Background: The criteria for determining technical efficacy of thermal ablation for papillary thyroid carcinoma (PTC) are not clearly defined. We analyzed the involution process of the ablation zone with clear pathologic results on core-needle biopsy (CNB) to clarify the relationship between sonographic changes and pathologic findings. Methods: This retrospective cohort study included 382 patients with unifocal T1N0M0 PTC who underwent radiofrequency ablation (RFA) between May 2014 and August 2021. Patients with a single ablation zone biopsy (recommended at 3 or 6 months for T1a and 6 or 12 months for T1b) and regular neck ultrasound (US)/contrast-enhanced ultrasound imaging follow-up at 1, 3, 6, and 12 months and every 6-12 months thereafter after RFA were included. Patients also underwent yearly chest computed tomography. CNB was performed in the target lesion ablation zone\'s central, peripheral, and surrounding thyroid parenchyma to detect the presence of tumor cells. If the thyrotropin (TSH) was >2 mU/L, levothyroxine was prescribed with the intention of keeping the TSH 0.5-2 mU/L. Technical efficacy was defined as tumor disappearance by imaging follow-up together with the pathologically confirmed absence of tumor cells in the ablation zone. Results: During the mean follow-up period of 67.8 ± 18.2 months (22-110 months), the overall incidence of persistent disease and the technical efficacy rate were 3.9% (15/382; 2.9% of T1a, and 12.2% of T1b) and 96.1%, respectively. Tumor size (p = 0.03) and subcapsular location (p = 0.04) were risk factors associated with persistent disease. The technical success rate was 100%. Of the 367 ablation zones with benign CNB results, 336 (91.6%) showed tumor disappearance on US and no re-emergence of imaging-visible tumors during follow-up. Male sex (p = 0.006), age <40 years (p = 0.003), T1a tumor (p < 0.01), and energy per milliliter (p < 0.03) were significantly associated with tumor disappearance. Conclusions: US-guided RFA is an effective treatment for small low-risk PTC. Tumor disappearance on US after RFA may suggest an excellent prognosis and confirm complete ablation of the macroscopic tumor, but this sonographic finding is generally late and requires histological confirmation.

UNASSIGNED: This study sought to evaluate the safety and diagnostic performance of computed tomography (CT)-guided fine-needle aspiration (FNA) immediately before microwave ablation (MWA) for pulmonary ground-glass nodules (GGNs).
UNASSIGNED: This retrospective study analyzed the synchronous CT-guided biopsy and MWA data of 92 GGNs (male to female ratio 37:55; age 60.4±12.5 years; size 1.4±0.6 cm). FNA was performed in all patients, and sequential core-needle biopsy (CNB) was performed in 62 patients. The positive diagnosis rate was determined. The diagnostic yield was compared on the basis of the biopsy methods (FNA, CNB, or both), the nodule diameter (<1.5 and ≥1.5 cm), and the lesion component (pure GGN or part-solid GGN). The procedure-related complications were recorded.
UNASSIGNED: The technical success rate was 100%. The positive rates of FNA and CNB were 70.7% and 72.6% respectively, but did not differ significantly (P=0.8). Sequential FNA and CNB showed better diagnostic performance (88.7%) than did either alone (P=0.008 and P=0.023, respectively). The diagnostic yield of CNB for pure GGNs was significantly lower than that for part-solid GGNs (P=0.016). The diagnostic yield was lower for smaller nodules (78.3% vs. 87.5%; P=0.28), but the differences were not significant. Grade 1 pulmonary hemorrhages were observed in 10 (10.9%) sessions after FNA, including 8 cases of hemorrhage along the needle track and 2 cases of perilesional hemorrhage, but these hemorrhages did not hamper the accuracy of the antenna placement.
UNASSIGNED: FNA immediately before MWA is a reliable technique for the diagnosis of GGNs that does not alter the accuracy of the antenna placement. Sequential FNA and CNB improves the diagnostic ability of GGNs compared to either method used alone.

