Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

Koegelenberg, Coenraad F.N.; Bolliger, Chris T.; Plekker, D.; Wright, Colleen A.; Brundyn, Karen; Louw, Mercia; Schubert, Pawel; Heuvel, Marry M. van den; Diacon, Andreas H.

doi:10.1183/09031936.00128108

Cited by 23 publications

(37 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Transthoracic ultrasound (US) has become a valuable guide for interventional procedures [7,8], and plays an increasing role in biopsies of the chest wall, pleura and peripheral lung [9,10,11,12,13]. US-assisted biopsies of mediastinal masses were first described by Saito et al [14] two decades ago, enabling them to diagnose 87% of all malignant tumours and 67% of benign masses.…”

Section: Introductionmentioning

confidence: 99%

“…US-assisted transthoracic fine-needle aspiration (TTFNA) and CNB in the setting of chest wall, pleural and pulmonary malignancies abutting the chest wall have a very high diagnostic yield and are safe, even in the hands of non-radiologists [10,11,12]. The use of TTFNA with rapid on-site evaluation (ROSE) and CNB has been shown to be complementary [11,12,22].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

et al. 2010

View full text Add to dashboard Cite

Background: Ultrasound (US)-assisted transthoracic biopsy offers a less invasive alternative to surgical biopsy in the setting of mediastinal masses. Objectives: The aim of this 1-year prospective study was to assess the diagnostic yield and safety of a novel single-session sequential approach of US-assisted transthoracic fine-needle aspirations (TTFNA) with rapid on-site evaluation (ROSE) followed by cutting needle biopsies (CNB) performed by physicians on patients with anterosuperior mediastinal masses. Methods: US-assisted TTFNA with ROSE was performed on 45 consecutive patients (49.5 ± 27.7 years, 24 males), immediately followed by CNB where a provisional diagnosis of epithelial carcinoma or tuberculosis could not be established, provided a safety range could be assured. Results: TTFNA alone was deemed adequate by means of ROSE in 27 (60%) patients. CNB could be performed in 17 of the remaining 18. The on-site diagnosis corresponded to the final diagnosis in 26/45 (57.8%). An accurate cytological diagnosis was made in 33 (73.3%), and was more likely to be diagnostic in epithelial carcinoma and tuberculosis (28/30) than all other pathologies (5/15, p < 0.001). CNB yielded a diagnosis in 15/17 (88.2%). Overall, 42/45 patients were diagnosed by the single-session approach (93.3%). The final diagnoses included 41 neoplasms, with small cell lung cancer (n = 13) the commonest diagnosis. We observed no pneumothorax or major haemorrhage. Conclusions: A single-session sequential approach of US-assisted TTFNA with ROSE followed by CNB, where indicated, has a high diagnostic yield for anterosuperior mediastinal masses, is safe and offers an alternative to surgical biopsy.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Echogenicity is the ability to reflect an echo, and the echogenicity of any tissue or lesion is defined relative to that of the normal liver, which is arbitrarily considered isoechoic (9). Sound waves propagate well though liquids (e.g., pleural effusions) and through tissues with a high fluid content (e.g., consolidated lung, tumors, and liver) (8,10,11). Tissues that have higher echogenicity are called "hyperechoic" and are usually represented with lighter colors.…”

Section: Basics: Physics and Principlesmentioning

confidence: 99%

“…However, when a significant difference in density between tissues is encountered, the sound waves are reflected in a phenomenon called "acoustic impedance. " This is readily seen when imaging gas (e.g., normal lung or a pneumothorax) or solid tissue (e.g., bone) (10,11). Thus, the anatomy beyond the visceral pleura is not discernible in healthy individuals.…”

Section: Basics: Physics and Principlesmentioning

confidence: 99%

“…When conducting a study, correct positioning of the patient is essential because it aids in obtaining high quality images (8,11). If available, it is advisable to study the available images [chest X-ray and computed tomography (CT) scan] prior to performing a thoracic US scan because this aids not only in the positioning of the patient but also in the identification of the area of interest and in shortening the study procedure time.…”

Section: Conducting a Studymentioning

confidence: 99%

See 1 more Smart Citation

Transthoracic Ultrasonography for Clinicians

Vorster¹,

Allwood²,

Koegelenberg³

2015

Eurasian J Pulmonol

View full text Add to dashboard Cite

Transthoracic ultrasonography (US) has become an essential tool for respiratory, emergency, and critical care physicians. It can be performed with basic equipment and by personnel with minimum training as a modality for the evaluation of a wide range of thoracic pathologies. Its advantages include immediate application at the point of care, low cost, and lack of radiation. The main indications for transthoracic US are the qualitative and quantitative assessment of pleural effusions, pleural thickening, diaphragmatic pathology, as well as chest wall and pleural tumors. Transthoracic US is also useful in visualizing pulmonary pathologies that abut the pleura, such as pneumonic consolidation and interstitial syndromes, including pulmonary edema. Transthoracic US is more sensitive than the traditional chest radiograph in the detection of pneumothoraces, and it is useful in diagnosing skeletal abnormalities such as rib fractures. It is the ideal tool to guide transthoracic procedures, including thoracocentesis and pleural biopsy. Moreover, transthoracic US-guided procedures can be performed by a single clinician with no sedation and minimal monitoring. Transthoracic US-guided fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes and lesions arising from the chest wall, pleura, peripheral lung, and mediastinum are safe to perform and have a high yield in the of hands of experienced clinicians. Transthoracic US can also potentially guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations, and lung abscesses. Moreover, transthoracic US may be used in the detection of pulmonary embolism.

show abstract

Transbronchial fine needle aspiration biopsy and rapid on‐site evaluation in the setting of superior vena cava syndrome

Brundyn

Koegelenberg

Diacon

et al. 2011

Diagnostic Cytopathology

Self Cite

View full text Add to dashboard Cite

There is a paucity of prospective data on flexible bronchoscopy with rapid on-site evaluation (ROSE) in the setting of superior vena cava (SVC) syndrome. The aims of this prospective study were to assess the diagnostic yield and safety of these investigations and specifically to evaluate the role of ROSE in limiting the need for tissue biopsies. Over a 5-year period 48 patients (57.4 ± 9.7 years) with SVC syndrome secondary to intrathoracic tumors underwent flexible bronchoscopy with TBNA and ROSE. Endobronchial Forceps biopsy was reserved for visible endobronchial tumors with no on-site confirmation of diagnostic material. ROSE confirmed diagnostic material in 41 cases (85.4%), and in only one of the remaining cases did the addition of a forceps biopsy increase the diagnostic yield (overall diagnostic yield of 87.5%). No serious complications were noted. The final diagnoses made included nonsmall lung cancer (n = 27), small cell lung cancer (n = 16), and metastatic carcinoma (n = 3). Two undiagnosed cases died of suspected advanced neoplasms (unknown primary tumors). We conclude that TBNA has a high diagnostic yield and is safe in the setting of SVC syndrome. With the addition of ROSE, tissue biopsy is required in the minority of cases.

show abstract

Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome

Cited by 23 publications

References 32 publications

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

The Diagnostic Yield and Safety of Ultrasound-Assisted Transthoracic Biopsy of Mediastinal Masses

Transthoracic Ultrasonography for Clinicians

Transbronchial fine needle aspiration biopsy and rapid on‐site evaluation in the setting of superior vena cava syndrome

Contact Info

Product

Resources

About