Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

Ahn, Jae‐Jun; Jang, Jong Geol

doi:10.3390/jcm8060821

“…However, there are also some complications after percutaneous lung biopsy and the COPD patients should be paid more attention to the risk of pneumothorax. Previous literature reported that incidence rates of pneumothorax were 12.0%‐45.0% and 2%‐15.0% of chest tube placement rate to cope with pneumothorax 11,22‐24 . In our study, the incidence of pneumothorax after percutaneous pulmonary puncture in the total population was 21.5% and that of pneumothorax requiring closed drainage was about 3.2%, which was accepted.…”

Section: Discussionsupporting

confidence: 62%

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Zhou

¹

,

Wang

²

,

Wei

³

et al. 2020

Clinical Respiratory J

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Background The feasibility of pneumothorax following low‐dose CT‐guided puncture lung biopsy in different severities of COPD has not been reported. Methods The data of the patients with pulmonary lesion who underwent low‐dose CT‐guided lung biopsy by one experienced operator in our hospital from January 1st to September 30th in 2019 were retrospectively collected. They were divided into COPD group and non‐COPD group. The risk factors, incidence and severity of pneumothorax with the severity of COPD and changes in MMRC score, treatment way and discharge time after pneumothorax were assessed. Results Two hundred and nineteen patients were retrospectively enrolled in this study with 64 in the COPD group and 155 in the non‐COPD group. The average age, MMRC score and the incidence of pneumothorax after biopsy were significantly higher in the COPD group (64.7 ± 1.27 years, 1.02 ± 0.13, 31.3%) than in the non‐COPD group (58.8 ± 1.16 years, 0.35 ± 0.06, 17.4%, P < 0.05). The incidence of pneumothorax between I‐II and III‐IV in COPD did not reach the significant difference (P = 0.863). COPD was the only independent risk factor for pneumothorax after biopsy in a multivariable regression (P < 0.05). MMRC score was significantly increased at post‐pneumothorax in the two groups (P < 0.001). There was no significant difference in diagnostic rate, severity of pneumothorax, the proportion of delayed pneumothorax, the changes in treatment way and discharge time between the two groups (P > 0.05). Conclusion Although the incidence of pneumothorax after low dose CT‐guided lung biopsy is increased in COPD, there was no difference in the severity of pneumothorax amongst the different severities of COPD and it is well‐tolerated without increasing medical burden.

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“…However, the use of ROSE in this process can provide real-time guidance, improve diagnostic accuracy, reduce the risk of operation, and avoid unnecessary harm. ROSE should be applied to CT-guided FNA [11,[13][14][15][16][17][18][19]. Some studies indicate that the success of ROSE requires an experienced and united team; otherwise, more time will be wasted [15,20,21].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Rapid On‐Site Evaluation for CT‐Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions

Peng

¹

,

Ren

²

,

Wang

³

et al. 2020

BioMed Research International

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Objective. Rapid on-site evaluation (ROSE) is an effective and efficient auxiliary examination, but its value for CT-guided percutaneous fine-needle aspiration (FNA) in the diagnosis of pulmonary occupying lesions is unclear. This study is aimed at evaluating the clinical utility of ROSE for CT-guided percutaneous FNA. Methods. We reviewed 234 patients from September 2018 to April 2019. The result using ROSE was compared with the final pathological diagnosis of CT-guided percutaneous FNA, and we also compared the complications between the ROSE group and the NO-ROSE group. The final pathological diagnosis results served as the gold standard. We also analyzed the diagnostic rate of FNA and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of malignancy. The correlation between diverse pathological types of lung cancer was also taken into consideration. Results. In total, 132 patients underwent CT-guided percutaneous FNA with ROSE (ROSE group), and 102 did not (NO-ROSE group). The diagnostic rate, sensitivity, specificity, PPV, and NPV of the ROSE group were 91.6%, 89.1%, 94.1%, 93.4%, and 90.1%, respectively. The complication rates of the ROSE group and the NO-ROSE group were 8.33% and 16.67%, respectively. This difference was not statistically significant ( P > 0.05 ). In subsets of adenocarcinoma (AC) and small cell lung cancer (SCLC) patients, the ROSE result was highly consistent with the final pathological result. Conclusion. CT-guided percutaneous FNA combined with ROSE has a high diagnostic rate, sensitivity, and specificity for pulmonary occupying lesions and an acceptable rate of complications. This method is worthy of wide use given its high efficiency and safety.

