Stone Nelson N, Mouraviev Vladimir, Schechter David, Lucia M Scott, Smith Elizabeth E, Arangua Paul, Hoenemeyer John, Rosa Jim, Bawa Rajan, Crawford E David
Fitzsimons Innovation Campus, Bioscience Park Center, Aurora, CO.
Fitzsimons Innovation Campus, Bioscience Park Center, Aurora, CO.
Urology. 2017 Sep;107:257-261. doi: 10.1016/j.urology.2017.05.046. Epub 2017 Jun 7.
To increase the likelihood of detecting anterior cancers within the prostate and provide a specimen that spans the length of the gland. Newly designed 17- and 15-gauge (G) biopsy needles, a variable actuator, and an integrated pathology system intended for the longer cores were developed and tested for this purpose.
Testing was performed comparing 2 common cannula tip grinds, a Vet-point (sharp tip) and a Menghini-point (atraumatic tip), and were tested against 18-G Bard Monopty in porcine kidney. A variable actuator was developed to fire the needle 20-60 mm and tested in cadaver prostates.
The aggregate firings for 3 different shot lengths comparing the Vet- with the Menghini-tip cannulas demonstrated 91% vs 85.2% fill (length of specimen/length of core bed, P = .007). A 15-G trocar needle with the Vet-tip cannula also had the best performance, with an aggregate standard deviation of 6.4% across 3 firing ranges and a minimum to maximum specimen length of 81%-105% of potential fill. Cadaver testing with the Vet-tip needles in the actuator for the transrectal (17-G) and transperineal (15-G) biopsies demonstrated mean fills of 93.3% and 76.5%, respectively. The new transrectal ultrasound needle obtained a 2-fold increase in specimen length over the standard Bard device (P <.001).
Longer and consistent cores were obtained using the new biopsy needles. Combined with an adjustable actuator, the physician can obtain specimens that include peripheral and anterior zone tissue in 1 core. Determination of cancer location on the longer specimens could enhance focal therapy planning.
提高检测前列腺前部癌的可能性,并提供一个跨越腺体长度的标本。为此,研发并测试了新设计的17号和15号(G)活检针、可变驱动器以及用于获取更长组织芯的集成病理系统。
进行测试,比较两种常见的套管针尖端研磨方式,即兽医点式(尖锐尖端)和门基尼点式(无创尖端),并在猪肾中与18G巴德单针进行对比测试。开发了一种可变驱动器,使针可穿刺20 - 60毫米,并在尸体前列腺中进行测试。
比较兽医点式和门基尼点式套管针在3种不同穿刺长度下的总体穿刺情况,填充率分别为91%和85.2%(标本长度/芯床长度,P = 0.007)。带有兽医点式套管针的15G套管针性能也最佳,在3个穿刺范围内总体标准差为6.4%,标本最小长度至最大长度为潜在填充量的81% - 105%。在经直肠(17G)和经会阴(15G)活检的驱动器中使用兽医点式针进行尸体测试,平均填充率分别为93.3%和76.5%。新型经直肠超声针的标本长度比标准巴德设备增加了2倍(P < 0.001)。
使用新型活检针可获得更长且更一致的组织芯。结合可调节的驱动器,医生可以在1个组织芯中获取包括外周区和前部区域组织的标本。在更长的标本上确定癌症位置可增强聚焦治疗计划。