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Helical-Tip Needle for Transthoracic Percutaneous Image-Guided Biopsy of Lung Tumors: Results of a Pilot Prospective Comparative Study with a Standard Tru-Cut Needle

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Abstract

Purpose

To prospectively evaluate feasibility and diagnostic performance of the 14-gauge helical-tip (Spirotome™, Cook® Medical, Bloomington, USA) needle in transthoracic needle biopsy (TTNB) of lung lesions, compared to a conventional 18-gauge Tru-Cut needle.

Materials and Methods

Study was institutional review board approved, with informed consent obtained. Data from synchronous Spirotome and Tru-Cut image-guided TTNB of 20 consecutive patients with malignant peripheral lung tumors larger than 3 cm were enrolled for pathologic characterization and mutational analysis. Samples obtained with Spirotome and Tru-Cut needle were compared for fragmentation, length, weight, morphologic and immunohistochemistry typifying, tumor cellularity (TC) and DNA concentration.

Results

The technical success rate for TTNB with Spirotome was 100%, and no major complications occurred. Less fragmentation (mean 2 vs. 3 fragments, P = .418), greater weight (mean 13 vs. 8.5 mg, P = .027) and lower length (mean 10.2 vs. 12.6 mm, P = .174) were observed with Spirotome compared to Tru-Cut needle. Accuracy of Spirotome and Tru-Cut needle in defining cancer histotype was similar (90%). Absolute and relative TC (mean 42 vs. 38, 124 vs. 108/10HPF), and DNA concentration (mean 49.6 vs. 39.0 ng/μl) were higher with Spirotome compared to Tru-Cut needle, with no statistical significance (P = .787 and P = .140, respectively).

Conclusions

Percutaneous 14-gauge Spirotome TTNB of selected lesions is feasible and accurate. It provides adequate samples for diagnosis, comparable to 18-gauge Tru-Cut needle, with a higher amount of tumor tissue (weight, TC, DNA concentration) even in shorter samples.

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Authors and Affiliations

  1. Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy

    Andrea Veltri, Marco Busso, Diego Sardo, Valeria Angelino, Adriano M. Priola & Matteo Barba

  2. Department of Oncology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy

    Silvia Novello

  3. Department of Pathology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy

    Gaia Gatti & Luisella Righi

Authors
  1. Andrea Veltri
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  2. Marco Busso
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  3. Diego Sardo
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  4. Valeria Angelino
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  5. Adriano M. Priola
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  6. Silvia Novello
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  7. Matteo Barba
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  8. Gaia Gatti
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  9. Luisella Righi
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Correspondence to Andrea Veltri.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Veltri, A., Busso, M., Sardo, D. et al. Helical-Tip Needle for Transthoracic Percutaneous Image-Guided Biopsy of Lung Tumors: Results of a Pilot Prospective Comparative Study with a Standard Tru-Cut Needle. Cardiovasc Intervent Radiol 40, 930–936 (2017). https://doi.org/10.1007/s00270-017-1585-5

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  • DOI: https://doi.org/10.1007/s00270-017-1585-5

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