Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

Overview

Journal J Clin Med

Specialty General Medicine

Date 2019 Jun 12

PMID 31181794

Citations 5

Authors

June Hong Ahn

Jong Geol Jang

Affiliations

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Abstract

In the diagnosis of lung lesions, computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) has a high diagnostic yield and a low complication rate. The procedure is usually performed by interventional radiologists, but the diagnostic yield and safety of CT-guided PTNB when performed by pulmonologists have not been evaluated. A retrospective study of 239 patients who underwent CT-guided PTNB at Yeungnam University Hospital between March 2017 and April 2018 was conducted. A pulmonologist performed the procedure using a co-axial technique with a 20-gauge needle. Then diagnostic yield and safety were assessed. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 96.1% (171/178), 100% (46/46), 100% (171/171), and 86.8% (46/53), respectively. The diagnostic accuracy was 96.9% (217/224) and the overall complication rate was 33.1% (82/248). Pneumothorax, hemoptysis, and hemothorax occurred in 27.0% (67/248), 5.2% (13/248), and 0.8% (2/248) of the patients, respectively. Univariate analyses revealed that pneumothorax requiring chest tube insertion was a significant risk factor (odds ratio, 25.0; < 0.001) for diagnostic failure. CT-guided PTNB is a safe procedure with a high diagnostic accuracy, even when performed by an inexperienced pulmonologist. The results were similar to those achieved by interventional radiologists as reported in previously published studies.

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References

Laurent F, Michel P, Latrabe V, Tunon de Lara M, Marthan R . Pneumothoraces and chest tube placement after CT-guided transthoracic lung biopsy using a coaxial technique: incidence and risk factors. AJR Am J Roentgenol. 1999; 172(4):1049-53. DOI: 10.2214/ajr.172.4.10587145. View

Tsukada H, Satou T, Iwashima A, Souma T . Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR Am J Roentgenol. 2000; 175(1):239-43. DOI: 10.2214/ajr.175.1.1750239. View

Hirose T, Mori K, Machida S, Tominaga K, Yokoi K, Adachi M . Computed tomographic fluoroscopy-guided transthoracic needle biopsy for diagnosis of pulmonary nodules. Jpn J Clin Oncol. 2000; 30(6):259-62. DOI: 10.1093/jjco/hyd070. View

Haaga J, ALFIDI R . Precise biopsy localization by computer tomography. Radiology. 1976; 118(3):603-7. DOI: 10.1148/118.3.603. View

Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C . CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 2003; 180(6):1665-9. DOI: 10.2214/ajr.180.6.1801665. View

Geraghty P, Kee S, McFarlane G, Razavi M, Sze D, Dake M . CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology. 2003; 229(2):475-81. DOI: 10.1148/radiol.2291020499. View

Diacon A, Schuurmans M, Theron J, Schubert P, Wright C, Bolliger C . Safety and yield of ultrasound-assisted transthoracic biopsy performed by pulmonologists. Respiration. 2004; 71(5):519-22. DOI: 10.1159/000080638. View

Choi C, Um S, Yoo C, Kim Y, Han S, Shim Y . Incidence and risk factors of delayed pneumothorax after transthoracic needle biopsy of the lung. Chest. 2004; 126(5):1516-21. DOI: 10.1378/chest.126.5.1516. View

Lagethon Heck S, Blom P, Berstad A . Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses. Eur Radiol. 2006; 16(6):1387-92. DOI: 10.1007/s00330-006-0152-2. View

10.

Hiraki T, Mimura H, Gobara H, Iguchi T, Fujiwara H, Sakurai J . CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: diagnostic yield and risk factors for diagnostic failure. Chest. 2009; 136(6):1612-1617. DOI: 10.1378/chest.09-0370. View

11.

Kim G, Hur J, Lee S, Lee H, Hong Y, Nam J . CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol. 2010; 21(2):232-9. DOI: 10.1007/s00330-010-1936-y. View

12.

Wu R, Tzeng W, Lee W, Chang S, Chen C, Fung J . CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: comparison between coaxial and single needle technique. Eur J Radiol. 2011; 81(5):e712-6. DOI: 10.1016/j.ejrad.2011.05.032. View

13.

Freund M, Petersen J, Goder K, Bunse T, Wiedermann F, Glodny B . Systemic air embolism during percutaneous core needle biopsy of the lung: frequency and risk factors. BMC Pulm Med. 2012; 12:2. PMC: 3608336. DOI: 10.1186/1471-2466-12-2. View

14.

Lal H, Neyaz Z, Nath A, Borah S . CT-guided percutaneous biopsy of intrathoracic lesions. Korean J Radiol. 2012; 13(2):210-26. PMC: 3303905. DOI: 10.3348/kjr.2012.13.2.210. View

15.

Choi S, Chae E, Kim J, Kim E, Oh S, Hwang H . Percutaneous CT-guided aspiration and core biopsy of pulmonary nodules smaller than 1 cm: analysis of outcomes of 305 procedures from a tertiary referral center. AJR Am J Roentgenol. 2013; 201(5):964-70. DOI: 10.2214/AJR.12.10156. View

16.

Lee S, Park C, Lee K, Bahn Y, Kim J, Goo J . C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules: clinical experience in 1108 patients. Radiology. 2014; 271(1):291-300. DOI: 10.1148/radiol.13131265. View

17.

Boskovic T, Stanic J, Pena-Karan S, Zarogoulidis P, Drevelegas K, Katsikogiannis N . Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis. 2014; 6 Suppl 1:S99-S107. PMC: 3966161. DOI: 10.3978/j.issn.2072-1439.2013.12.08. View

18.

Yang W, Sun W, Li Q, Yao Y, Lv T, Zeng J . Diagnostic Accuracy of CT-Guided Transthoracic Needle Biopsy for Solitary Pulmonary Nodules. PLoS One. 2015; 10(6):e0131373. PMC: 4482532. DOI: 10.1371/journal.pone.0131373. View

19.

Meena N, Bartter T . Ultrasound-guided Percutaneous Needle Aspiration by Pulmonologists: A Study of Factors With Impact on Procedural Yield and Complications. J Bronchology Interv Pulmonol. 2015; 22(3):204-8. DOI: 10.1097/LBR.0000000000000175. View

20.

Garcia-Ortega A, Briones-Gomez A, Fabregat S, Martinez-Tomas R, Martinez-Garcia M, Cases E . Benefit of Chest Ultrasonography in the Diagnosis of Peripheral Thoracic Lesions in an Interventional Pulmonology Unit. Arch Bronconeumol. 2015; 52(5):244-9. DOI: 10.1016/j.arbres.2015.07.012. View