IExamining the tissue from a suspected tumor under a microscope is currently the only way to definitively diagnose suspected mesothelioma. But doctors at the University of Catania say cutting-needle biopsy, the pleural biopsy technique used by most surgeons, may be unnecessarily painful for patients.
In their response to a recent published article on the subject in the journal Chest, Dr. Marco Sperandeo and colleagues present the case for what they say is a less traumatic type of biopsy – thoracic ultrasound-guided fine needle aspiration.
According to the Italian researchers, “These tools, quite neglected, are complementary to CT imaging in patients with malignant pleural mesothelioma (MPM) or lung cancer (LC), are less traumatic, and are equally or more successful, with minimal discomfort for the patient.”
Like standard cutting-needle biopsy, fine needle aspiration biopsy (FNAB) relies on ultrasound guidance. The Italian team uses a specialized ultrasound technique called thoracic ultrasound (TUS) designed specifically for chest imaging. But, unlike the cutting-needle technique, FNAB uses a finer needle and, instead of cutting, aspirates a small amount of tissue for examination.
Although tissue samples obtained with FNAB tend to be smaller than those obtained with the cutting-needled technique, Sperandeo and colleagues say the samples they took from 55 mesothelioma patients were adequate for evaluation in most cases. Of the 934 cases of FNAB conducted at the University of Catania Hospital between 2008 and 2013, only 20 had to be repeated for insufficient sample size.
The researchers conclude that FNAB is their preferred technique for mesothelioma diagnosis. They also believe that the information gathered from TUS-guided FNAB, along with CT imaging and histological examination of tissue, could help in the development of non-invasive screening techniques for asbestos-exposed workers at risk of developing mesothelioma.
Sperandeo, M et al, “Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma”, Novebmer 1, 2014, Chest, pp. 178-179.