HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kundra, V. Articles by Silverman, S. G. Search for Related Content PubMed PubMed Citation Articles by Kundra, V. Articles by Silverman, S. G.

Telomerase Activity Predicts Malignancy in Percutaneous Image-guided Needle Biopsy Specimens of the Abdomen and Pelvis¹

¹ From the Division of Abdominal Imaging and Intervention, Department of Radiology (V.K., P.N., D.S.G., K.H.Z., K.T., E.v.S., S.G.S.) and Division of Cytology, Department of Pathology (J.F.K.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass. Received October 30, 2003; revision requested January 13, 2004; revision received April 7; accepted May 24. Supported in part by the Wylie J. Dodds Research Grant awarded by the Society of Gastrointestinal Radiologists in 2000. Address correspondence to V.K., Division of Diagnostic Imaging, Box 57, M. D. Anderson Cancer Center, University of Texas, 1515 Holcombe Blvd, Houston, TX 77030 (e-mail: vkundra@di.mdacc.tmc.edu).

PURPOSE: To determine prospectively if assessment of telomerase activity in percutaneous needle biopsy specimens improves sensitivity and specificity in the diagnosis of abdominal and pelvic malignancy.

MATERIALS AND METHODS: The study was approved by the institutional review board, and written informed consent was obtained from all patients. A prospective double-blinded design was used to assess telomerase activity in abdominal and pelvic biopsy specimens from 99 patients (64 men, 35 women; age range, 22–87 years). After the clinical sample was retrieved, a study specimen from an extra needle pass was divided and independently analyzed for cytologic characteristics and telomerase activity. The final diagnosis was based on chart review at a minimum 1-year follow-up. Statistical analyses included sensitivity, specificity, and accuracy of cytologic examination and/or telomerase activity in predicting malignancy.

RESULTS: Data from study specimens indicated that the sensitivity, specificity, and accuracy of telomerase activity (n = 99) in predicting malignancy were 55%, 79%, and 60%, respectively. For cytologic examination (n = 86), the sensitivity, specificity, and accuracy in predicting malignancy were 74%, 94%, and 78%, respectively. Combining the two tests (n = 86) and classifying a positive reading with either test as malignant improved sensitivity (83%) (P < .05) without altering specificity (76%). In 20 patients who had clinical sample reports that were classified as indeterminate, telomerase activity (n = 20) yielded a higher sensitivity (62%) (P < .05) and similar specificity (86%) compared with cytologic examination (n = 15), which yielded a sensitivity of 11% and a specificity of 83%.

CONCLUSION: In percutaneous biopsy specimens of the abdomen and pelvis, the combination of cytologic examination and telomerase activity yielded an increased sensitivity in predicting malignancy. In addition, assessing telomerase activity can help identify cancer even when cytologic results are indeterminate.

© RSNA, 2005

This article has been cited by other articles:

				S. G. Silverman, Y. U. Gan, K. J. Mortele, K. Tuncali, and E. S. Cibas Renal Masses in the Adult Patient: The Role of Percutaneous Biopsy Radiology, July 1, 2006; 240(1): 6 - 22. [Abstract] [Full Text] [PDF]