Computed tomography-guided cutting needle biopsy for lung nodules

Zhang, Huimei; Huo, Xiao-Bing; Wang, Hua-Long; Xiao, Zhang; Fu, Yu‐Fei

doi:10.1097/md.0000000000024001

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…Diagnostic yield rates were reported in four trials [ 12 , 13 , 15 , 16 ], with a total of 291 patients undergoing low-dose CT-guided biopsy and 285 undergoing standard-dose CT-guided biopsy. Low-dose and normal-dose groups show no remarkable heterogeneity ( I 2 = 0%, Figure 3 A ) in their pooled diagnostic yield rates, which are similar at 48.8% and 51.2%, respectively ( p = 0.55).…”

Section: Resultsmentioning

confidence: 99%

“…There were 3 studies that looked at how long the biopsy process took, reporting on 221 patients who had a low-dose CT-guided biopsy and 220 patients who had a normal-dose CT-guided biopsy [ 12 , 15 , 16 ]. Neither the low- nor the normal-dose groups showed any significant heterogeneity ( I 2 = 0%) in the pooled biopsy procedure time (MD = –0.50, p = 0.30, Figure 3 C ).…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary hemorrhage rates have been reported in five investigations, including 431 and 335 patients who had low- and standard-dose CT-guided biopsy, respectively [ 12 – 16 ]. Comparison of the pooled rates of pulmonary bleeding between the low-dose and normal-dose groups reveals no remarkable heterogeneity ( I 2 = 0%; 14.8% vs. 13.5%, p = 0.29, Figure 3 F ).…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta-analysis of low-dose CT-driven biopsy for pulmonary nodules.

Zhao,

Xiong,

2023

Videosurgery and Other Miniinvasive Techniques

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Introduction The diagnosis of pulmonary nodules (PNs) has traditionally relied on computed tomography (CT)-guided biopsy. To reduce radiation exposure, low-dose CT-guided PN biopsy has been employed. Aim This meta-analysis aimed at evaluating the efficacy and safety of low-dose CT-guided biopsy in the diagnosis of PNs. Material and methods PubMed, Web of Science, and Wanfang were searched for relevant articles until June 2023. Comparing low-dose CT to normal-dose CT, we considered factors such as diagnostic yield, diagnostic accuracy, biopsy process time, dose-length product (DLP) value, the frequency of pneumothorax and pulmonary bleeding, and the frequency with which complications necessitated the placement of a chest tube. Results This meta-analysis included data from a total of 6 investigations. There was a total of 459 patients who had a CT-guided PN biopsy performed at a low dosage, and 384 patients who had a normal-dose CT-guided PN biopsy. There were no statistically significant differences between the low-dose CT and normal-dose CT groups in terms of diagnostic accuracy (p = 0.08), diagnostic yield (p = 0.55), biopsy procedure duration (p = 0.30), pneumothorax (p = 0.61), pulmonary hemorrhage (p = 0.29), or complications requiring a chest tube (p = 0.48). Low-dose CT patients obtained a DLP that was 91% lower than those in the standard-dose CT group (p = 0.01). According to Egger’s test, there is a significant possibility of publication bias in DLP (p = 0.034). Conclusions The diagnostic and safety results of low-dose CT-driven PN biopsy are equivalent to those of the standard one, although patients are much less exposed to radiation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta-analysis of low-dose CT-driven biopsy for pulmonary nodules.

Zhao,

Xiong,

2023

Videosurgery and Other Miniinvasive Techniques

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“…In the study performed by Zhang et al, the mean effective radiation dose was calculated as 5.3±1.6 mSv, and the doselength product (DLP) was 375.3±115.7 mGy.cm in lung biopsy procedures performed with standard protocol in 69 patients (29). In our study, the mean effective radiation dose was 5.26±3.25 mSv, DLP was 435.25±234.88 mGy.cm, and computed tomography dose index (CTDI) was 124.92± 93.24 mGy, which is similar to the literature data.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy and Complications of Percutaneous Ct-Guided Needle Biopsy of Lung Nodules in 161 Patients

