Tru-Cut needle

One of the first major compilations of statistics was produced by H. Thaler in 1964 in 23,382 biopsies, the lethality rate was 0.017% and the complication rate 0.10%. (158) In evaluating 79,381 liver biopsies, H. Lindner (1967) calculated a lethality rate of 0.015% and a morbidity rate of 0.34%. (85) In 19,563 liver biopsies, E. WiLDHiRT registered no fatal cases with a morbidity rate of 0.089%. (176) In a multicentre study carried out by F. PiccioNiNo et af, 68,276 liver biopsies were recorded during the period 1973-1983 with a lethality rate of 0.009% and a morbidity rate of 0.21%. In this study, the Vim-Silverman and Tru-cut needle types proved to have the highest risk rate (0.31% to 0.34%). (121) Severe complications were found in 0.57% of cases by J.F. Cadranel et al. (15) Among 4,124 of our own biopsies (Menghini needle), we registered no cases of death whatsoever from 1961 to 1987 the complication rate was 0.15% (s. tab. 7.7). 

In cirrhosis and fibrosis, the biopsy needle used will either be the Vim-Silverman needle or the Tru-Cut needle. Adequate tissue can thereby be obtained for assessment. Because of the increased bleeding tendency connected with these needle types, the diameter should not exceed 1.6 mm (which is generally not required anyway). The liver is punctured tangentially, mainly in the lateral area of the right lobe. Subsequent to the puncture, the stylet is removed, the outer cannula advanced, the inner needle sheath pushed forwards in a rotating movement out of the outer cannula before both are finally withdrawn together. 

Due to their cutting action (which differs from the Menghini technique), Vim-Silverman and Tru-cut needles produce a sufficiently large and almost intact cirrhosis tissue sample. As a consequence, the false-positive results can be brought down to below 10%. Nevertheless, the risk of subsequent bleeding is clearly higher. For this reason, the diameter of the needle should not exceed 1.6 mm. 

Akan H, Ozen N, Incesu L et al (1998) Are percutaneous trans-gastric biopsies using 14, 16 and 18 G Tru-Cut needles safe An experimental study in the rabbit. Australas Radiol 42 99-101... 

Fig. 4.3. Tru-Cut needles consist of an inner needle with a sampling chamber at its distal end and an outer circular knife...

Minkowitz S, Moskowitz R, Khalif RA, Alderete MN (1986) Tru-Cut needle biopsy of the breast. An analysis of its specificity and sensitivity. Cancer 57 320 323... 

Both classical and modified types of biopsy needles are available suction needles (e. g. Menghini, Klatskin, and Jamshidi) and cutting needles (e. g. Vim-Silverman and Tru-cut) as well as spring-loaded needles. (12, 26, 86, 123, 129, 158, 162)... 

Vargas-Tank, L., Martinez, V., Jiron, M.I., Soto, J.R., Armas-Merino, R. Tru-cut and Menghini needles different yield in the histological diagnosis of liver disease. Liver 1985 5 178-181... 

Fig.4.12a-c. The directional vacuum-assisted biopsy (DVAB) method. Compared to the core needles of the Tru-Cut type (see Fig. 4.5 b-d), the DVAB probe need not necessarily to be fired directly into the target for tissue acquisition. Vacuum can be used to acquire tissue at a distance from the probe... 

Fig. 37.4a,b. Patient (supine position) with multiple hepatic rim-enhancing lesions in both liver lobes (preinterventional CT, venous phase) (a). An easy-to-access lesion in segment 3 was chosen for Tru-Cut biopsy with al6-G(10cm) needle under CTF guidance (b). Histopathology revealed hepatic metas-tases of gall bladder carcinoma... 

Fig. 37.6. Patient (prone position) with suspect mass of the right psoas muscle. A posterior paravertebral (5th lumbar vertebra) access was chosen for Tru-Cut biopsy with an 18-G (13 cm) needle under CTF guidance. Histopathology revealed metastasis of ovarian carcinoma...

Fig. 37.7a,b. Patient (supine position) with a history of diffuse large B-cell lymphoma (DLCL). Preinterventional CT showed a moderately enhancing nodule (large arrow) next to the iliac vessels (small arrows) (a). The 18-G (13 cm) Tru-Cut biopsy needle was introduced under CTF guidance next to the left iliac crest through the peritoneal fat (b). Histopathology revealed recurrence of DLCL... 

In comparison to aspiration biopsy, the punch biopsy (synonymous with core biopsy) technique is performed either with spring-activated cutting needles (Tru-Cut) in combination with a biopsy gun or with manually activated cutting needles. This technique allows for obtaining cores of tissue with an intact histological structure that facilitates a precise histological diagnosis or immunohistochemical analysis. 

Fig. 37.8. Schematic fig. illustrating the automated Tru-Cut across the trough and thereby cuts out the specimen (3). Final-biopsy technique The inner needle (characterized by a trough ly, the specimen can be safely removed with the inner needle or...

Tru-Cut manual biopsy needle (Allegiance, McGaw Park, 111., USA) 14,18 7,11,15... 

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