2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

Yoon, Soon Ho; Lee, Sang Min; Park, Chul Hwan; Lee, Jong Hyuk; Kim, Hyung Jin; Chae, Kum Ju; Jin, Kwang Nam; Lee, Kyung Hee; Kim, Jung Im; Hong, Jung Hee; Hwang, Eui Jin; Kim, Hee Kyung; Suh, Young Joo; Park, Samina; Park, Young Sik; Kim, Dong Wan; Choi, Miyoung; Park, Chang Min

doi:10.3348/kjr.2020.0137

Cited by 45 publications

(34 citation statements)

References 96 publications

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“…Third, we did not use CT fluoroscopy in our study. CT fluoroscopy has become popular recently, because it has been shown to significantly reduce the total procedure time and radiation dose for patients while providing higher diagnostic accuracy (31,32). However, a fundamental problem with CT fluoroscopy is that the physicians need to stay in the examination room during the scanning process and are exposed to radiation (33).…”

Section: Discussionmentioning

confidence: 99%

Low-dose CT with tin filter combined with iterative metal artefact reduction for guiding lung biopsy

Liu¹,

Liu²,

Li³

et al. 2022

Quant Imaging Med Surg

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Section: Discussionmentioning

confidence: 99%

Low-dose CT with tin filter combined with iterative metal artefact reduction for guiding lung biopsy

Liu¹,

Liu²,

Li³

et al. 2022

Quant Imaging Med Surg

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“…The 2020 Clinical Practical guideline for percutaneous transthoracic needle biopsy of pulmonary nodules reports: ‘When systemic air embolism occurs, we recommend supplying oxygen at as high concentration as possible, including hyperbaric oxygen therapy, and anticonvulsants, if needed’ as an A recommendation with a level of evidence at III and based on case reports. 34 …”

Section: Discussionmentioning

confidence: 99%

“…The 2020 Clinical Practical guideline for percutaneous transthoracic needle biopsy of pulmonary nodules reports: 'When systemic air embolism occurs, we recommend supplying oxygen at as high concentration as possible, including hyperbaric oxygen therapy, and anticonvulsants, if needed' as an A recommendation with a level of evidence at III and based on case reports. 34 Hyperbaric oxygen therapy is recommended and is described in numerous of the case reports included in this review. 34 Boyle's law states that the size of an air bubble in liquidin this case in the arterial systemdecreases with increased surrounding pressure.…”

Section: Discussionmentioning

confidence: 99%

“…34 Hyperbaric oxygen therapy is recommended and is described in numerous of the case reports included in this review. 34 Boyle's law states that the size of an air bubble in liquidin this case in the arterial systemdecreases with increased surrounding pressure. Using hyperbaric oxygen therapy, the patient breathes 100% oxygen at a pressure above atmospheric pressure which theoretically decreases the size of the air embolism by raising the ambient pressure and by causing systemic hyperoxia.…”

Section: Discussionmentioning

confidence: 99%

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Systemic air embolism following computed-tomography-guided transthoracic needle biopsy of lung lesion – a systematic search of case reports and case series

Pietersen

Kristjánsdóttir

Laursen

et al. 2022

Acta Radiologica Open

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Background Systemic air embolism is a rare, however potentially fatal, low incidence, complication to CT-guided transthoracic needle biopsy of lung lesions. Purpose The purpose of this review of case reports and series was to pool data about this rare complication and glance for a pattern or similarities in the patients’ initial symptoms and course, as well as the management of the patients in relation to current guidelines. Material and methods PubMed was searched for case reports and case series about systemic air embolisms following CT-guided transthoracic needle biopsy of lung lesions from inception to November 2021. A reviewer screened the results for eligibility and included studies which reported at least two outcomes of interest. Data was extracted by one author and a descriptive analysis was conducted. Results Of 1,136 studies screened, 83 were eligible for inclusion involving 97 patients. The mean age was 64.8±11.7 years and ≈60% of the patients were men. In 15 cases the outcome was fatal, and most of the fatal cases ( n = 12) had cardiac arrest as the primary initial symptom. In addition to conventional oxygen therapy, 34 patients received hyperbaric oxygen therapy, and in 30 cases the physician in charge chose to change the patient from standard supine position to – most often – Trendelenburg position. Conclusion No similarities were found that could lead to more rapid diagnosis or more correct management. The staff should keep systemic air embolisms in mind, when more common complications are ruled out, and consider hyperbaric oxygen therapy in case of suspicion.

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“…All procedures were performed in accordance with the relevant guidelines and regulations 14 , 21 . This clinical observational study was approved by our institutional ethics committee and the need for informed consent was waived (Ajou institutional review board).…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy and safety of CT-guided percutaneous lung biopsy with a coaxial cutting needle for the diagnosis of lung cancer in patients with UIP pattern

Kim

Sun

Kim

et al. 2022

Sci Rep

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This study aimed to assess the diagnostic accuracy and safety of CT-guided percutaneous core needle biopsy (PCNB) with a coaxial needle for the diagnosis of lung cancer in patients with an usual interstitial pneumonia (UIP) pattern of interstitial lung disease. This study included 70 patients with UIP and suspected to have lung cancer. CT-guided PCNB was performed using a 20-gauge coaxial cutting needle. The diagnostic accuracy, sensitivity, specificity, and percentage of nondiagnostic results for PCNB were determined in comparison with the final diagnosis. PCNB-related complications were evaluated. Additionally, the risk factors for nondiagnostic results and pneumothorax were analyzed. The overall diagnostic accuracy, sensitivity, and specificity were 85.7%, 85.5%, and 87.5%, respectively. The percentage of nondiagnostic results was 18.6% (13/70). Two or less biopsy sampling was a risk factor for nondiagnostic results (p = 0.003). The overall complication rate was 35.7% (25/70), and pneumothorax developed in 22 patients (31.4%). A long transpulmonary needle path was a risk factor for the development of pneumothorax (p = 0.007). CT-guided PCNB using a coaxial needle is an effective method with reasonable accuracy and an acceptable complication rate for the diagnosis of lung cancer, even in patients with UIP.

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2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

Cited by 45 publications

References 96 publications

Low-dose CT with tin filter combined with iterative metal artefact reduction for guiding lung biopsy

Low-dose CT with tin filter combined with iterative metal artefact reduction for guiding lung biopsy

Systemic air embolism following computed-tomography-guided transthoracic needle biopsy of lung lesion – a systematic search of case reports and case series

Diagnostic accuracy and safety of CT-guided percutaneous lung biopsy with a coaxial cutting needle for the diagnosis of lung cancer in patients with UIP pattern

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