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Ari Breiner - One of the best experts on this subject based on the ideXlab platform.
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muscle Biopsy technical safety and quality using a self contained vacuum assisted Biopsy Technique
Neuromuscular Disorders, 2018Co-Authors: Antonio Gallo, Hans D Katzberg, Vera Bril, Alon Abraham, Suganthini Ilaalagan, Ari BreinerAbstract:Abstract Muscle sampling via percutaneous Biopsy has been shown to be safe and effective using a Bergstrom needle; however, the use of a single-operator, self-contained, vacuum-assisted Biopsy Technique has not been explored. We performed a retrospective chart review of muscle Biopsy samples obtained using the Vacora® self-contained vacuum-assisted Biopsy system between 2013 and 2016, at the Toronto General Hospital. During this period, 102 single-operator muscle biopsies were performed using the Vacora® system. 54/102 showed normal or non-specific findings, while 39/102 were suggestive or diagnostic of a neuromuscular condition. 8 samples did not provide sufficient muscle tissue for diagnosis, and complications (intramuscular hematoma) occurred in 3/102 cases. Mean sample weight was 0.19 grams, which exceeded reported mean sample weights using the suction-modified Bergstrom Technique (0.125 grams). We therefore conclude that the Vacora® vacuum-assisted Biopsy system provides a safe and effective method to obtain diagnostic muscle Biopsy samples; although complication rates are slightly higher than reported using the Bergstrom Technique, possibly related to more vigorous suction or a sharp needle tip.
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review of muscle Biopsy technical safety and quality using a self contained vacuum assisted Biopsy Technique p2 142
Neurology, 2017Co-Authors: Antonio Gallo, Hans D Katzberg, Vera Bril, Ari BreinerAbstract:Objective: To describe our experience with a novel vacuum-assisted muscle sampling Technique. Background: Percutaneous muscle Biopsy is an accepted method of muscle tissue sampling for research and clinical practice. Excellent technical safety and sample quality have previously been demonstrated with the suction-modified Bergstrom percutaneous muscle Biopsy Technique, although this Technique requires two operators and may require multiple muscle insertions (to obtain sufficient tissue volume). The Vacora self-contained vacuum-assisted Biopsy system is an easy to use, single-operator system developed and studied as a safe and effective tool for Biopsy of breast lesions. The Vacora system has been noted as a potential tool for percutaneous muscle biopsies, however data about Technique safety, sample quality, and cost effectiveness are not available. Design/Methods: The Vacora system has been used for muscle Biopsy at our clinic (a large, tertiary-care neuromuscular clinic) since November 2013, with over 100 consecutive muscle biopsies performed. We performed a retrospective review of all percutaneous muscle biopsies over this time period. Results: We report on ease of use, sample size, sample quality and complication rates (including patient morbidity and need for repeat or open Biopsy) in this cohort. Our results are compared to literature descriptions of Bergstrom percutaneous and open Biopsy Techniques. Conclusions: The description of safety, feasibility and sample quality results associated with a novel muscle Biopsy Technique is intended to offer clinicians an alternative method to obtain muscle samples for diagnostic testing or research studies. Disclosure: Dr. Gallo has nothing to disclose. Dr. Katzberg has received personal compensation for activities with Genzyme and CSL Behring. Dr. Bril has received personal compensation for activities with CSL, Grifols, Bionevia, and UCB for consulting and research grants. Dr. Breiner has received research support from Grifols and GBS/CIDP Foundation.
A W Barrett - One of the best experts on this subject based on the ideXlab platform.
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what is the optimal site and Biopsy Technique for the diagnosis of oral mucosal autoimmune blistering disease
Journal of Oral Pathology & Medicine, 2019Co-Authors: Ciro Gilvetti, J Collyer, Aakshay Gulati, A W BarrettAbstract:BACKGROUND: The aim of this study was to determine which Biopsy method produces the best diagnostic yield in patients presenting with autoimmune blistering diseases (AIBDs) of the oral mucosa. METHODS: This was a retrospective audit of patients who were biopsied at least once for a suspected AIBD of the oral mucosa. The type (incisional or punch) and site of biopsies were recorded in conjunction with case notes, electronic records and histopathological reports in order to calculate sensitivity, specificity and the method of Biopsy which produced the superior diagnostic yield. RESULTS: A total of 125 Biopsy samples from 66 patients were identified and reviewed. A diagnosis of AIBD was established in 49 (74%) patients. The chi-square test showed there was a statistically significantly higher (P = 0.0016) diagnostic yield using the punch Biopsy Technique compared to the scalpel method. The gingiva was the best Biopsy site in terms of achieving a definitive diagnosis (P = 0.0001) regardless of the Biopsy method used. CONCLUSIONS: A punch Biopsy is more likely than scalpel Biopsy to obtain a definitive diagnosis in patients presenting with a suspected oral AIBD. The gingiva is the optimal site to sample.
