CT fluoroscopy-guided cutting needle biopsy of focal pure ground-glass opacity lung lesions: Diagnostic yield in 83 lesions

PURPOSE: To report the experience of a radiology department in the use of computed tomography - guided cutting needle biopsy of pulmonary nodules, by evaluating diagnostic yield and incidence of complications. METHODS: This is a retrospective analysis of 52 consecutive patients who underwent lung lesion biopsy guided by computed tomography, performed between May 1997 and May 2000. Thirty-five patients were male and 17 were female, with ages ranging from 5 to 85 years (median, 62 years). The size of the lesions ranged from 1.8 to 15 cm (median, 5.4 cm). RESULTS: In a total of 52 biopsies of lung lesions, 51 biopsies (98.1%) supplied appropriate material for histopathological diagnosis, with 9 diagnosed (17.3%) as benign and 42 (80.8%) as malignant lesions. Specific diagnosis was obtained in 44 (84.6%) biopsies: 4 benign (9.1%) and 40 (90.9%) malignant lesions. The sensitivity, specificity, and accuracy of the cutting needle biopsies for determining presence of malignancy were 96.8%, 100%, and 97.2%, respectively. Complications occurred in 9 cases (17.3%), including 6 cases (11.5%) of small pneumothorax, 1 (1.9%) of hemoptysis, 1 (1.9%) of pulmonary hematoma, and 1 (1.9%) of thoracic wall hematoma. All had spontaneous resolution. There were no complications requiring subsequent intervention. CONCLUSION: The high sensitivity and specificity of the method and the low rate of complications have established cutting needle biopsy as an efficient and safe tool for the diagnosis of lung lesions. In our hospital, cutting needle biopsy is considered a reliable procedure for the evaluation of indeterminate pulmonary nodules.

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CT fluoroscopy-guided renal tumour cutting needle biopsy: retrospective evaluation of diagnostic yield, safety, and risk factors for diagnostic failure

European Radiology ◽

10.1007/s00330-017-4969-7 ◽

2017 ◽

Vol 28 (1) ◽

pp. 283-290 ◽

Cited By ~ 4

Author(s):

Toshihiro Iguchi ◽

Takao Hiraki ◽

Yusuke Matsui ◽

Hiroyasu Fujiwara ◽

Jun Sakurai ◽

...

Keyword(s):

Risk Factors ◽

Needle Biopsy ◽

Diagnostic Yield ◽

Renal Tumour ◽

Retrospective Evaluation ◽

Ct Fluoroscopy ◽

Cutting Needle

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CT-Guided Cutting Needle Biopsy of Lung Lesions — Safety and Efficacy of an Out-patient Service

Clinical Radiology ◽

10.1053/crad.2000.0964 ◽

2000 ◽

Vol 55 (12) ◽

pp. 964-969 ◽

Cited By ~ 59

Author(s):

M.J. CHARIG ◽

A.J. PHILLIPS

Keyword(s):

Needle Biopsy ◽

Ct Guided ◽

Safety And Efficacy ◽

Lung Lesions ◽

Patient Service ◽

Cutting Needle

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

Journal of Clinical Medicine ◽

10.3390/jcm8060821 ◽

2019 ◽

Vol 8 (6) ◽

pp. 821 ◽

Cited By ~ 2

Author(s):

June Hong Ahn ◽

Jong Geol Jang

Keyword(s):

