Journal article
Fluoroscopic percutaneous brush cytology, forceps biopsy and both in tandem for diagnosis of malignant biliary obstruction
European radiology, v 28(2), pp 522-529
01 Feb 2018
PMID: 28779396
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate percutaneous brush cytology, forceps biopsy and a tandem procedure consisting of both, in the diagnosis of malignant biliary obstruction.
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.
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.
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.
• 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.
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Details
- Title
- Fluoroscopic percutaneous brush cytology, forceps biopsy and both in tandem for diagnosis of malignant biliary obstruction
- Creators
- Johannes Boos - Beth Israel Deaconess Medical CenterRaphael J Yoo - Beth Israel Deaconess Medical CenterJennifer Steinkeler - Beth Israel Deaconess Medical CenterGamze Ayata - Beth Israel Deaconess Medical CenterMuneeb Ahmed - Beth Israel Deaconess Medical CenterAmmar Sarwar - Beth Israel Deaconess Medical CenterJeffrey Weinstein - Beth Israel Deaconess Medical CenterSalomao Faintuch - Beth Israel Deaconess Medical CenterOlga R Brook - Beth Israel Deaconess Medical Center
- Publication Details
- European radiology, v 28(2), pp 522-529
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000418576300009
- Scopus ID
- 2-s2.0-85026804995
- Other Identifier
- 991021861655504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Radiology, Nuclear Medicine & Medical Imaging