CT-guided transthoracic biopsy: histopathologic results and complication rates

Aktaş, Ahmet; Gozlek, Emel; Yılmaz, Ömer; Kayan, Mustafa; Ünlü, Nisa; Demirtaş, Hakan; Değirmenci, Bumin; Kara, Mustafa

doi:10.5152/dir.2014.140140

Cited by 25 publications

(27 citation statements)

References 15 publications

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“…The most common complication was pneumothorax (17.8%), followed by mild hemoptysis (7.7%) and hemothorax (1.2%); these data are in line with other reports on this technique, even though reported complication rates are highly variable [21,25,26,46]. Apart from the patient who died from procedure-related complication, none of the other events that occurred in our study were considered life-threatening for patients undergoing CT-guided transthoracic lung biopsy.…”

Section: Discussionsupporting

confidence: 80%

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Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

et al. 2018

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Background: Accurate diagnosis is essential for successful management of diffuse lung disease (DLD). Histopathology may sometimes be necessary. Surgical lung biopsy, the gold standard, carries a risk of morbidity and mortality. Computed tomography (CT) guided transthoracic lung biopsy (CT-TLB) is a minimally invasive method for obtaining lung tissue. However, its diagnostic yield is unknown in DLD. Objective: To assess the diagnostic yield of CT-TLB in DLD according to the predominant high-resolution CT (HRCT) patterns. Methods: Between January 2009 and December 2016, we enrolled all consecutive adult patients with suspicion of DLD who underwent CT-guided transthoracic lung biopsy during the diagnostic work-up. All biopsies were performed by a senior interventional radiologist using CT fluoroscopy. Results: The study included 169 patients (50.3% men) with a mean (±SD) age of 58.3 ± 14 years. Consolidation was the predominant HRCT pattern. A definitive or probable diagnosis was made in 66.3%. The most frequent diagnosis was organizing pneumonia (36.2%). Diagnostic yield was higher when the predominant HRCT pattern was consolidation or nodular. The most common complication was pneumothorax (17.8%); other complications included mild hemoptysis (7.7%), hemothorax (1.2%), and death (0.59%). No acute exacerbation of the underlying condition was observed. Conclusions: CT-TLB proved to be accurate and safe for the diagnosis of DLD. The overall diagnostic yield of the procedure was 66.3%. Given its low complication rates, CT-TLB can be an option in patients whose respiratory function is seriously impaired and in those with substantial comorbidities, where more invasive procedures cannot be performed for reasons of safety.

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Section: Discussionsupporting

confidence: 80%

“…In this context, this technique has widespread acceptance as a preferred method of diagnosis, since it has already been demonstrated to be significantly accurate and safe [20][21][22][23][24]. The diagnostic yield of CT-guided transthoracic lung biopsy in nodules or masses has been reported to be as high as 95% [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

et al. 2018

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“…Complications were more frequent among patients with a lower diffusing capacity of the lung for carbon monoxide. The most common complications were pneumothorax (17.8%), hemoptysis (7.7%), and hemothorax (1.2%), comparable to previous reports [27,28]. CT-TLB can be performed on the majority of patients, but those with altered mental status, intractable cough, invasive or noninvasive mechanical ventilation, severe ILD or emphysema, or bleeding diathesis are not eligible.…”

supporting

confidence: 53%

Lung Biopsy in Interstitial Lung Diseases: There Is More than One Way to Cook an Egg

Nasser¹,

Cottin²

2018

Respiration

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“…Metal artifact.-The metal artifacts were quantified by using the CT number reduction (CTNR), as well as the metal diameter blurring (MDB) (15). The CTNR was measured in a 1 3 1 3 1 cm region of interest peripheral to the needle tip, where hypodense streaks are commonly observed extending from the needle tip due to beam hardening (16). The size of the region of interest was chosen to include the complete cross-sectional area of the needle including artifacts in the CT volume.…”

Section: Uld Ct Fluoroscopic Reconstructionmentioning

confidence: 99%

Ultra–Low Radiation Dose CT Fluoroscopy for Percutaneous Interventions: A Porcine Feasibility Study

Wagner

Hinshaw

et al. 2019

Radiology

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To determine the feasibility of ultra-low-dose (ULD) CT fluoroscopy for performing percutaneous CT-guided interventions in an in vivo porcine model and to compare radiation dose, spatial accuracy, and metal artifact for conventional CT versus CT fluoroscopy. Materials and Methods: An in vivo swine model was used (n = 4, ~50 kg) for 20 procedures guided by 246 incremental conventional CT scans (mean, 12.5 scans per procedure). The procedures were approved by the Institutional Animal Care and Use Committee and performed by two experienced radiologists from September 7, 2017, to August 8, 2018. ULD CT fluoroscopic acquisitions were simulated by using only two of 984 conventional CT projections to locate and reconstruct the needle, which was superimposed on a previously acquired and motion-compensated CT scan. The authors (medical physicists) compared the ULD CT fluoroscopy results to those of conventional CT for needle location, radiation dose, and metal artifacts using Deming regression and generalized mixed models. Results: The average distance between the needle tip reconstructed using conventional CT and ULD CT fluoroscopy was 1.06 mm. Compared with CT fluoroscopy, the estimated dose for a percutaneous procedure, including planning acquisitions, was 0.99 mSv (21% reduction) for patients (effective dose) and 0.015 µGy (97% reduction) for physicians (scattered dose in air). Metal artifacts were statistically significantly reduced (P , .001, bootstrapping), and the average registration error of the motion compensation was within 1-3 mm. Conclusion: Ultra-low-dose CT fluoroscopy has the potential to reduce radiation exposure for intraprocedural scans to patients and staff by a factor of approximately 500 times compared with conventional CT acquisition, while maintaining image quality without metal artifacts.

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CT-guided transthoracic biopsy: histopathologic results and complication rates

Cited by 25 publications

References 15 publications

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

Diagnostic Yield of Computed Tomography-Guided Transthoracic Lung Biopsy in Diffuse Lung Diseases

Lung Biopsy in Interstitial Lung Diseases: There Is More than One Way to Cook an Egg

Ultra–Low Radiation Dose CT Fluoroscopy for Percutaneous Interventions: A Porcine Feasibility Study

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