Diagnostic Accuracy ◽

Complication Rate ◽

Predictive Value ◽

Needle Biopsy ◽

Diagnostic Yield ◽

Safe Procedure ◽

Transthoracic Needle Biopsy ◽

Ct Guided ◽

Lung Lesions ◽

Percutaneous Transthoracic Needle Biopsy

In the diagnosis of lung lesions, computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) has a high diagnostic yield and a low complication rate. The procedure is usually performed by interventional radiologists, but the diagnostic yield and safety of CT-guided PTNB when performed by pulmonologists have not been evaluated. A retrospective study of 239 patients who underwent CT-guided PTNB at Yeungnam University Hospital between March 2017 and April 2018 was conducted. A pulmonologist performed the procedure using a co-axial technique with a 20-gauge needle. Then diagnostic yield and safety were assessed. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of malignancy were 96.1% (171/178), 100% (46/46), 100% (171/171), and 86.8% (46/53), respectively. The diagnostic accuracy was 96.9% (217/224) and the overall complication rate was 33.1% (82/248). Pneumothorax, hemoptysis, and hemothorax occurred in 27.0% (67/248), 5.2% (13/248), and 0.8% (2/248) of the patients, respectively. Univariate analyses revealed that pneumothorax requiring chest tube insertion was a significant risk factor (odds ratio, 25.0; p < 0.001) for diagnostic failure. CT-guided PTNB is a safe procedure with a high diagnostic accuracy, even when performed by an inexperienced pulmonologist. The results were similar to those achieved by interventional radiologists as reported in previously published studies.

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CT fluoroscopy guided transpleural cutting needle biopsy of small (≤2.5cm) subpleural pulmonary nodules

European Journal of Radiology ◽

10.1016/j.ejrad.2009.07.021 ◽

2011 ◽

Vol 77 (1) ◽

pp. 164-166 ◽

Cited By ~ 4

Author(s):

Helmut Prosch ◽

Elisabeth Oschatz ◽

Edith Eisenhuber ◽

Helmut Wohlschlager ◽

Gerhard H. Mostbeck

Keyword(s):

Needle Biopsy ◽

Pulmonary Nodules ◽

Ct Fluoroscopy ◽

Cutting Needle

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Plasminogen improves lung lesions and hypoxemia in patients with COVID-19

QJM ◽

10.1093/qjmed/hcaa121 ◽

2020 ◽

Vol 113 (8) ◽

pp. 539-545 ◽

Cited By ~ 16

Author(s):

Y Wu ◽

T Wang ◽

C Guo ◽

D Zhang ◽

X Ge ◽

...

Keyword(s):

Oxygen Saturation ◽

Ground Glass Opacity ◽

Ground Glass ◽

Critical Conditions ◽

Lung Lesions ◽

Heart Rates ◽

Freeze Dried ◽

Computed Tomography Scanning ◽

Before And After ◽

The Difference

Abstract Background Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin and ‘ground-glass’ opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection. Aim We aimed to investigate whether plasminogen can improve lung lesions and hypoxemia of COVID-19. Design Thirteen clinically moderate, severe or critical COVID-19 patients were treated with atomization inhalation of freeze-dried plasminogen. Methods Levels of their lung lesions, oxygen saturation and heart rates were compared before and after treatment by computed tomography scanning images and patient monitor. Results After plasminogen inhalation, conditions of lung lesions in five clinically moderate patients have quickly improved, shown as the decreased range and density of ‘ground glass’ opacity. Improvements of oxygen saturation were observed in six clinically severe patients. In the two patients with critical conditions, the oxygen levels have significantly increased from 79–82% to 91% just about 1 h after the first inhalation. In 8 of 13 patients, the heart rates had slowed down. For the five clinically moderate patients, the difference is even statistically significant. Furthermore, a general relief of chest tightness was observed. Conclusion Whereas it is reported that plasminogen is dramatically increased in adults with ARDS, this study suggests that additional plasminogen may be effective and efficient in treating lung lesions and hypoxemia during COVID-19 infections. Although further studies are needed, this study highlights a possible hope of efficiently combating this rapid epidemic emergency.

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Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

Diagnostics ◽

10.3390/diagnostics11050781 ◽

2021 ◽

Vol 11 (5) ◽

pp. 781

Author(s):

Caroline Burgard ◽

Robert Stahl ◽

Giovanna Negrao de Figueiredo ◽

Julien Dinkel ◽

Thomas Liebig ◽

...

Keyword(s):

