title: 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.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy. andrea.veltri@unito.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Veltri
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Busso
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Sardo
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Angelino
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Adriano M
authors.initials: AM
authors.lastname: Priola
authors.affiliation: Department of Oncology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Novello
authors.affiliation: Department of Radiology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Barba
authors.affiliation: Department of Pathology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Gatti
authors.affiliation: Department of Pathology, San Luigi Gonzaga Hospital, University of Torino, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
authors.forename: Luisella
authors.initials: L
authors.lastname: Righi
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies
keywords: Biopsy; DNA mutational analysis; Image-guided biopsy; Lung; Needle; Neoplasms