Imaging specialist Dr. Yordan Spirdonov, part of the team of the University General Hospital for Active Treatment “Tsaritsa Joanna – ISUL”, developed an innovative modification of fine needle aspiration biopsy, improving the diagnosis of tumors. The method, named by the research team, “Modus Spirdonov 1”, allows taking up to 5.5 times more cytological material compared to standard techniques. This unique modification is expected to significantly improve the diagnosis of breast and thyroid cancer, lymph nodes, liver, pancreas, kidney and superficial tumors. The inventor of the scanner attachment improving the diagnosis of mammary gland cancer, Dr. Spirdonov, presented his next big discovery in the Auditorium of the Gastroenterology Clinic of ISUL. In 2021, the specialist won the BLS Doctor of the Year award in the “Innovations” category. Conducting a needle biopsy is an established practice in the diagnosis of cancer, explained Dr. Spirdonov. In modern medicine, it is defined as the optimal initial method for taking tissue from the diseased area for microscopic examination. Its main goal is to minimize the number of patients with malignant lesions who subsequently undergo surgical biopsies. The advantages of fine-needle aspiration biopsy are minimal trauma to the patient, rapid performance of the accessible examination, and minimal iatrogenic decimation (the spread of scatter). Despite its advantages, in up to 25.3% of cases, fine-needle aspiration biopsy does not provide sufficient biological material and this necessitates reintervention. This rate is influenced by factors related to the nature of the lesion (68% of cases), the experience of the biopsy operator (32%), and, less commonly, the availability of equipment. The solution of Dr. Spirdonov and his team is “Modus Spirdonov 1”. The initial steps in �Stage 1� completely replicate the standard FNAB technique up to the point of creating a vacuum in the syringe. The thumb and forefinger of one hand are then placed directly over the syringe and fix the plunger. In “Stage 2” follow three sharp rotations around the piston with the other hand in one direction of the syringe along the longitudinal axis. In “Stage 3” the biopsy operator makes three more rotations in the other direction, and in “Stage 4” three rotations in the original direction. This gives a total of nine spins. The processed results of the liver examination show that in FNAB “Modus Spirdonov 1” the biological material is 3.87 times more in weight compared to the samples obtained in FNAB with pistol-grip mechanical syringe holder, which leads to an increase in the results by 287.4% and 5.53 times more compared to those of FNAB with direct finger grip, which equates to an increase of 452.7%. In the comparison, it turns out that the sample taken from the musculus longissimus dorsi at FNAB “Modus Spirdonov 1” weighs 4,20 times more than that obtained by FNAB with pistol-grip mechanical syringe holder (320.5% increase) and 3.91 times more than that obtained by FNAB with direct finger grip (291.5% increase). “We recommend that the new modification of the fine-needle aspiration biopsy, “Modus Spirdonov 1”, used in our UMBAL “Tsaritsa Joanna” base, be introduced by colleagues in the country and abroad. In this way, we will increase the detection of carcinomas not only in the mammary glands, but also those with other localization”, said Dr. Spirdnov. The specialist says that for many years he has faced the problem of the insufficient diagnostic value of preoperative biopsy studies, which hinders the diagnosis and staging of breast cancer. This leads to the need for reintervention or false negative results. “That’s how I came to the idea of ??needing to improve the picking technique. I began to think in the direction of developing and applying a different approach in order to obtain a larger amount of cytological material. Over a period of 6 years (2016-2022), I performed over 900 fine needle aspiration biopsies under ultrasound guidance. Observations showed that the amount of biological sample taken was visually significantly more with the modified and implemented new technique. Seeing these results, I decided to form a team to objectify the method to demonstrate it to colleagues. The measurements were carried out by an authorized specialist in the only laboratory specialized for standards of the Bulgarian Institute of Metrology. The results showed that even the minimal amount of biopsy material retrieved using the new technique was superior in quantity to the material obtained with standard techniques. The performed analysis showed that when comparing the results with the standard method, a statistically significant difference is obtained,” explained Dr. Spirdonov. During the presentation of the method he developed, Dr. Spirdonov thanked his colleagues who participated in the research of the innovative diagnostic approach. Among them are the executive director of ISUL Lyubomir Penev and the specialists from the hospital of the same name – surgeons Assoc. Dr. Teofil Sedloev and Dr. Slavyana Usheva, radiologist Dr. Georgi Varbanov and otolaryngologist Prof. Ivan Chalakov. The chairman of the Bulgarian Institute of Metrology, Snezhana Spasova, and the expert in mechanical measurements from the same institute, Tsvetomir Petkov, also participated in the research, to whom Dr. Spirdonov also thanked.that for many years he faced the problem of the insufficient diagnostic value of preoperative biopsy studies, which hindered the