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an audit of the efficacy of the oral brush Biopsy Technique in a specialist oral medicine unit
Oral Oncology, 2004Co-Authors: Timothy Poate, Jag Buchanan, T A Hodgson, P M Speight, A W Barrett, David R Moles, C Scully, S R PorterAbstract:The diagnosis of oral epithelial. dysplasia has traditionally been based upon histopathological evaluation of a full thickness Biopsy specimen from lesional tissue. It has recently been proposed that cytological examination of "brush Biopsy" samples is a non-invasive method of determining the presence of cellular atypia, and hence the likelihood of oral epithelial. dysplasia. The present audit determined, retrospectively the sensitivity, specificity and positive and negative predictive values of the oral brush Biopsy Technique in the diagnosis of potentially malignant disease in a group of 112 patients attending a specialist Oral Medicine unit. The sensitivity of detection of oral epithelial dysplasia or squamous cell carcinoma of the oral brush Biopsy system was 71.4% while the specificity was 32%. The positive predictive value of an abnormal brush Biopsy result (positive or atypical) was 44.1%, while the negative predictive value was 60%. It is concluded that not all. potentially malignant disease is detected with this non-invasive investigative procedure. (C) 2004 Elsevier Ltd. All rights reserved.
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an audit of the efficacy of the oral brush Biopsy Technique in a specialist oral medicine unit
Oral Oncology, 2004Co-Authors: Timothy Poate, Jag Buchanan, T A Hodgson, P M Speight, A W Barrett, David R Moles, Stephen PorterAbstract:The diagnosis of oral epithelial dysplasia has traditionally been based upon histopathological evaluation of a full thickness Biopsy specimen from lesional tissue. It has recently been proposed that cytological examination of "brush Biopsy" samples is a non-invasive method of determining the presence of cellular atypia, and hence the likelihood of oral epithelial dysplasia. The present audit determined, retrospectively the sensitivity, specificity and positive and negative predictive values of the oral brush Biopsy Technique in the diagnosis of potentially malignant disease in a group of 112 patients attending a specialist Oral Medicine unit. The sensitivity of detection of oral epithelial dysplasia or squamous cell carcinoma of the oral brush Biopsy system was 71.4% while the specificity was 32%. The positive predictive value of an abnormal brush Biopsy result (positive or atypical) was 44.1%, while the negative predictive value was 60%. It is concluded that not all potentially malignant disease is detected with this non-invasive investigative procedure.
Antonio Gallo - One of the best experts on this subject based on the ideXlab platform.
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muscle Biopsy technical safety and quality using a self contained vacuum assisted Biopsy Technique
Neuromuscular Disorders, 2018Co-Authors: Antonio Gallo, Hans D Katzberg, Vera Bril, Alon Abraham, Suganthini Ilaalagan, Ari BreinerAbstract:Abstract Muscle sampling via percutaneous Biopsy has been shown to be safe and effective using a Bergstrom needle; however, the use of a single-operator, self-contained, vacuum-assisted Biopsy Technique has not been explored. We performed a retrospective chart review of muscle Biopsy samples obtained using the Vacora® self-contained vacuum-assisted Biopsy system between 2013 and 2016, at the Toronto General Hospital. During this period, 102 single-operator muscle biopsies were performed using the Vacora® system. 54/102 showed normal or non-specific findings, while 39/102 were suggestive or diagnostic of a neuromuscular condition. 8 samples did not provide sufficient muscle tissue for diagnosis, and complications (intramuscular hematoma) occurred in 3/102 cases. Mean sample weight was 0.19 grams, which exceeded reported mean sample weights using the suction-modified Bergstrom Technique (0.125 grams). We therefore conclude that the Vacora® vacuum-assisted Biopsy system provides a safe and effective method to obtain diagnostic muscle Biopsy samples; although complication rates are slightly higher than reported using the Bergstrom Technique, possibly related to more vigorous suction or a sharp needle tip.
