Percutaneous Lung Biopsy in a Patient with a Cavitating Lung Mass: Indications, Technique, and Complications

Maher, Michael M.; Kalra, Mannudeep K.; Titton, Ross L.; Boland, Giles W.; Wittram, Conrad; Aquino, Suzanne L.; Müeller, Peter R.; Shepard, Jo-Anne O.

doi:10.2214/ajr.05.0489

Cited by 13 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The advantage of these techniques is the safe insertion of the needle into the lesion; the radiologist can follow the trajectory of the needle until it reaches the target, using only a local anesthetic. The correct placement of the needle into a vital part of the lesion in order to obtain the most complete and accurate pathological diagnosis is one of the aspects that can affect the success of these procedures 4 . In addition, the presence of the ribs and the shoulder blades and the proximity of hilar and mediastinal structures represent a further difficulty to favorably perform a lung biopsy.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System

Grasso

Luppi

Cazzato

et al. 2012

Tumori

View full text Add to dashboard Cite

The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.

show abstract

Section: Introductionmentioning

confidence: 99%

Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System

Grasso

Luppi

Cazzato

et al. 2012

Tumori

View full text Add to dashboard Cite

show abstract

“…3,7,[29][30][31] If biopsy of a cavitary lung nodule is indicated, a recent article describes using a tangential approach to biopsy the cavity wall to maximize the diagnostic yield and to minimize bleeding into the cavity. 12 Ideally, the thickest portion of the wall is targeted. Positioning the patient such that the lesion remains below the level of the left atrium at the time of biopsy, together with a hemostatic valve, has also been posited to reduce SAE risk.…”

Section: Discussionmentioning

confidence: 99%

“…3 In one of the first reported cases of SAE, Westcott claimed in 1973 that one should avoid biopsying cavitary areas of the lung (ie, pulmonary nodules, masses, or consolidation containing air-filled spaces 4 ), following a fatal air embolism after fluoroscopic-guided biopsy of a cavitary pneumonia. 5 Since then, numerous publications have cited biopsy of cavitary lung lesions as a risk factor of SAE, [6][7][8][9][10][11][12] discouraging PTLB of cavitary lesions, which has the potential to cause delays in diagnosis.…”

mentioning

confidence: 99%

Systemic Air Embolism Complicating Computed Tomography–guided Percutaneous Transthoracic Biopsy of Cavitary Lung Lesions

Roberts

Chou

Byrne

et al. 2021

Journal of Thoracic Imaging

View full text Add to dashboard Cite

Purpose: Cavitary lung lesions often pose a diagnostic challenge, and tissue sampling can be required to obtain a confident diagnosis. Many authors contend that a computed tomography-guided percutaneous transthoracic lung biopsy (PTLB) of a cavitary lung lesion places a patient at higher risk for systemic air embolism (SAE) compared with biopsy of a noncavitary lesion. Materials and Methods:We reviewed the literature for studies of SAE complicating PTLB. We searched English-language articles indexed through PubMed, Embase, and Ovid Medline and included articles published up to March 31, 2020Results: We identified 10 case reports of SAE complicating PTLB, and 3 case-cohort studies comparing cavitary and noncavitary lesion biopsy. Among the case-cohort studies reviewed, 4 SAE occurred among 145 biopsies of cavitary lesions (2.7%), and 65 SAE occurred among 3050 biopsies of noncavitary lesions (2.1%). The pooled odds ratio of PTLB complicating SAE of cavitary lesions compared with noncavitary lesions was 1.29 (95% confidence interval: 0.47-3.60). No deaths following SAE after computed tomography-guided PTLB of cavitary lesions were reported in recent literature.Conclusions: On the basis of available evidence, air embolism rates are similar for PTLB of cavitary and noncavitary lesions. Additional research and registry studies are necessary to better understand this topic.

show abstract

“…The latter allows various options for the radiologist. Many radiologists prefer, whenever possible, the supine or prone position to the lateral one as it is generally considered more stable and consistent [52]. A prone or supine position has also been recommended for the prevention of air embolism in the “Guidelines for radiologically guided lung biopsy” of the British Thoracic Society but significantly without any reasonable justification for this [53].…”

Section: Discussionmentioning

confidence: 99%

Influenceable and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique—Case Report, Systematic Literature Review, and a Technical Note

Rott¹,

Boecker²

2014

Radiology Research and Practice

View full text Add to dashboard Cite

Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influenceable or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemostatic valve.

show abstract

Percutaneous Lung Biopsy in a Patient with a Cavitating Lung Mass: Indications, Technique, and Complications

Cited by 13 publications

References 15 publications

Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System

Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System

Systemic Air Embolism Complicating Computed Tomography–guided Percutaneous Transthoracic Biopsy of Cavitary Lung Lesions

Influenceable and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique—Case Report, Systematic Literature Review, and a Technical Note

Contact Info

Product

Resources

About