Efficacy of the tract embolization technique with gelatin sponge slurry to reduce pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy

Abstract

Background and purpose: Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have recently been identified as potential causal agents of RRP but its real incidence and potential risk factors remain unknown. Materials and methods: Medical records and CTs of patients treated with programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors for advanced lung cancer between 2014 and 2019 at our tertiary center, and who had a previous history of lung irradiation were retrospectively analyzed. We identified RRP as lung CT modifications occurring in the irradiation field >6 months after conventionally fractionated radiotherapy completion and >1 year after stereotactic body radiation therapy. Clinical and dosimetric data were analyzed to identify potential risk factors for RRP. Results: Among 348 patients treated with ICIs, data from 80 eligible patients were analyzed (median age, 69 years [interquartile range, 11]; 45 men). Fifteen patients (18.8%) presented with RRP. Median time between end of radiotherapy and RRP was 450 days (range, 231-1859). No risk factor was significantly associated with RRP. ICI-related pneumonitis was associated with RRP in 33.3% of cases (p = 0.0021), developing either concomitantly or after RRP. Incidence of grade ! 3 pneumonitis in the RRP population was 13.3 %. Conclusion:We demonstrated a high incidence of RRP (18.8%) in our population of previously irradiated patients treated with ICIs for lung cancer. We identified no risk factors for RRP, but an association was noted between RRP and ICI-related pneumonitis.

Feasibility Analysis of the Bone Cement‐Gelatine Sponge Composite Intravertebral Prefilling Technique for Reducing Bone Cement Leakage in Stage I and II Kümmell's Disease: A Prospective Randomized Controlled Trial

“…On the other hand, gelatine sponges are widely used in clinical settings and are easily and economically sourced. Gelatine sponges primarily comprise collagen, which provides bulk and mechanical strength and enhances absorption, making it a common component in surgical procedures for hemostasis and vascular embolisation 33–35 . Bhatia et al 22 .…”

Ultrasound-guided percutaneous implantation of rabbit VX2 carcinoma, using a coaxial technique and gelfoam pellet injection combination to establish a rabbit liver tumor model

“…Previous studies have used coaxial technology to implant rabbit VX2 liver tumor, finding that the rate of extrahepatic tumor seeding was significantly lower with this technique. 13,16 However, no previous studies have assessed the use of this coaxial technique plus insertion of a gelfoam pellet in the creation of a rabbit VX2 liver tumor model, although this combination has previously been tried in clinical biopsies of the liver, 23 lung, 24 and spleen. 25 With this technique, the coaxial needle protects the puncture tract while gelfoam pellets prevent bleeding and leakage of tumor fragments.…”

Fiducial markers for stereotactic lung radiation therapy: review of the transthoracic, endovascular and endobronchial approaches

“…Recently, the application of gelatine sponge slurry/powder or intra-parenchymal blood patching has led to a significantly lower pneumothorax rate (10% [24], 11%, [25] and 30% [26]) and the need for chest tube placement [24][25][26]. Only one study has described FM percutaneous insertion associated with gelatine powder application and it showed a pneumothorax rate of 9% [27].…”