Yılmazsoy

2022

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Transthoracic needle biopsy is a diagnostic method that has proven its reliability in lung nodules and is frequently applied in daily practice. The diagnostic accuracy of biopsies performed with computed tomography navigation is quite high, even if the lesion sizes are smaller than 1 cm. We aimed to evaluate the diagnostic accuracy and complications of the computed tomography-guided percutaneous transthoracic needle biopsy procedure performed in our center. Material and Methods: Patients who underwent computed tomography guided percutaneous transthoracic pulmonary nodule biopsy procedure between January 2017 and January 2020 were included in the study. The size and anatomic location of lesions, the distance between the pleura and the lesion, the angle of the needle with the pleura, the procedure time, the number of pathologic samples taken per patient, the total radiation dose, complications, and the pathological results of the lesions were analyzed from the patients’ computed tomography images and patients’ records. Results: Among the 161 patients admitted for the transthoracic percutaneous needle biopsy procedure, 135 were male (mean age 64.3±11.1 years) and 26 were females (mean age 61.3±15.4 years). The pathological evaluation of 32 patients were reported as non-diagnostic. The diagnostic accuracy of computed tomography guided transthoracic biopsy was calculated as 80.1%. Major complications occurred in 10 patients (6.2%), and minor complications occurred in 60 patients (37.2%). The rate of procedure requiring chest tube insertion was 4.9%. The mean effective radiation dose of the patients per procedure was calculated as 5.26±3.25 mSv. Conclusion: Computed tomography guided transthoracic biopsy procedure are a method with a high diagnostic accuracy rate, low rate of complications and can be preferred in all appropriate pulmonary nodules.

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“…Many recent studies have focused on the implementation of ULD protocols during percutaneous lung biopsies under CT guidance [21][22][23][24][25][26][27]. One of the most robust prospective randomised studies was published by Fu et al, demonstrating a ten-fold decrease of mean DLP (36.0 ± 14.1 mGy cm vs. 361.8 ± 108.0 mGy cm, p < 0.001) and effective dose (0.5 ± 0.2 mSv vs. 5.1 ± 1.5 mSv, p < 0.001) with comparable diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

Golin¹,

Izaaryene²,

Dassa³

et al. 2022

J. Radiol. Prot.

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Purpose To evaluate safetey and efficacy of an ultra low dose (ULD) protocol implementation during lung radiofrequency ablations. Methods All patients who underwent a lung RFA were consecutively and retrospectively included between November 2017 and January 2021. 30 patiens were treated with a historical standard protocol (SP), 31 with an ULD protocol. Patient characteristics, dose indicators, technical efficacy (minimal margin MM, recurrence during the follow up) and complications (pneumothorax, alveolar hemorrhage, hemoptysis) were recorded. Results 61 patients were included (median age, 65 [54. 73], 33 women). There was no significant difference in the characteristics of the patients according to the type of protocol, except for the type of anesthesia. Even if the number of helical acquisitions had not significantly changed, all the dose indicators significantly decreased by 1.5-fold to 3-fold. The median dose-length-product and effective dose were respectively 465mGy.cm [315; 554] and 6.5mSv [4.4; 7.8] in the SP group versus 178 mGy.cm [154; 267] and 2.5mSv [2.2; 3.7] in the ULD group, (p<.001). The ULD group presented a lower intra-operator variability and a better inter-operator alignment. The MM were not significantly different in the 2 groups (4.6mm versus 5mm, p=.16). One local recurrence was observed in each group, at 8 months for the SP and at one year for the ULD group (p=1). No significant difference was found in the complications rates. Conclusion Implmenting an ultra-low dose protocol during lung RFA may allow with the same efficacy, a reduction of dose indicators, intra- and inter-operator alignments, without increasing complications rates.

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Computed tomography-guided cutting needle biopsy for lung nodules

Cited by 8 publications

References 15 publications

Systematic review and meta-analysis of low-dose CT-driven biopsy for pulmonary nodules.

Systematic review and meta-analysis of low-dose CT-driven biopsy for pulmonary nodules.

Diagnostic Accuracy and Complications of Percutaneous Ct-Guided Needle Biopsy of Lung Nodules in 161 Patients

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

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