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Determining the Optimal Number of Core Needle Biopsy Passes for Molecular Diagnostics

  • Laboratory Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The number of core biopsy passes required for adequate next-generation sequencing is impacted by needle cut, needle gauge, and the type of tissue involved. This study evaluates diagnostic adequacy of core needle lung biopsies based on number of passes and provides guidelines for other tissues based on simulated biopsies in ex vivo porcine organ tissues.

Methods

The rate of diagnostic adequacy for pathology and molecular testing from lung biopsy procedures was measured for eight operators pre-implementation (September 2012–October 2013) and post-implementation (December 2013–April 2014) of a standard protocol using 20-gauge side-cut needles for ten core biopsy passes at a single academic hospital. Biopsy pass volume was then estimated in ex vivo porcine muscle, liver, and kidney using side-cut devices at 16, 18, and 20 gauge and end-cut devices at 16 and 18 gauge to estimate minimum number of passes required for adequate molecular testing.

Results

Molecular diagnostic adequacy increased from 69% (pre-implementation period) to 92% (post-implementation period) (p < 0.001) for lung biopsies. In porcine models, both 16-gauge end-cut and side-cut devices require one pass to reach the validated volume threshold to ensure 99% adequacy for molecular characterization, while 18- and 20-gauge devices require 2–5 passes depending on needle cut and tissue type.

Conclusion

Use of 20-gauge side-cut core biopsy needles requires a significant number of passes to ensure diagnostic adequacy for molecular testing across all tissue types. To ensure diagnostic adequacy for molecular testing, 16- and 18-gauge needles require markedly fewer passes.

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Authors and Affiliations

  1. Division of Interventional Radiology, Stanford University School of Medicine, Stanford, CA, USA

    Nam S. Hoang, Benjamin H. Ge, Lorraine Y. Pan, Michael G. Ozawa, Christina S. Kong, John D. Louie & Rajesh P. Shah

  2. Division of Interventional Radiology, Veteran Administration Palo Alto Health Care System, Palo Alto, CA, USA

    Rajesh P. Shah

  3. Department of Radiology, Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Room H3630, M/C: 5642, Stanford, CA, 94305, USA

    Rajesh P. Shah

Authors
  1. Nam S. Hoang
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  2. Benjamin H. Ge
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  3. Lorraine Y. Pan
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Correspondence to Rajesh P. Shah.

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All authors declare that they have no conflicts of interest.

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All applicable institutional and/or national guidelines for the care and use of animals were followed.

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Hoang, N.S., Ge, B.H., Pan, L.Y. et al. Determining the Optimal Number of Core Needle Biopsy Passes for Molecular Diagnostics. Cardiovasc Intervent Radiol 41, 489–495 (2018). https://doi.org/10.1007/s00270-017-1861-4

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  • DOI: https://doi.org/10.1007/s00270-017-1861-4

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