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review of muscle Biopsy technical safety and quality using a self contained vacuum assisted Biopsy Technique p2 142
Neurology, 2017Co-Authors: Antonio Gallo, Hans D Katzberg, Vera Bril, Ari BreinerAbstract:Objective: To describe our experience with a novel vacuum-assisted muscle sampling Technique. Background: Percutaneous muscle Biopsy is an accepted method of muscle tissue sampling for research and clinical practice. Excellent technical safety and sample quality have previously been demonstrated with the suction-modified Bergstrom percutaneous muscle Biopsy Technique, although this Technique requires two operators and may require multiple muscle insertions (to obtain sufficient tissue volume). The Vacora self-contained vacuum-assisted Biopsy system is an easy to use, single-operator system developed and studied as a safe and effective tool for Biopsy of breast lesions. The Vacora system has been noted as a potential tool for percutaneous muscle biopsies, however data about Technique safety, sample quality, and cost effectiveness are not available. Design/Methods: The Vacora system has been used for muscle Biopsy at our clinic (a large, tertiary-care neuromuscular clinic) since November 2013, with over 100 consecutive muscle biopsies performed. We performed a retrospective review of all percutaneous muscle biopsies over this time period. Results: We report on ease of use, sample size, sample quality and complication rates (including patient morbidity and need for repeat or open Biopsy) in this cohort. Our results are compared to literature descriptions of Bergstrom percutaneous and open Biopsy Techniques. Conclusions: The description of safety, feasibility and sample quality results associated with a novel muscle Biopsy Technique is intended to offer clinicians an alternative method to obtain muscle samples for diagnostic testing or research studies. Disclosure: Dr. Gallo has nothing to disclose. Dr. Katzberg has received personal compensation for activities with Genzyme and CSL Behring. Dr. Bril has received personal compensation for activities with CSL, Grifols, Bionevia, and UCB for consulting and research grants. Dr. Breiner has received research support from Grifols and GBS/CIDP Foundation.
Timothy Poate - One of the best experts on this subject based on the ideXlab platform.
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an audit of the efficacy of the oral brush Biopsy Technique in a specialist oral medicine unit
Oral Oncology, 2004Co-Authors: Timothy Poate, Jag Buchanan, T A Hodgson, P M Speight, A W Barrett, David R Moles, C Scully, S R PorterAbstract:The diagnosis of oral epithelial. dysplasia has traditionally been based upon histopathological evaluation of a full thickness Biopsy specimen from lesional tissue. It has recently been proposed that cytological examination of "brush Biopsy" samples is a non-invasive method of determining the presence of cellular atypia, and hence the likelihood of oral epithelial. dysplasia. The present audit determined, retrospectively the sensitivity, specificity and positive and negative predictive values of the oral brush Biopsy Technique in the diagnosis of potentially malignant disease in a group of 112 patients attending a specialist Oral Medicine unit. The sensitivity of detection of oral epithelial dysplasia or squamous cell carcinoma of the oral brush Biopsy system was 71.4% while the specificity was 32%. The positive predictive value of an abnormal brush Biopsy result (positive or atypical) was 44.1%, while the negative predictive value was 60%. It is concluded that not all. potentially malignant disease is detected with this non-invasive investigative procedure. (C) 2004 Elsevier Ltd. All rights reserved.
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an audit of the efficacy of the oral brush Biopsy Technique in a specialist oral medicine unit
Oral Oncology, 2004Co-Authors: Timothy Poate, Jag Buchanan, T A Hodgson, P M Speight, A W Barrett, David R Moles, Stephen PorterAbstract:The diagnosis of oral epithelial dysplasia has traditionally been based upon histopathological evaluation of a full thickness Biopsy specimen from lesional tissue. It has recently been proposed that cytological examination of "brush Biopsy" samples is a non-invasive method of determining the presence of cellular atypia, and hence the likelihood of oral epithelial dysplasia. The present audit determined, retrospectively the sensitivity, specificity and positive and negative predictive values of the oral brush Biopsy Technique in the diagnosis of potentially malignant disease in a group of 112 patients attending a specialist Oral Medicine unit. The sensitivity of detection of oral epithelial dysplasia or squamous cell carcinoma of the oral brush Biopsy system was 71.4% while the specificity was 32%. The positive predictive value of an abnormal brush Biopsy result (positive or atypical) was 44.1%, while the negative predictive value was 60%. It is concluded that not all potentially malignant disease is detected with this non-invasive investigative procedure.