BACKGROUND: The object of this study was to compare the diagnosis performance of US-guided fine-needle aspiration (FNA) and core-needle biopsy (CNB) for patients with thyroid nodules, in aspects of sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV).
METHODS: Four hundred seven Chinese patients from July 2019 to June 2022 were retrospectively recruited in this study. Cytological diagnoses were categorized into six categories based on the 2017 Bethesda System for Reporting Thyroid Cytopathology (BSRTC), and histological specimens were drawn a diagnosis by means of an analogy with the Bethesda system.
RESULTS: All patients incorporated were proceed with surgical excision (SE) and received final surgical diagnoses. The rate of malignancy (ROM) was comparable between two methods, with the exception that the test-negative category of the FNA group was significantly higher than that of the CNB group (39.25% vs. 23.86%, p = .022). Sensitivity and accuracy were higher in CNB group (82.50% and 87.83%, respectively) than that in FNA group (72.00% and 79.36%, respectively), as well as NPV (76.14% in CNB vs. 60.75% in FNA), but not in terms of the specificity and PPV (95.59% and 97.30% in FNA vs. 97.10% and 98.02% in CNB).
CONCLUSIONS: CNB displayed a higher sensitivity and accuracy than FNA in malignant lesions of thyroid. Both FNA and CNB exhibit excellent performance with the understanding that both need to be applied under the most appropriate conditions to maximize their benefits.

BACKGROUND: Successful practice of precision medicine in advanced lung cancers relies on therapeutic regimens tailored to individual molecular characteristics. The aim of this study was to investigate the accuracy of small specimens for molecular profiling using next-generation sequencing (NGS).
METHODS: Genetic alternations, tumor mutational burden (TMB), status of microsatellite instability (MSI), and expression of programmed death ligand 1 (PD-L1) were compared side-by-side between the concurrently obtained core needle biopsy (CNB) and resection specimens in 17 patients with resectable non-small cell lung cancers.
RESULTS: DNA yield and library complexity were significantly lower in CNB specimens (both p < 0.01), whereas the insert size, sequencing depth, and Q30 ratio were similar between the matched specimens (all p > 0.05). The total numbers of genetic alternations detected in resection and CNB specimens were 186 and 211, respectively, with 156 alternations in common, yielding a specific concordance rate of 83.9%. The prevalence of mutations in 8 major driver genes was 100% identical between surgical and CNB specimens, though the allele frequency was lower in CNB specimens, with a median underestimation of 57%. Results of TMB were similar (p = 0.547) and MSI status was 100% matched in all paired specimens.
CONCLUSIONS: Pulmonary CNB specimens were suitable for NGS given the satisfactory accuracy when compared to corresponding surgical specimens. NGS results yielding from CNB specimens should be deemed reliable to provide instructive information for the treatment of advanced lung cancers.

UNASSIGNED: To develop and validate a deep learning (DL)-based primary tumor biopsy signature for predicting axillary lymph node (ALN) metastasis preoperatively in early breast cancer (EBC) patients with clinically negative ALN.
UNASSIGNED: A total of 1,058 EBC patients with pathologically confirmed ALN status were enrolled from May 2010 to August 2020. A DL core-needle biopsy (DL-CNB) model was built on the attention-based multiple instance-learning (AMIL) framework to predict ALN status utilizing the DL features, which were extracted from the cancer areas of digitized whole-slide images (WSIs) of breast CNB specimens annotated by two pathologists. Accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curves, and areas under the ROC curve (AUCs) were analyzed to evaluate our model.
UNASSIGNED: The best-performing DL-CNB model with VGG16_BN as the feature extractor achieved an AUC of 0.816 (95% confidence interval (CI): 0.758, 0.865) in predicting positive ALN metastasis in the independent test cohort. Furthermore, our model incorporating the clinical data, which was called DL-CNB+C, yielded the best accuracy of 0.831 (95%CI: 0.775, 0.878), especially for patients younger than 50 years (AUC: 0.918, 95%CI: 0.825, 0.971). The interpretation of DL-CNB model showed that the top signatures most predictive of ALN metastasis were characterized by the nucleus features including density (p = 0.015), circumference (p = 0.009), circularity (p = 0.010), and orientation (p = 0.012).
UNASSIGNED: Our study provides a novel DL-based biomarker on primary tumor CNB slides to predict the metastatic status of ALN preoperatively for patients with EBC.

Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm3]treated by RFA from June 2016 to September 2018 were evaluated in this study.During the RFA procedure,enlarged ablation was performed.Patients were followed up 1,3,6,12 months after RFA and every 6 months thereafter.The volume of ablation area and the volume reduction ratio(VRR)were calculated.To evaluate the ablation performance,CNB was performed to the central zone,the peripheral zone,and surrounding thyroid parenchyma 3 or 6 months after RFA. Results The mean follow-up time was(30.04±12.41)months.The mean volume of tumor significantly decreased from(106.29±96.15)mm3 to(1.47±8.00)mm3.Two ablated tumors were diagnosed to have residue by CNB and underwent additional RFA.No recurrence,metastatic lymph nodes,or distal metastasis were found during the follow-up.All the patients were tolerable to RFA and CNB procedure. Conclusion CNB can be used to evaluate the ablation performance after RFA for low-risk PTMC.

