Interventional radiology of pleural diseases

Matin, Tahreema; Gleeson, Fergus

doi:10.1111/j.1440-1843.2011.01948.x

Cited by 14 publications

(19 citation statements)

References 131 publications

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“…It is believed that the choice between US and CT guidance is often influenced by factors such as individual preference, expertise, appliance availability, and cost [8,20]. These results suggest that both methods offer certain advantages.…”

Section: Discussionmentioning

confidence: 62%

“…We performed a prospective study comparing the safety and efficacy of CT scan-guided Abrams' needle pleural biopsy (CT-ANPB) and MT and observed that the two methods did not differ significantly with respect to both diagnostic sensitivity and complication rates [6]. US-assisted pleural biopsy performed using Tru-Cut needles (US-CNPB) has also been utilized frequently [7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Discussionmentioning

confidence: 62%

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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“…The risk of complications is lower than with blind biopsy. 2,4,16,20 Although complications were not the primary focus of this study, serious complications, such as hemothorax or laceration of the spleen or kidney, did not occur in either group. The percentage of pneumothorax was higher in the ultrasound group, which might be in relation to the greater percentage of subjects with pleural effusion less than two thirds on chest radiograph.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Ultrasound-Assisted Selection for Pleural Biopsy With Abrams Needle

Botana-Rial¹,

Leiro-Fernández²,

Represas-Represas³

et al. 2013

Respir Care

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BACKGROUND: Closed pleural biopsy (CPB) in patients with malignant pleural effusion is less sensitive than cytology. Ultrasound-assisted CPB allows biopsies to be performed in the lower thoracic parietal pleura, where secondary spread from pleural metastases is initially more likely to be found. We analyzed whether choosing the point of entry for CPB with thoracic ultrasound assistance influences the diagnostic yield in malignant pleural effusion. METHODS: This prospective study included patients who underwent CPB performed by an experienced pulmonologist in 2008 -2010 (group A) and thoracic ultrasound was used to select the biopsy site. The results were compared with a historical series of CPB performed by the same pulmonologist without the assistance of thoracic ultrasound (group B). An Abrams needle was used in all cases. We analyzed the obtaining of pleural tissue and the diagnostic yield. RESULTS: We included 114 CPBs from group A (23% tuberculous pleural effusion, 27% malignant pleural effusion) and 67 CPBs from group B (24% tuberculous pleural effusion, 30% malignant pleural effusion) (P ‫؍‬ .70). Pleural tissue was obtained in 96.5% of the group A CPBs and 89.6% of the group B CPBs (P ‫؍‬ .05). The diagnostic yields of CPB for tuberculous pleural effusion and malignant pleural effusion in group A were 89.5% and 77.4%, respectively, and 91.7% and 60%, respectively, in group B (P ‫؍‬ .80 for tuberculous pleural effusion, and P ‫؍‬ .18 for malignant pleural effusion). CONCLUSIONS: Selecting the point of entry for CPB using thoracic ultrasound increases the likelihood of obtaining pleural tissue and the diagnostic yield, but without statistical significance. We recommend ultrasound-assisted CPB to investigate pleural effusion, since the diagnostic yield of a pleural biopsy with an Abrams needle increased by > 17% in subjects with malignant pleural effusion.

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“…Success with US-guided thoracentesis can be as high as 97%, while the incidence of pneumothorax is around 3%. 71 However, US may not reduce the incidence of intercostal vessel lacerations as vascular structures are often not identified sonographically, especially when they run medial to the angle of the rib. Advanced age and the performance of pleural procedures less than 7 cm from the spinous processes of thoracic vertebrae are risk factors for intercostal artery injury.…”

Section: Bronchoscopic Intervention and Imagingmentioning

confidence: 99%

“…Advanced age and the performance of pleural procedures less than 7 cm from the spinous processes of thoracic vertebrae are risk factors for intercostal artery injury. 71 Treatment for this complication is exploratory thoracotomy or, in poor surgical candidates, transcatheter arterial embolization using coils and polyvinyl alcohol particles. Radiofrequency ablation is a minimally invasive treatment for lung cancer in nonsurgical candidates and a palliative measure for intractable pain.…”

Section: Bronchoscopic Intervention and Imagingmentioning

confidence: 99%