Image-guided pleural biopsy: diagnostic yield and complications

Benamore, Rachel; Scott, K.; Richards, Cathy; Entwisle, James

doi:10.1016/j.crad.2006.05.002

Cited by 72 publications

(46 citation statements)

References 24 publications

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“…CT guided biopsy has a reported sensitivity of 76-88% and specificity of up to 100% for the diagnosis of malignant pleural thickening including a sensitivity of 83-86% for the diagnosis of mesothelioma which is superior to prior reports of blind closed pleural biopsy (35)(36)(37)(38). US guided biopsies are also superior to blind closed pleural biopsy (14,39,40).…”

Section: Image-guided Biopsymentioning

confidence: 90%

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Diagnosis and management of malignant pleural effusions: state of the art in 2017

Desai

Lee

2017

J. Thorac. Dis.

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Malignant pleural effusion (MPE) is a known complication of both thoracic and extra thoracic malignancies. The presence of MPE regardless of the primary site translates into advanced stage disease.Diagnosis and management of MPE with the goals of palliation and improving quality of life poses a challenge for chest physicians. Recently, multiple studies have made attempts to answer questions regarding optimal management in various clinical scenarios. We will review the current evidence and available options for the management of MPE.

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Section: Image-guided Biopsymentioning

confidence: 90%

“…US guided biopsies are also superior to blind closed pleural biopsy (14,39,40). Reported sensitivity range from 70% to 94% (35)(36)(37)39). In patients with suspected mesothelioma where there is no pleural effusion image-guided biopsy (CT or US guided) is preferred compared to closed pleural biopsy (41).…”

Section: Image-guided Biopsymentioning

confidence: 99%

Diagnosis and management of malignant pleural effusions: state of the art in 2017

Desai

Lee

2017

J. Thorac. Dis.

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“…In the presence of non-diagnostic cytology, medical thoracoscopic and image-guided pleural biopsies are the preferred diagnostic modalities, as both are characterized by a greater diagnostic sensitivity compared with blind pleural biopsy [3,4]. However, medical thoracoscopy (MT) requires a degree of expertise and is not available in many parts of the world; therefore, image-guided pleural biopsies are the preferred initial diagnostic procedure [4,5]. Recent studies have proposed that image guidance with either ultrasound (US) or computerized tomography (CT) significantly increases the yield of such biopsies and also decreases the risk of complications [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

CT Scan-Guided Abrams' Needle Pleural Biopsy versus Ultrasound-Assisted Cutting Needle Pleural Biopsy for Diagnosis in Patients with Pleural Effusion: A Randomized, Controlled Trial

et al. 2016

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Background: Image-guided pleural biopsies, both using ultrasound (US) or computed tomography (CT), are important in the diagnosis of pleural disease. However, no consensus exists regarding which biopsy needles are appropriate for specific procedures. Objectives: In this randomized, prospective study, we aimed to compare CT scan-guided pleural biopsy using an Abrams' needle (CT-ANPB) with US-assisted pleural biopsy using a cutting needle (US-CNPB) with respect to both diagnostic yield and safety. Methods: Between February 2009 and April 2013, 150 patients with exudative pleural effusion who could not be diagnosed by cytological analysis were included in the study. The patients were randomized into either the US-CNPB group or the CT-ANPB group. The two groups were compared in terms of diagnostic sensitivity and complications. Results: Of the 150 patients enrolled in this study, 45 were diagnosed with malignant mesothelioma, 46 were diagnosed with metastatic pleural disease, 18 were diagnosed with pleural tuberculosis, 34 were diagnosed with benign pleural disease, and 7 were lost to follow-up. In the US-CNPB group, the diagnostic sensitivity was 66.7%, compared with 82.4% in the CT-ANPB group; the difference between the two groups was statistically significant (p = 0.029). The sensitivity of CT-ANPB increased to 93.7% for patients with a pleural thickness ≥1 cm. The complication rates were low and acceptable. Conclusions: The first diagnostic intervention that should be preferred in patients with pleural effusion and associated pleural thickening on a CT scan is CT-ANPB. US-CNPB should be used primarily in cases for which only pleural thickening but no pleural effusion is noted.

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“…Image-guided CPB was initially the domain of specialist radiologists utilising either computed tomography (CT) or ultrasound to identify and sample localised pleural thickening and/or nodularity [99][100][101][102]. More recently though, and with thoracic ultrasound competencies being incorporated into pulmonology training programmes [32][33][34], this technique has been successfully adopted by physicians with a diagnostic yield comparable to that obtained by radiologists [9,103].…”

Section: Medical Thoracoscopy and Closed Pleural Biopsymentioning

confidence: 99%

Advanced medical interventions in pleural disease

et al. 2016

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The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease. @ERSpublications Technological advances and greater availability of techniques give a broad range of interventions for pleural disease http://ow.ly/ZNya2

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Image-guided pleural biopsy: diagnostic yield and complications

Cited by 72 publications

References 24 publications

Diagnosis and management of malignant pleural effusions: state of the art in 2017

Diagnosis and management of malignant pleural effusions: state of the art in 2017

CT Scan-Guided Abrams' Needle Pleural Biopsy versus Ultrasound-Assisted Cutting Needle Pleural Biopsy for Diagnosis in Patients with Pleural Effusion: A Randomized, Controlled Trial

Advanced medical interventions in pleural disease

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