%) with 100% specificity, respectively. There were 9/43 (20.9%) additional cancers diagnosed when forceps biopsy was performed in addition to brush cytology, while there were 13/43 (30.2%) more cancers diagnosed when brush cytology was performed in addition to forceps biopsy. Additional costs per additionally diagnosed malignancy if tandem approach is to be utilised in all cases was $704.96.Conclusion: Using brush cytology and forceps biopsy in tandem improves sensitivity compared to brush cytology and forceps biopsy alone in the diagnosis of malignant biliary obstruction.Key Points: • Tandem procedure improves sensitivity compared to brush cytology and forceps biopsy. • Brush cytology may help to overcome "crush artefacts" from forceps biopsy. • The cost per diagnosed malignancy may warrant tandem procedure in all patients. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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