Biopsy and re-biopsy in lung cancer: the oncologist requests and the role of endobronchial ultrasounds transbronchial needle aspiration

Tuzi, Alessandro; Bolzacchini, Elena; Suter, Matteo B.; Giaquinto, Alice; Passaro, Antonio; Gobba, Stefania; Vallini, I.; Pinotti, Graziella

doi:10.21037/jtd.2017.04.09

Cited by 12 publications

(9 citation statements)

References 30 publications

(25 reference statements)

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“…27 Rebiopsy for molecular workup may be required if diagnostic samples are inadequate for mutation analysis or the patient has disease progression ( Box 2 ). 28…”

Section: Resultsmentioning

confidence: 99%

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

Kaushal,

Menon,

Shetty

et al. 2023

Indian J Med Paediatr Oncol

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Molecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the optimization of tissue handling and processing practices in India in the era of precision medicine. This study aimed to evaluate the clinical gaps related to tissue handling for molecular analysis and develop expert recommendations to mitigate preanalytical issues associated with biospecimen processing. These expert recommendations will help in increasing the diagnostic yield and accuracy of biomarker testing in clinical practice. A virtual advisory board meeting was convened with 19 experts, including pathologists, molecular biologists, medical oncologists, surgical oncologists, interventional radiologists, and a senior histology technician from 10 hospitals in India, along with an accreditation officer for testing and calibration of laboratory procedures. The scientific coordinators developed specific questions to address the salient issues associated with the preanalytic phase of tissue specimen preparation. The experts discussed each question until a complete set of recommendations was obtained. The expert panel provided recommendations for tissue collection, processing, fixation, and block preparation to ensure high-quality biospecimens. As per the expert panel recommendations, tissue sampling can be performed from any easily accessible site, regardless of the primary or metastatic locations. In addition, the cold ischemia time should be <1 hour, 10% neutral-buffered formalin should be used as the fixative, isopropyl alcohol should be used as the dehydrating agent, the volume of tissue to fixative ratio should be 1:10, and all the paraffin blocks should be archived in dry, pest-free conditions at room temperature. The experts suggested that the formalin used for fixation should be freshly prepared and its pH should be checked daily; moreover, the pH and date of formalin preparation should be mentioned on the containers. The experts highlighted the need to educate multidisciplinary teams on the optimization of tissue handling practices and emphasized that a pathologist should always check the tissue for adequate quality and quantity for biomarker testing. The existing routine clinical procedures for collecting and handling biospecimens adversely affect their quality. The expert recommendations for preanalytical quality control would ensure high-quality biospecimens for molecular analysis and precision medicine.

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“…27 Rebiopsy for molecular workup may be required if diagnostic samples are inadequate for mutation analysis or the patient has disease progression ( Box 2 ). 28…”

Section: Resultsmentioning

confidence: 99%

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

Kaushal,

Menon,

Shetty

et al. 2023

Indian J Med Paediatr Oncol

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show abstract

“…Percutaneous approaches include transthoracic needle aspiration (TTNA) or needle/core biopsy (TTNB) of the primary tumor. The samples collected will be analysed in immunohistochemical stains and molecular tests in order to assess the mutation status of predominant oncogenes and identify the main biomarkers of the tumor, supporting precision medicine [ 31 ].…”

Section: Clinical Pathway For Lung Cancermentioning

confidence: 99%

Towards Machine Learning-Aided Lung Cancer Clinical Routines: Approaches and Open Challenges

Silva

Pereira

Neves

et al. 2022

JPM

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Advancements in the development of computer-aided decision (CAD) systems for clinical routines provide unquestionable benefits in connecting human medical expertise with machine intelligence, to achieve better quality healthcare. Considering the large number of incidences and mortality numbers associated with lung cancer, there is a need for the most accurate clinical procedures; thus, the possibility of using artificial intelligence (AI) tools for decision support is becoming a closer reality. At any stage of the lung cancer clinical pathway, specific obstacles are identified and “motivate” the application of innovative AI solutions. This work provides a comprehensive review of the most recent research dedicated toward the development of CAD tools using computed tomography images for lung cancer-related tasks. We discuss the major challenges and provide critical perspectives on future directions. Although we focus on lung cancer in this review, we also provide a more clear definition of the path used to integrate AI in healthcare, emphasizing fundamental research points that are crucial for overcoming current barriers.

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“…It is the preferred modality for re-biopsy to assess for relapse after therapy or response after neoadjuvant treatment (32,33). These re-biopsies are useful in detecting specific new mutations, which may have therapeutic implications (the use of osimertinib for T790M mutation for instance) (34).…”

Section: Diagnosis and Staging Of Nsclcmentioning

confidence: 99%

Convex probe endobronchial ultrasound: historical, contemporary, and cutting-edge applications

Avasarala¹,

Aravena²,

Almeida³

2020

J Thorac Dis

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The use of convex-probe endobronchial ultrasound (CP-EBUS) has revolutionized bronchoscopy. It has provided the option of a relatively safe, minimally invasive approach for the assessment of various intrathoracic diseases. In current practice, its most dramatic impact has been on the diagnosing and staging of lung cancer. It has served as an invaluable tool that has replaced mediastinoscopy in a variety of clinical scenarios. Many pulmonologists and thoracic surgeons consider CP-EBUS the most significant milestone in bronchoscopy after the development of the flexible bronchoscope itself. In this review, we summarize the historical aspects, current indications, technical approach, and future direction of CP-EBUS.

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Biopsy and re-biopsy in lung cancer: the oncologist requests and the role of endobronchial ultrasounds transbronchial needle aspiration

Cited by 12 publications

References 30 publications

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

Towards Machine Learning-Aided Lung Cancer Clinical Routines: Approaches and Open Challenges

Convex probe endobronchial ultrasound: historical, contemporary, and cutting-edge applications

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