Core Needle Biopsy ◽

Needle Biopsy ◽

Diagnostic Yield ◽

Lesion Size ◽

Histopathological Diagnosis ◽

Safe Procedure ◽

Ct Fluoroscopy ◽

Mediastinal Tumors ◽

Core Needle ◽

Mediastinal Masses

Purpose: To evaluate technical outcome, diagnostic yield and safety of computed tomographic fluoroscopy-guided percutaneous core needle biopsies in patients with mediastinal masses. Methods: Overall, 155 CT fluoroscopy-guided mediastinal core needle biopsies, performed from March 2010 to June 2020 were included. Size of lesion, size of needle, access path, number of success, number of biopsies per session, diagnostic yield, patient’s position, effective dose, rate of complications, tumor localization, size of tumor and histopathological diagnosis were considered. Post-interventional CT was performed, and patients observed for any complications. Complications were classified per the Society of Interventional Radiology (SIR). Results: 148 patients (age, 54.7 ± 18.2) underwent 155 CT-fluoroscopy-guided percutaneous biopsies with tumors in the anterior (114; 73.5%), middle (17; 11%) and posterior (24; 15.5%) mediastinum, of which 152 (98%) were technically successful. For placement of the biopsy needle, in 82 (52.9%) procedures a parasternal trajectory was chosen, in 36 (23.3%) a paravertebral access, in 20 (12.9%) through the lateral intercostal space and in 17 (11%) the thoracic anterior midline, respectively. A total of 136 (89.5%) of the biopsies were considered adequate for a specific histopathologic analysis. Total DLP (dose-length product) was 575.7 ± 488.8 mGy*cm. Mean lesion size was 6.0 ± 3.3 cm. Neoplastic pathology was diagnosed in 115 (75.7%) biopsies and 35 (23%) biopsy samples showed no evidence of malignancy. Minor complications were observed in 18 (11.6%) procedures and major pneumothorax requiring drainage insertion in 3 interventions (1.9%). Conclusion: CT fluoroscopy-guided percutaneous core needle biopsy of mediastinal masses is an effective and safe procedure for the initial assessment of patients with mediastinal tumors.

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Diagnostic yield of percutaneous computed tomography guided core needle biopsy of lung lesion and its complications in tertiary hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205293 ◽

2020 ◽

Vol 8 (12) ◽

pp. 4223

Author(s):

Prakash Kayastha ◽

Binaya Adhikari ◽

Sundar Suwal ◽

Benu Lohani ◽

Sharma Paudel

Keyword(s):

Computed Tomography ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Lung Biopsy ◽

Diagnostic Yield ◽

Lung Lesion ◽

Ct Guided ◽

Core Needle ◽

Lung Lesions ◽

Image Guided

Background: Early diagnosis of lung cancer can reduce its mortality and morbidity. Minimally invasive image guided percutaneous core needle biopsy can obtain tissue sample for diagnosis and staging of lung cancer, which is crucial for correct management of lung lesions. Common complications of lung biopsy include pneumothorax, parenchymal haemorrhage and haemoptysis. The study was aimed to determine diagnostic yield and complications of the percutaneous computed tomography (CT) guided core needle biopsy of lung lesion in tertiary hospital.Methods: Hospital based prospective study was performed in 40 patients in Tribhuvan University Teaching Hospital. CT guided biopsy of lung lesions was performed with 18-gauge semi-automated biopsy instrument. The complications following the biopsy were recorded and correlated with different factors using chi-square test. Histopathology report were obtained to measure the diagnostic yield.Results: Among 40 patients who underwent guided lung biopsy, histopathology showed definitive diagnosis in 37 patients; 31 malignant and 6 benign lesions. Parenchymal haemorrhage, pneumothorax and haemoptysis were seen in 13, 8 and 5 respectively; however, none required active intervention. Emphysema in traversing lung and numbers of pleural punctures used were predictive factors of complication (p value <0.05).Conclusions: The study showed percutaneous image guided core needle biopsy has high diagnostic yield with fewer complication rates and is thus recommended for routine biopsies of lung lesions.

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Immunological Profiling of COVID-19 Patients with Pulmonary Sequelae

mBio ◽

10.1128/mbio.01599-21 ◽

2021 ◽

Author(s):

Jianghua Wu ◽

Lu Tang ◽

Yanling Ma ◽

Yu Li ◽

Dongmei Zhang ◽

...

Keyword(s):

Immune Responses ◽

Ground Glass Opacity ◽

Host Immunity ◽

Ground Glass ◽

Considerable Proportion ◽

Lung Lesions ◽

Extensive Analysis ◽

The Relationship

A considerable proportion of COVID-19 survivors have residual lung lesions such as ground-glass opacity and fiber streak shadow. To determine the relationship between host immunity and residual lung lesions, we performed an extensive analysis of immune responses in convalescent patients with COVID-19 1 year after discharge.

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