Practice Pattern of Transthoracic Needle Biopsy: 2016 Survey in the Members of Korean Society of Thoracic Radiology

Abstract

ObjectiveTo assess the current practice patterns of radiologists who perform transthoracic needle biopsy (TNB).Materials and MethodsAn email survey of 71 questions on TNB was sent to 240 members of the Korean Society of Thoracic Radiology. The answers to multiple-choice questions (n = 56) were analyzed.ResultsOf 60 respondents, 45% had 10 or more years of experience in chest radiology, and 70% had 5 or more years of experience in TNB. For the question on the most frequently used diagnostic method for lesions with high probability of being resectable-stage lung cancer, 70% of respondents answered that TNB is initially used, with or without bronchoscopy. In patients at high-risk of TNB-related complications, the proportion of the respondents who consistently declined TNB was only 5%. The number of rebiopsies was said to be increased; molecular analysis for an established target therapy (43.6%) and clinical trial of a new drug (28.2%) were the two most common reasons for it. The most popular needle type was the coaxial cutting needle (55%), and the popular guiding modality was conventional computed tomography (CT) (56.7%). In addition, 15% of respondents have encountered air embolism.ConclusionDespite high variation in how TNB is being performed in Korea, some patterns were noted. It is common for patients with resectable-stage lung cancer to undergo TNB prior to surgery. Rebiopsy is now more common than before, with personalized medicine as the most important reason for it. The most popular type of needle is the coaxial system; the most popular modality for guidance is still CT.

Patterns of percutaneous transthoracic needle biopsy (PTNB) of the lung and risk of PTNB-related severe pneumothorax: A nationwide population-based study

“…The number of repeated biopsies could have partially contributed to the increasing trend. According to a survey of Korean radiologists in 2016, the number of repeated biopsies increased over the past 5 years, and molecular analysis for an established target therapy and clinical trials of new drugs were identified as the main reasons [ 25 ].…”

2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

“…Nevertheless, the 2003 BTS guideline remains the sole guideline dedicated to PTNB. Wide variations in domestic practice patterns of PTNB were reported among surveyed radiologists in Korea ( 7 ), the United States ( 8 ), and the United Kingdom ( 9 ). The lack of an up-to-date guideline for PTNB may be responsible for these variations in practice, potentially hampering the delivery of standardized diagnoses and management of lung cancer.…”

Analysis of indications for pulmonary peripheral lesions diagnosed using radial endobronchial ultrasound‑guided transbronchial lung biopsy

“…Blind bronchoscopic examination has a low success rate ( 12 ), whereas thoracic and thoracoscopic biopsies result in significant trauma in patients ( 13 , 14 ). For percutaneous transthoracic biopsy, although it remains the principal approach for the PPL diagnosis, it is less effective for lesions near the major vessels of the heart and diaphragm, in addition to those distant from the body surface ( 15 , 16 ); importantly, percutaneous transthoracic biopsy is performed through the non-natural lumina, leading to a high incidence of postoperative complications such as pneumothorax and bleeding ( 17 ). Hospitalization is therefore required for all patients undergoing percutaneous transthoracic biopsy, increasing the treatment cost and the use of medical resources ( 18 ).…”