diagnosis and staging of breast cancer. This leads to the need for reintervention or false negative results. “That’s how I came to the idea of ??needing to improve the picking technique. I began to think in the direction of developing and applying a different approach in order to obtain a larger amount of cytological material. Over a period of 6 years (2016-2022), I performed over 900 fine needle aspiration biopsies under ultrasound guidance. Observations showed that the amount of biological sample taken was visually significantly more with the modified and implemented new technique. Seeing these results, I decided to form a team to objectify the method to demonstrate it to colleagues. The measurements were carried out by an authorized specialist in the only laboratory specialized for standards of the Bulgarian Institute of Metrology. The results showed that even the minimal amount of biopsy material retrieved using the new technique was superior in quantity to the material obtained with standard techniques. The performed analysis showed that when comparing the results with the standard method, a statistically significant difference is obtained,” explained Dr. Spirdonov. During the presentation of the method he developed, Dr. Spirdonov thanked his colleagues who participated in the research of the innovative diagnostic approach. Among them are the executive director of ISUL Lyubomir Penev and the specialists from the hospital of the same name – surgeons Assoc. Dr. Teofil Sedloev and Dr. Slavyana Usheva, radiologist Dr. Georgi Varbanov and otolaryngologist Prof. Ivan Chalakov. The chairman of the Bulgarian Institute of Metrology, Snezhana Spasova, and the expert in mechanical measurements from the same institute, Tsvetomir Petkov, also participated in the research, to whom Dr. Spirdonov also thanked.that for many years he faced the problem of the insufficient diagnostic value of preoperative biopsy studies, which hindered the diagnosis and staging of breast cancer. This leads to the need for reintervention or false negative results. “That’s how I came to the idea of ??needing to improve the picking technique. I began to think in the direction of developing and applying a different approach in order to obtain a larger amount of cytological material. Over a period of 6 years (2016-2022), I performed over 900 fine needle aspiration biopsies under ultrasound guidance. Observations showed that the amount of biological sample taken was visually significantly more with the modified and implemented new technique. Seeing these results, I decided to form a team to objectify the method to demonstrate it to colleagues. The measurements were carried out by an authorized specialist in the only laboratory specialized for standards at the Bulgarian Institute of Metrology. The results showed that even the minimal amount of biopsy material obtained using the new technique was superior in quantity to material obtained with standard techniques. The performed analysis showed that when comparing the results with the standard method, a statistically significant difference is obtained,” explained Dr. Spirdonov. During the presentation of the method he developed, Dr. Spirdonov thanked his colleagues who participated in the research of the innovative diagnostic approach. Among them are the executive director of ISUL Lyubomir Penev and the specialists from the hospital of the same name – surgeons Assoc. Dr. Teofil Sedloev and Dr. Slavyana Usheva, radiologist Dr. Georgi Varbanov and otolaryngologist Prof. Ivan Chalakov. The chairman of the Bulgarian Institute of Metrology, Snezhana Spasova, and the expert in mechanical measurements from the same institute, Tsvetomir Petkov, also participated in the research, to whom Dr. Spirdonov also thanked.superior in quantity of material taken with standard techniques. The performed analysis showed that when comparing the results with the standard method, a statistically significant difference is obtained,” explained Dr. Spirdonov. During the presentation of the method he developed, Dr. Spirdonov thanked his colleagues who participated in the research of the innovative diagnostic approach. Among them are the executive director of ISUL Lyubomir Penev and the specialists from the hospital of the same name – surgeons Assoc. Dr. Teofil Sedloev and Dr. Slavyana Usheva, radiologist Dr. Georgi Varbanov and otolaryngologist Prof. Ivan Chalakov. The chairman of the Bulgarian Institute of Metrology, Snezhana Spasova, and the expert in mechanical measurements from the same institute, Tsvetomir Petkov, also participated in the research, to whom Dr. Spirdonov also thanked.superior in quantity of material taken with standard techniques. The performed analysis showed that when comparing the results with the standard method, a statistically significant difference is obtained,” explained Dr. Spirdonov. During the presentation of the method he developed, Dr. Spirdonov thanked his colleagues who participated in the research of the innovative diagnostic approach. Among them are the executive director of ISUL Lyubomir Penev and the specialists from the hospital of the same name – surgeons Assoc. Dr. Teofil Sedloev and Dr. Slavyana Usheva, radiologist Dr. Georgi Varbanov and otolaryngologist Prof. Ivan Chalakov. The chairman of the Bulgarian Institute of Metrology, Snezhana Spasova, and the expert in mechanical measurements from the same institute, Tsvetomir Petkov, also participated in the research, to whom Dr. Spirdonov also thanked.