A novel biopsy method to increase yield of subcutaneous abdominal adipose tissue

Abstract

Collection of abdominal subcutaneous adipose tissue (SAT) for research testing is traditionally performed using punch biopsy or needle aspiration techniques, yielding small amounts of very superficial SAT (100-500 mg). Although liposuction techniques can be used to obtain large amounts of SAT, these approaches can compromise the integrity of the adipose tissue. Therefore, we investigated a novel method using a 6-mm Bergström side-cutting biopsy needle to acquire suitable amounts of intact abdominal SAT for multiple complex studies such as flow cytometry, RNA extraction, ex vivo expression of molecular and post-translational protein mediators, and histology. Fifty biopsies were obtained from 29 participants using a Bergström biopsy needle, applying transient manual suction and shearing large pieces of fat within the inner-cutting trochar. Eighteen of the biopsies were performed under ultrasound guidance, whereby we successfully sampled deep SAT (dSAT) from below Scarpa's fascia. The average weight of SAT sampled was 1.5 ± 0.4 g. There was no clinically important bleeding or ecchymosis on the abdominal wall and no infection occurred with this procedure. The 6-mm Bergström biopsy needle yielded substantially more SAT than what has been obtained from superficial procedures and, for the first time, allowed sampling of dSAT by a percutaneous approach.

Conflict of interest statement

Disclosure:

The authors declared no conflict of interest.

Figures

Figure 1. Biopsy Method With the Bergström Biopsy Needle

A. Tubing was cut at a 45-degree angle in order to fit more securely into the top of the Bergström biopsy needle for generating suction. Tubing inserted into the cutting trochar of the Bergström biopsy needle. B. A 6–7 mm incision was made through the skin up to the hub of a number 11 Bard Parker blade. C. When US guidance was not used, the Bergström biopsy needle was inserted approximately 1.5 inches in the incision site. D. The average SAT biopsy weight taken was 1.5±0.4 grams. E. Representative hematoxylin and eosin staining showing integrity of adipose tissue is maintained when using the Bergström biopsy needle.

Figure 2. Location of Subcutaneous Adipose Tissue Biopsies with MRI and Ultrasound Guidance

A. Single slice from 3-Tesla MRI scan shows VAT as well as sSAT and dSAT separated by the Scarpa’s fascia. Adipose tissue was obtained from dSAT (denoted by circle) below the Scarpa’s fascia (arrowhead). B-C. Representative US images are from 1 of the 18 biopsies performed under US guidance. B. Bergström biopsy needle above the Scarpa’s fascia (arrowhead). C. Bergström biopsy needle below the Scarpa’s fascia, approximately 2–3 inches below the skin (arrowhead), where we sampled dSAT.