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Gun needle device

Core needle biopsy, without vacuum assistance, can be done under ultrasound guidance, utilizing a variety of the gun needle devices. These devices are hand-held spring loaded 14-gauge devices. At least 5 passes are required for adequate sampling. Do not use a smaller device than 14-gauge as the accuracy for diagnosis of a carcinoma is significantly reduced with smaller devices (from 100%, 92% and 65% four 14, 16-gauge and 18-gauge respectively).

1. No expensive specialized equipment, only ultrasound required.
2. Quickest procedure.

1. Prone to sampling error, after first pass target often disappears into hematoma.
2. Needle must be withdrawn after each pass.
3. Much less tissue is obtained, consistent with 11-gauge vacuum core needle biopsy.
3. Long throw devices may cause pneumothorax if improperly positioned.
4. Difficult to biopsy microcalcifications (because of difficult localization with ultrasound).