Single-specimen bile cytology: A prospective study of 80 patients with obstructive jaundice

Scott J. Savader, Frank C. Lynch, Martin G. Radvany, Bruce T. Kudryk, Robert T. Andrews, Jean Francois Geschwind, Harjit Singh, Marc R. Hamet

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To determine the sensitivity, specificity, and charges associated with single-specimen bile cytologic study in patients with obstructive jaundice. MATERIALS AND METHODS: Eighty consecutive patients with presumed malignant biliary strictures underwent percutaneous biliary drainage (PBD). Cytologic evaluation was performed on a single bile specimen from each patient collected at the time of the PBD. Final diagnoses were obtained from either percutaneous (n = 14) or surgical (n = 66) histologic specimens (gold standard). Both data sets were then compared to determine the sensitivity and specificity of bile cytology. The charges associated with bile cytodiagnosis were compared to those for other biopsy procedures utilized in the same setting. RESULTS: Eighty bile specimens were obtained with a mean of 14 mL (range, 3-65 mL) per patient with 79 (99%) specimens adequate for cytologic processing. Eleven (13%) specimens were acellular. The overall sensitivity was 15% and specificity was 100%; these values were not dependent on the volume of the bile specimen (P > .10) or type of malignancy (P = .10). For bile cytodiagnosis, the mean charge was $160 and the successful biopsy rate (true-positive plus true-negative results/total number procedures) was 27%. CONCLUSION: Single-specimen bile cytology has a low sensitivity; however, because of its convenience, simplicity, atraumatic nature, and low relative charge versus comparable procedures, it may be useful as an adjunct to PBD in patients with suspected malignant biliary disease.

Original languageEnglish (US)
Pages (from-to)817-821
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume9
Issue number5
DOIs
StatePublished - Jan 1 1998

Keywords

  • Bile ducts, biopsy
  • Bile ducts, cytology
  • Bile ducts, percutaneous drainage
  • Biopsies, technology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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