CT-guided cutting needle lung biopsy using modified coaxial technique: Factors effecting risk of complications

Yıldırım, Erkan; Kırbaş, İsmail; Harman, Ali; Ozyer, Umut; Töre, Hüseyin Gürkan; Aytekin, Cüneyt; Boyvat, Fatih

doi:10.1016/j.ejrad.2008.01.006

Cited by 74 publications

(77 citation statements)

References 15 publications

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“…The pulmonary compression accounted for 30% of the patients with pneumothorax after microwave ablation, and all patients were cured after oxygen inhalation or thoracic puncture and aspiration. The incidence of pneumothorax after CT guided percutaneous pulmonary biopsy was estimated to be about 14., 4%-17.87%, which was similar to that of the incidence of pneumothorax in the study [15,16]. Pneumothorax may be induced by microwave puncture for pleural lesions.…”

Section: Discussionsupporting

confidence: 64%

A comparative study of chemotherapy combined with intermittent microwave ablation and chemotherapy in the treatment of oligometastatic non-small cell lung cancer

Zhu¹,

Yuan²,

Liang³

et al. 2018

Oncotarget

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Objective: To compare chemotherapy combined with intermittent microwave ablation and chemotherapy alone in the treatment of oligometastatic non-small cell lung cancer.Results: In the experimental group (n = 34), the total effective rate (CR+PR) was 70.59% vs. 36.36% in the control group (n = 33) (χ 2 =7.890, P < 0.01). The score of KPS in the experimental group was higher than that in the control group, indicating obvious difference (P < 0.05). The median PFS in the control group and the experimental group was (3.6 ± 0.2) months and (5.4 ± 0.1) months (χ 2 = 42.731, P < 0.01). There was statistical difference that the incidence of pneumothorax and blood sputum in the experimental group was higher than that in the control group (χ 2 = 6.031, P < 0.05). However, no significant differences were found regarding other common complications of microwave ablation and chemotherapy.Conclusions: Chemotherapy combined with intermittent microwave ablation is superior to chemotherapy alone in improving the rate of disease control and the quality of life of patients, as well as prolonging the PFS of patients.Methods: A total of 34 cases of oligometastatic NSCLC who received chemotherapy with intermittent CT guided microwave ablation and 33 cases of oligometastatic NSCLC patients who received chemotherapy only were enrolled. The efficacy and the adverse effects were evaluated. www.impactjournals.com/oncotarget/ Oncotarget, Advance Publications 2018

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Section: Discussionsupporting

confidence: 64%

A comparative study of chemotherapy combined with intermittent microwave ablation and chemotherapy in the treatment of oligometastatic non-small cell lung cancer

Zhu¹,

Yuan²,

Liang³

et al. 2018

Oncotarget

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“…Our meta-analysis demonstrated an overall pneumothorax rate of just 1.0%, and an overall intercostal drain insertion rate of 0.4%. In comparison, many studies describing CT-PNB report pneumothorax rates .25% [49,[51][52][53][54], and as high as 69% [55], with many of these patients requiring admission or even intercostal catheter drainage. Pulmonary haemorrhage is less frequent, but still complicates 1-10% of CT-PNB [51,52].…”

Section: Discussionmentioning

confidence: 99%

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Steinfort¹,

Khor²,

Manser³

et al. 2010

Eur Respir J

373

309

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Improved diagnostic sensitivity of bronchsocopy for the investigation of peripheral pulmonary lesions (PPLs) with the use of radial probe endobroncial ultrasound (EBUS) has been reported, although diagnostic performance varies considerably.A systematic review of published literature evaluating radial probe EBUS accuracy was performed to determine point sensitivity and specificity, and to construct a summary receiveroperating characteristic curve. Sub-group analysis and linear regression was used to identify possible sources of study heterogeneity.16 studies with 1,420 patients fulfilled inclusion criteria. Significant inter-study variation in EBUS method was noted. EBUS had point specificity of 1.00 (95% CI 0.99-1.00) and point sensitivity of 0.73 (95% CI 0.70-0.76) for the detection of lung cancer, with a positive likelihood ratio of 26.84 (12.60-57.20) and a negative likelihood ratio of 0.28 (0.23-0.36). Significant interstudy heterogeneity for sensitivity was observed, with prevalence of malignancy, lesion size and reference standard used being possible sources.EBUS is a safe and relatively accurate tool in the investigation of PPLs. Diagnostic sensitivity of EBUS may be influenced by the prevalence of malignancy in the patient cohort being examined and lesion size. Further methodologically rigorous studies on well-defined patient populations are required to evaluate the generalisability of our results.

