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针吸活检中的针偏斜和组织采样长度。

Needle deflection and tissue sampling length in needle biopsy.

作者信息

Li Annie D R, Plott Jeffrey, Chen Lei, Montgomery Jeffrey S, Shih Albert

机构信息

Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA.

Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Surgery, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Mech Behav Biomed Mater. 2020 Apr;104:103632. doi: 10.1016/j.jmbbm.2020.103632. Epub 2020 Jan 11.

Abstract

This study investigates the effect of needle tip geometry on the needle deflection and tissue sampling length in biopsy. Advances in medical imaging have allowed the identification of suspicious cancerous lesions which then require needle biopsy for tissue sampling and subsequent confirmatory pathological analysis. Precise needle insertion and adequate tissue sampling are essential for accurate cancer diagnosis and individualized treatment decisions. However, the single-bevel needles in current hand-held biopsy devices often deflect significantly during needle insertion, causing variance in the targeted and actual locations of the sampled tissue. This variance can lead to inaccurate sampling and false-negative results. There is also a limited understanding of factors affecting the tissue sampling length which is a critical component of accurate cancer diagnosis. This study compares the needle deflection and tissue sampling length between the existing single-bevel and exploratory multi-bevel needle tip geometries. A coupled Eulerian-Lagrangian finite element analysis was applied to understand the needle-tissue interaction during needle insertion. The needle deflection and tissue sampling length were experimentally studied using tissue-mimicking phantoms and ex-vivo tissue, respectively. This study reveals that the tissue separation location at the needle tip affects both needle deflection and tissue sampling length. By varying the tissue separation location and creating a multi-bevel needle tip geometry, the bending moments induced by the insertion forces can be altered to reduce the needle deflection. However, the tissue separation location also affects the tissue contact inside the needle groove, potentially reducing the tissue sampling length. A multi-bevel needle tip geometry with the tissue separation point below the needle groove face may reduce the needle deflection while maintaining a long tissue sampling length. Results from this study can guide needle tip design to enable the precise needle deployment and adequate tissue sampling for the needle biopsy procedures.

摘要

本研究调查了活检针针尖几何形状对针偏转和组织采样长度的影响。医学成像技术的进步使得能够识别可疑的癌性病变,随后需要进行针吸活检以获取组织样本并进行后续的确诊病理分析。精确的针插入和足够的组织采样对于准确的癌症诊断和个体化治疗决策至关重要。然而,当前手持式活检设备中的单斜面针在插入过程中常常会显著偏转,导致采样组织的目标位置与实际位置出现偏差。这种偏差可能导致采样不准确和假阴性结果。对于影响组织采样长度的因素,人们的了解也很有限,而组织采样长度是准确癌症诊断的关键组成部分。本研究比较了现有的单斜面和探索性多斜面针尖几何形状之间的针偏转和组织采样长度。应用耦合欧拉 - 拉格朗日有限元分析来理解针插入过程中的针 - 组织相互作用。分别使用组织模拟体模和离体组织对针偏转和组织采样长度进行了实验研究。本研究表明,针尖处的组织分离位置会影响针偏转和组织采样长度。通过改变组织分离位置并创建多斜面针尖几何形状,可以改变插入力引起的弯矩,以减少针的偏转。然而,组织分离位置也会影响针槽内的组织接触,可能会缩短组织采样长度。组织分离点位于针槽面下方的多斜面针尖几何形状可能会减少针的偏转,同时保持较长的组织采样长度。本研究结果可为针尖设计提供指导,以实现针吸活检程序中针的精确部署和足够的组织采样。

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