Abstract:
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Purpose: The diagnostic accuracy of CT guided needle core biopsies (NCB) from suspected tumours of the pancreas were compared to the accuracy of fine needle aspiration (FNA) biopsies.
Methods and Materials: 29 patients (15f /14m) 50 to 82 years (mean age 66 years) with pancreatic tumours underwent CT guided core biopsy and fine needle aspiration in one procedure. 26 patients had radiographic features of nonresectable pancreatic neoplasm. One patient underwent biopsy to proof clinical and morphologic diagnosis of chronic pancreatitis and in 2 other patients a serous cystadenoma respectively a neuroendocrine tumour had to be confirmed. In 3 patients a transgastral approach was chosen. Needle size of the introducer needle ranged from 17 gauges to 19 gauges. FNA and NBC were both acquired through the introducer needle, FNA with a 22 gauge needle, NCB with needles ranging from 18 to 20 gauge.
Results: In 18 of 28 patients with suspicious neoplastic pancreatic disease both methods (NBC and FNA) demonstrated malignant disease, but NBC allowed more accurate tumour subtyping in 1 patient with mucinous cystic tumour and in another patient with metastasis to the pancreas (using immunohistology). Cytology misinterpreted one lesion as metastasis, whereas NCB and immunohistology made the definite diagnoses of pancreatic adenocarcinoma. In 4 patients only NCB identified malignant disease, whereas in 3 patients only cytology made the diagnoses of carcinoma. In 2 patients both methods (NBC and FNA) demonstrated benign disease (one serous Cystadenoma and one non malignant neuroendocrine tumour. In one patient both methods were false negative. None of the patients suffered biopsy related complications.
Conclusion: NCB provides more accurate classification of tumours, however a combination of these two sampling techniques increases diagnostic sensitivity and should be considered complementary in the investigation of pancreatic tumours.
Unger MD, B,
Pancreatic Neoplasms: Comparison of Fine Needle Aspiration Cytology and Needle Core Biopsy. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103226.html