OBJECTIVE: To investigate the diagnostic value of core-needle biopsy (CNB) guided by contrast-enhanced ultrasound (CEUS) in cervical tuberculous lymphadenitis (CTL).
METHODS: 178 patients with pathological confirmation of CTL were retrospectively enrolled. All of them had undergone CNB prior to the final surgery. According to the different ways of puncture guidance, they were divided into two groups: conventional ultrasound (US) group (n = 81) and CEUS group (n = 97). The comparison of diagnostic efficacy between two groups was compared and analyzed.
RESULTS: Among the 178 patients, 146 were directly diagnosed as CTL by CNB, including 59 patients in CEUS group and 87 patients in US group. The diagnostic accuracy were 89.7% (87/97) and 72.8% (59/81), respectively (P < 0.01). For subgroup analyses, differences among diagnostic efficacy ascribed to the different guiding methods were significant in medium size group (>2.0 cm and ≤3.0 cm) and large size group (>3.0 cm), 91.7% for CEUS group vs. 69.0% for US group (P < 0.05) and 84.4% for CEUS group vs. 57.7% for US group (P < 0.05), respectively.
CONCLUSIONS: In the diagnosis of CTL, compared with the US-guided CNB, CEUS-guided CNB have certain advantages, especially for larger lymph nodes.

In this study, we reported seven patients who underwent diagnostic evaluation through core-needle biopsy (CNB) of the spleen. After biopsy, gelatin sponge particles mixed with hemocoagulase were gradually injected using a coaxial introducer needle. One patient received microwave ablation following the CNB. All patients were followed up by computed tomography to rule out bleeding or accidental injuries both immediately after the biopsy and within 24 h. Adequate specimens for pathologic examination were obtained from all patients, and the biopsy technical success rate was 100%. No serious complications were observed in our case series. There was no evidence of postbiopsy bleeding. Therefore, injection of gelatin sponge particles mixed with hemocoagulase or microwave ablation may be effective options to prevent hemorrhage after splenic core-needle biopsies.

Purpose: To evaluate the clinical application of core-needle biopsy (CNB) for low-risk papillary thyroid microcarcinoma (PTMC) after radiofrequency ablation (RFA) Methods: A total of 202 patients with 211 low-risk PTMCs were included in this study. RFA procedure was used the hydrodissection technique and moving-shot technique. Patients were followed at 1, 3, 6, 12 months and every 6 months thereafter. The volume of ablation area and the volume reduction ratio (VRR) were calculated. At 3 or 6 months after RFA, CNB was performed to the central zone, the peripheral zone and surrounding thyroid parenchyma for post-ablation evaluation. Results: The mean volume of tumors was 102.34±93.84 mm3 (range 4.19-424.10 mm3), which decreased significantly to 1.37±7.74 mm3 (range 0-73.30 mm3) at a mean follow-up time of 24.42±9.15 months (range 3-42 months) with a mean VRR of 99.14±4.18% (range 71.88-100%). A total of 3 ablation areas had positive CNB in the peripheral zone and underwent additional RFA. No recurrent or suspicious metastatic lymph nodes were detected Conclusion: CNB is a feasible and effective evaluation for low-risk PTMC after RFA, which can detect residual cancer cells early.

OBJECTIVE: To confirm the pre-treatment diagnosis of parapharyngeal space malignancy could aid the treatment plan.
METHODS: For patients with suspected malignant parapharyngeal space tumors following preoperative imaging, oral biopsy was conducted for pathological diagnosis with the use of 22-G biopsy needles.
RESULTS: A total of 11 patients were enrolled. There were three previously diagnosed cases of head and neck malignancy, and eight cases were newly diagnosed. The tumor diameters were in the range of 3 to 5.5 cm. Ten cases (90.9%) achieved positive results, of which eight cases (72.7%) obtained positive results with one puncture and two cases obtained positive pathological results with two punctures. One case did not obtain positive results with two punctures; open surgical resection was performed for this patient. There were no complications such as needle track implantation, heavy bleeding or neurological damage symptoms during the puncture process.
CONCLUSIONS: Oral biopsy is a minimally invasive, safe and effective technique for the diagnosis of parapharyngeal space tumors. It is easy to operate and could facilitate a comprehensive treatment plan for parapharyngeal space malignancies.