A pilot study published in European Radiology Experimental reported that an ultrasound-enhanced fine-needle aspiration biopsy (USeFNAB) technique produced larger tissue samples than conventional fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) in patients with benign parotid gland tumors, while maintaining comparable diagnostic quality.
Needle biopsies are commonly used to evaluate salivary gland masses, but both FNAB and CNB have limitations. FNAB may yield insufficient material for diagnosis, whereas CNB is more invasive and can be more difficult to perform near nerves or blood vessels.
The investigators evaluated USeFNAB in 10 adult patients undergoing parotidectomy for benign parotid gland tumors, most of which were pleomorphic adenomas. Before surgery, each tumor was sampled with USeFNAB, FNAB, and CNB under ultrasound guidance.
The USeFNAB device applies ultrasonic vibrations to the biopsy needle tip during aspiration. According to the researchers, these vibrations help release additional cells and tissue fragments into the sample without increasing needle size.
Pathologists found that tissue quality was similar across all three biopsy methods. All samples obtained with USeFNAB and FNAB contained adequate material for cytological evaluation, and all biopsy specimens were considered suitable for diagnosis when compared with the final surgical pathology findings.
However, USeFNAB produced more tissue overall. Average specimen mass was 25 mg with USeFNAB compared with 16 mg for FNAB and 6 mg for CNB. Histological tissue area was also larger with USeFNAB, measuring approximately 14 mm² versus 8 mm² with FNAB and 4 mm² with CNB.
The authors noted that obtaining larger tissue samples may help support ancillary testing methods increasingly used in pathology laboratories, including immunohistochemistry, fluorescence in situ hybridization, and molecular diagnostic testing. The ability to collect both cytological and histological material from a single fine-needle sample may also improve workflow efficiency and reduce the need for repeat biopsies.
No major complications related to the biopsy procedures were observed. One minor hematoma was identified during surgery, and no tumor seeding was detected along visible needle tracts. Investigators also reported that the procedure was technically similar to standard FNAB and remained compatible with ultrasound imaging guidance.
The researchers emphasized that this was a small pilot study limited to benign parotid gland tumors. They stated that additional studies involving larger patient populations and other tumor types are needed before the technique can be more broadly evaluated for clinical practice.
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