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“…Few studies have specifically examined predictors of hemoptysis in this setting (13,16), and most grouped hemoptysis together with alveolar hemorrhage under the term "pulmonary bleeding" (12,14,(17)(18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hemoptysis complicating 17-18 gauge CT-guided transthoracic needle core biopsy: multivariate analysis of 249 procedures

Chassagnon

Grégory²,

Ahmar³

et al. 2017

Diagn Interv Radiol

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C omputed tomography (CT)-guided transthoracic needle biopsy (TTNB) is a well-established method for investigating pulmonary nodules and masses. It offers a better diagnostic yield than bronchoscopy for the assessment of lung nodules and peripheral lesions (1, 2). Referral for CT-guided TTNB is expected to increase in the coming years. One reason is the higher proportion of adenocarcinomas among current lung cancers, which are more likely to be peripheral and not reachable by bronchoscopy (3, 4). Another reason is the recommendation of re-biopsy for molecular analysis of non-small cell lung cancers that progress or recur (5-7). Although TTNB is considered a safe and efficient method for obtaining a definite pathologic diagnosis, complications are reported in up to two-thirds of procedures (8, 9). The three main complications of TTNB are pneumothorax, alveolar hemorrhage, and hemoptysis. These complications are rarely life threatening, and pulmonary bleeding is usually self-resolving. However, severe hemoptysis can necessitate endobronchial tamponade, arterial embolization, or surgery (8, 10).It is important for the operator to be aware of potentially modifiable risk factors. Several modifiable risk factors for pneumothorax have been reported in the literature, including angle between needle and pleural surface (11), transpulmonary needle-path length (12, 13), patient position during the procedure (11), and operator's level of experience (12). A large pleural angle, a long needle path, the prone position, and limited expertise are all reported to increase the risk of pneumothorax. By contrast, data on risk factors for hemoptysis in this setting are scarce, and most published studies of transthoracic biopsy have combined alveolar hemorrhage and hemoptysis under the term "pulmonary bleeding. " Chakrabarti et al. (14) 347 C H E S T I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to identify modifiable and nonmodifiable risk factors for hemoptysis complicating computed tomography (CT)-guided transthoracic needle biopsy. METHODSAll procedures performed in our institution from November 2013 to May 2015 were reviewed. Hemoptysis was classified as mild if limited to hemoptoic sputum and abundant otherwise. Presence of intra-alveolar hemorrhage on postbiopsy CT images was also evaluated. Patient-and lesion-related variables were considered nonmodifiable, while procedure-related variables were considered modifiable. RESULTSA total of 249 procedures were evaluated. Hemoptysis and alveolar hemorrhage occurred in 18% and 58% of procedures, respectively, and were abundant or significant in 8% and 17% of procedures, respectively. Concordance between the occurrence of significant alveolar hemorrhage (grade ≥2) and hemoptysis was poor (κ=0.28; 95% CI [0.16-0.40]). In multivariate analysis, female gender (P = 0.008), a longer transpulmonary needle path (P = 0.014), and smaller lesion size (P = 0.044) were independent risk factors for hemoptysis. Transpulmonary needle-path length was the only risk factor for abundant ...

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CT-guided cutting needle lung biopsy using modified coaxial technique: Factors effecting risk of complications

Cited by 74 publications

References 15 publications

A comparative study of chemotherapy combined with intermittent microwave ablation and chemotherapy in the treatment of oligometastatic non-small cell lung cancer

A comparative study of chemotherapy combined with intermittent microwave ablation and chemotherapy in the treatment of oligometastatic non-small cell lung cancer

Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis

Risk factors for hemoptysis complicating 17-18 gauge CT-guided transthoracic needle core biopsy: multivariate analysis of 249 procedures

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