This presentation will review the biopsy methods used to obtain tissue from solid and cystic lesions of the lung, pancreas and thyroid. Each body site will be discussed separately with emphasis on the most current techniques used for diagnosis.
The presentation on biopsy of pulmonary lesions will review the use of percutaneous computed tomography (CT) guided biopsy with discussion of its diagnostic accuracy, limitations and complications for comparison with new techniques of biopsy including endobronchial ultrasound guided transbronchial fine-needle aspiration (EBUS-TBFNA) and endobronchial ultrasound guided transbronchial fine-needle biopsy (EBUS-TBFNB). A comparison of these latter two techniques will be made concerning their relative diagnostic accuracies including positive and negative predictive values as well as hazards. Their utility for obtaining material for special studies including molecular diagnostics will be discussed. Finally, alternative guidance techniques including endoscopic and navigational guidance will be addressed.
The second presentation will discuss currently available biopsy techniques including percutaneous core biopsy (CB), endoscopic ultrasound guided fine- needle aspiration (EUS-FNA) and endoscopic ultrasound guided fine needle biopsy (EUS-FNB). A discussion of the diagnostic accuracy, limitations and hazards of traditional core biopsy will serve as a background for review of newer fine-needle techniques used in the investigation of pancreatic lesions. Characteristics of the newer biopsy needles including SharkCore®, ProCore® and Acquire® will be reviewed. Comparisons of the sensitive specificity, positive predictive value and negative predictive value will be made for the FNA and FNB needles.
The final presentation will focus on the use of FNA for diagnosis of both cystic and solid thyroid nodules. Comparison of FNA with core biopsy and fine needle biopsy will be performed and diagnostic accuracy of each technique will be reviewed.
This session offers 1.0 CME/CMLE credit.