H Francis - One of the best experts on this subject based on the ideXlab platform.
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a novel optical Biopsy Technique using elastic scattering spectroscopy for dysplasia and cancer in barrett s esophagus
GASTROINTEST ENDOSC 51 (4) AB227 - AB227. (2000), 2000Co-Authors: Laurence Lovat, David Christopher O Pickard, Marco Novelli, Paul M Ripley, H Francis, Irving J Bigio, S G BownAbstract:sue and the other to detect scattered light. The probe tip was placed in gentle contact with the tissue surface for the sites being interrogated. Histologically, biopsies were defined as normal, dysplastic or carcinoma. Optical biopsies took less than 1 second to perform. Data were normalized to the region 650-700 nm and analysis of spectra was carried out between 330 and 650 nm using two mathematical pattern-recognition methods: artificial neural networks and hierarchical cluster analysis. Results: Histological findings were correlated with appropriate spectra. For each analysis some of the data sets (spectra and corresponding histology) were used for training the pattern recognition methods and others were reserved for testing. Preliminary analysis of these data gives a sensitivity for detecting an abnormality (cancer or dysplasia) of 90-95% with a specificity of 85-90% and a correct tissue diagnosis (neoplastic or normal) in about 90% of sites. Conclusions: Preliminary results using ESS show that this Technique has potential as a real time diagnostic test for in vivo diagnosis of dysplasia or cancer within Barrett’s mucosa. The Technique is complementary to fluorescence endoscopy and is more robust than fluorescence spectroscopy as it utilizes white light to generate a strong spectroscopic signal rather than a blue light to generate a weak fluorescent one and can be used during routine white light endoscopy.
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4919 a novel optical Biopsy Technique using elastic scattering spectroscopy for dysplasia and cancer in barrett s esophagus
Gastrointestinal Endoscopy, 2000Co-Authors: Laurence Lovat, Marco Novelli, Paul M Ripley, H Francis, David PickardAbstract:Background:Barrett's esophagus develops through dysplasia into adenocarcinoma. Surveillance for dysplasia using conventional white light endoscopy requires histological examination of multiple random biopsies, and has a poor diagnostic yield. Recently, fluorescence endoscopy has become available to detect abnormal areas for targeting Biopsy. Elastic scattering spectroscopy (ESS) is another novel Technique for minimally invasive optical diagnosis of tissue pathology, which is being developed by our groups. It takes a point measurement, which is sensitive to the size and structure of cellular and sub-cellular components. It is therefore complementary to fluorescence endoscopy and can potentially be used for realtime in vivo `optical Biopsy' measurements. We present our preliminary data using this technology to diagnose dysplasia or cancer within Barrett's esophagus. Patients & Methods:Elastic scattering spectra (optical Biopsy) and matched esophageal biopsies were taken from 41 sites in 27 patients with Barrett's metaplasia. A pulse of white light from a xenon arc lamp was passed down a probe the size of normal Biopsy forceps that contained two parallel and adjacent fibers, one to deliver the light to the tissue and the other to detect scattered light. The probe tip was placed in gentle contact with the tissue surface for the sites being interrogated. Histologically, biopsies were defined as normal, dysplastic or carcinoma. Optical biopsies took less than 1 second to perform. Data were normalized to the region 650-700 nm and analysis of spectra was carried out between 330 and 650 nm using two mathematical pattern-recognition methods: artificial neural networks and hierarchical cluster analysis. Results:Histological findings were correlated with appropriate spectra. For each analysis some of the data sets (spectra and corresponding histology) were used for training the pattern recognition methods and others were reserved for testing. Preliminary analysis of these data gives a sensitivity for detecting an abnormality (cancer or dysplasia) of 90-95% with a specificity of 85-90% and a correct tissue diagnosis (neoplastic or normal) in about 90% of sites. Conclusions:Preliminary results using ESS show that this Technique has potential as a real time diagnostic test for in vivo diagnosis of dysplasia or cancer within Barrett's mucosa. The Technique is complementary to fluorescence endoscopy and is more robust than fluorescence spectroscopy as it utilizes white light to generate a strong spectroscopic signal rather than a blue light to generate a weak fluorescent one and can be used during routine white light endoscopy.