Silvia Ferrari, Alessandra Weber, Paolo Marra, Paola Tebaldi, Chiara Pavoni, Anna Maria Barbui, Giuseppe Gritti, Ludovico Dulcetta, Francesco Saverio Carbone, Riccardo Muglia, Paola Anna Erba, Andrea Gianatti, Alessandro Rambaldi, Sandro Sironi
{"title":"Enhancing the diagnostic accuracy of core needle biopsy in patients with lymphoproliferative disorders by an optimized protocol.","authors":"Silvia Ferrari, Alessandra Weber, Paolo Marra, Paola Tebaldi, Chiara Pavoni, Anna Maria Barbui, Giuseppe Gritti, Ludovico Dulcetta, Francesco Saverio Carbone, Riccardo Muglia, Paola Anna Erba, Andrea Gianatti, Alessandro Rambaldi, Sandro Sironi","doi":"10.1007/s11547-025-01976-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Surgical excision biopsy of lymph nodes stands as the gold standard for histological characterization of lymphoproliferative disorders (LD). However, contemporary clinical practice increasingly leans toward core needle biopsy (CNB). This study seeks to explore the factors influencing the diagnostic yield of CNB in LD.</p><p><strong>Material and methods: </strong>This unicentric retrospective study presents data from patients referred for suspicion of new or relapsing LD. All patients underwent image-guided CNB of the target lesion based on PET/CT findings. The primary endpoint was the diagnostic outcome, comparing the ability to achieve a definitive diagnosis according to international guidelines with CNB versus the necessity for subsequent excisional biopsy.</p><p><strong>Results: </strong>We enrolled 478 consecutive patients undergoing CNB, categorized into two cohorts. Cohort A comprised patients who underwent CNB using 18-20G full-core Menghini needles, with a median macroscopic fragment dimension of 1 cm. Cohort B included patients who underwent CNB with 16-18G semiautomatic guillotine needles, with a median macroscopic fragment dimension of 1.5 cm. In cohort A, the rates of diagnostic and non-diagnostic (or non-sufficiently detailed) CNBs were 95 (73%) versus 35 (27%), respectively. In cohort B, these rates were 299 (86%) versus 49 (14%).</p><p><strong>Conclusion: </strong>The type and size of the needle used for CNB, as well as the histologic variant of LD, emerged as factors influencing diagnostic yield and accuracy. Given the swiftness of CNB compared to surgical excision, optimizing this technique could streamline the diagnostic and therapeutic workflow for patients with suspected LD.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiologia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11547-025-01976-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Enhancing the diagnostic accuracy of core needle biopsy in patients with lymphoproliferative disorders by an optimized protocol.
Purpose: Surgical excision biopsy of lymph nodes stands as the gold standard for histological characterization of lymphoproliferative disorders (LD). However, contemporary clinical practice increasingly leans toward core needle biopsy (CNB). This study seeks to explore the factors influencing the diagnostic yield of CNB in LD.
Material and methods: This unicentric retrospective study presents data from patients referred for suspicion of new or relapsing LD. All patients underwent image-guided CNB of the target lesion based on PET/CT findings. The primary endpoint was the diagnostic outcome, comparing the ability to achieve a definitive diagnosis according to international guidelines with CNB versus the necessity for subsequent excisional biopsy.
Results: We enrolled 478 consecutive patients undergoing CNB, categorized into two cohorts. Cohort A comprised patients who underwent CNB using 18-20G full-core Menghini needles, with a median macroscopic fragment dimension of 1 cm. Cohort B included patients who underwent CNB with 16-18G semiautomatic guillotine needles, with a median macroscopic fragment dimension of 1.5 cm. In cohort A, the rates of diagnostic and non-diagnostic (or non-sufficiently detailed) CNBs were 95 (73%) versus 35 (27%), respectively. In cohort B, these rates were 299 (86%) versus 49 (14%).
Conclusion: The type and size of the needle used for CNB, as well as the histologic variant of LD, emerged as factors influencing diagnostic yield and accuracy. Given the swiftness of CNB compared to surgical excision, optimizing this technique could streamline the diagnostic and therapeutic workflow for patients with suspected LD.
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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