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“…In addition, CT scan has good contrast and resolution, which can clearly display the morphology, size, and adjacent important structure of lesions and can display small lesions beside the mediastinum, behind the heart shadow, and beside the spine [ 15 , 16 ]. It has been reported that the accuracy of CT-guided lung biopsy in the diagnosis of benign lesions is >80% and that of malignant lesions is >90% [ 17 ]. In this study, the diagnostic efficiency of multislice spiral CT for pulmonary nodules of different sizes was observed.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Liu

¹

,

Xiao

²

,

Xu

³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This study is aimed at investigating the efficacy and safety of multislice spiral CT-guided transthoracic lung biopsy in the diagnosis of pulmonary nodules of different sizes. Methods. Data of 78 patients with pulmonary nodules who underwent CT-guided transthoracic lung biopsy in our hospital from January 2020 to December 2021 were retrospectively analyzed, and they were divided into the small nodules group ( n = 12 ), medium nodules group ( n = 35 ), and large nodules group ( n = 31 ) according to the diameter of pulmonary nodules. The results of puncture biopsy and final diagnosis of pulmonary nodules of different sizes were compared. The incidence of complications in patients with pulmonary nodules of different sizes was compared. Univariate analysis was used to compare the incidence of complications in 78 patients. Logistic multiple regression analysis was used to analyze the independent risk factors of pneumothorax in patients with pulmonary nodule puncture. Logistic multiple regression analysis was used to analyze the independent risk factors of pulmonary hemorrhage in patients with pulmonary nodule puncture. Results. The diagnostic accuracy, sensitivity, and specificity were 83.33%, 100.00%, and 77.78% in small nodules group. The diagnostic accuracy, sensitivity, and specificity of medium nodules group were 85.71%, 100.00%, and 73.68%, respectively. The diagnostic accuracy, sensitivity, and specificity of large nodules group were 93.55%, 100.00%, and 33.33%, respectively. There was no significant difference in the incidence of pneumothorax among the three groups ( P > 0.05 ). The incidence of pulmonary hemorrhage in small nodule group was higher than that in the medium nodule group and large nodule group, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in the incidence of total complications among the three groups ( P > 0.05 ). There were statistically significant differences in clinical data such as the needle tract length, the puncture position, and the distance of the puncture needle passing through the lung tissue in patients with or without pneumothorax ( P < 0.05 ). There were statistically significant differences in needle tract length, distance of puncture needle passing through lung tissue, and size of pulmonary nodules in patients with or without pulmonary hemorrhage ( P > 0.05 ). Logistic multivariate analysis showed that needle tract length ≤ 50 mm , lateral decubitus position, and the distance of puncture needle passing through lung tissue ≥ 14 mm were independent risk factors for pneumothorax after puncture in patients with pulmonary nodules ( P < 0.05 ). The needle tract length > 50 mm , the distance of puncture needle passing through lung tissue ≥ 14 mm , and small nodules (pulmonary nodules diameter ≤ 10 mm ) were independent risk factors for pulmonary hemorrhage after puncture in patients with pulmonary nodules ( P < 0.05 ). Conclusion. Multislice spiral CT-guided transthoracic lung biopsy is effective in diagnosing pulmonary nodules of different sizes.

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Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist

Cited by 9 publications

References 32 publications

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Diagnostic Value of Rapid On‐Site Evaluation for CT‐Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

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