scholarly journals 3:27 PM Abstract No. 202 Role of computed tomography–guided biopsies in the era of electromagnetic navigational bronchoscopy: a retrospective study of factors predicting diagnostic yield in electromagnetic navigational bronchoscopy and computed tomography biopsies

2020 ◽  
Vol 31 (3) ◽  
pp. S92-S93
Author(s):  
N. Atkins ◽  
G. Petroski ◽  
A. Bhat
Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.


2021 ◽  
Vol 71 (4) ◽  
pp. 1341-45
Author(s):  
Maryam Hussain ◽  
Sultan Mehmood Kamran ◽  
Rizwan Azam ◽  
Asifullah Khan ◽  
Sohaib Ahmed ◽  
...  

Objective: To determine role of endobronchial washings/biopsy in diagnosis of smear negative pulmonary tuberculosis and evaluate their association with computed tomography findings. Study Design: Cross-sectional - analytical study. Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2020. Methodology: Patients having symptoms of pulmonary tuberculosis and abnormal findings on chest imaging with negative sputum smears for acid fast bacilli were selected for endobronchial washings. Bronchoscopy for washings was carried out in these patients and sample was sent for Acid fast bacilli stain, Mycobacterium tuberculosis gene Xpert and acid fast bacilli culture and sensitivity bacterial culture and fungal hyphae. In case of mass lung endobronchial and/or transbronchial lung biopsy was done and sample was sent for histopathology Active pulmonary tuberculosis was labelled as per definition. Results: Out of 105, 75 (71.4%) were male and 30 (28.6%) were female. Mean age was 55.69 ± 17.33 years. Total 40 (38.09%) were diagnosed with pulmonary tuberculosis (based on smear, genexpert, culture and histopathology). In these 40 patients, computed tomographic findings showed consolidation in 10 (25%) cases, cavity in 7 (17.5%), bronchiectasis in 3 (7.5%), mass in 1 (2.5%), pleural effusion in 2 (5%), lymphadenopathy in 1 (2.5%) and tree-in-budappearance in 12 (30%) cases. Conclusion: High resolution computed tomography and endobronchial washing both combined together increase the diagnostic yield in smear negative cases.


2020 ◽  
Vol 10 ◽  
pp. 33
Author(s):  
Naomi K. Atkins ◽  
Jasraj Marjara ◽  
Jussuf T. Kaifi ◽  
Jeffrey R. Kunin ◽  
Sachin S. Saboo ◽  
...  

Objectives: Over 25% of the high-risk population screened for lung cancer have an abnormal computed tomography (CT) scan. Conventionally, these lesions have been biopsied with CT guidance with a high diagnostic yield. Electromagnetic navigational bronchoscopy (ENB) with transbronchial biopsy has emerged as a technology that improves the diagnostic sensitivity of conventional bronchoscopic biopsy. It has been used to biopsy lung lesions, due to the low risk of pneumothorax. It is, however, a new technology that is expensive and its role in the diagnosis of the solitary pulmonary nodule (SPN) is yet to be determined. The purpose of this study was to evaluate the diagnostic yield of CT-guided biopsy (CTB) following non-diagnostic ENB biopsy and identify characteristics of the lesion that predicts a low diagnostic yield with ENB, to ensure appropriate use of ENB in the evaluation of SPN. Materials and Methods: One hundred and thirty-five lung lesions were biopsied with ENB from January 2017 to August 2019. Biopsies were considered diagnostic if pathology confirmed malignancy or inflammation in the appropriate clinical and imaging setting. We evaluated lesions for several characteristics including size, lobe, and central/peripheral distribution. The diagnostic yield of CTB in patients who failed ENB biopsies was also evaluated. Logistic regression was used to identify factors likely to predict a non-diagnostic ENB biopsy. Result: Overall, ENB biopsies were performed in 135 patients with solitary lung lesions. ENB biopsies were diagnostic in 52% (70/135) of the patients. In 23 patients with solitary lung lesions, CTBs were performed following a non-diagnostic ENB biopsy. The CTBs were diagnostic in 87% of the patients (20/23). ENB biopsies of lesions <21.5 mm were non-diagnostic in 71% of cases (42/59); 14 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% of them were diagnostic (12/14). ENB biopsies of lesions in the lower lobes were non- diagnostic in 59% of cases (35/59); 12 of these patients with non-diagnostic ENB biopsies had CTBs, and 83% were diagnostic (10/12). ENB biopsies of lesions in the outer 2/3 were non-diagnostic in 57% of cases (50/87); 21 of these patients with non-diagnostic ENB biopsies had CTBs, and 86% were diagnostic (18/21). Conclusion: CTBs have a high diagnostic yield even following non-diagnostic ENB biopsies. Lesions <21.5 mm, in the outer 2/3 of the lung, and in the lower lung have the lowest likelihood of a diagnostic yield with ENB biopsies. Although CTBs have a slightly higher pneumothorax rate, these lesions would be more successfully diagnosed with CTB as opposed to ENB biopsy, in the process expediting the diagnosis and saving valuable medical resources.


2020 ◽  
Vol 130 ◽  
pp. 109202 ◽  
Author(s):  
Andrea Leonardi ◽  
Roberto Scipione ◽  
Giulia Alfieri ◽  
Roberta Petrillo ◽  
Miriam Dolciami ◽  
...  

Respiration ◽  
2021 ◽  
pp. 1-8
Author(s):  
James Katsis ◽  
Lance Roller ◽  
Michael Lester ◽  
Joyce Johnson ◽  
Robert Lentz ◽  
...  

<b><i>Background:</i></b> Digital fluoroscopic tomosynthesis-guided electromagnetic navigational bronchoscopy (F-ENB) is a novel adjunct to ENB associated with higher diagnostic yield. The likelihood of F-ENB allowing accurate placement of a biopsy needle within a target remains unclear. <b><i>Objective:</i></b> This study intends to determine the accuracy of F-ENB as confirmed by cone-beam computed tomography (CBCT) scan. <b><i>Methods:</i></b> Patients undergoing CBCT-assisted ENB for lung nodule biopsy were prospectively enrolled. ENB was performed followed by digital tomosynthesis correction. Once optimal F-ENB alignment was achieved, and a needle was advanced into the expected location of the nodule followed by CBCT. The primary outcome was the percentage of “needle-in-lesion” hits, defined as needle tip within the nodule in 3 planes. Secondary outcomes were diagnostic yield, procedure and room time, complications, radiation, and distance between the needle tip and nodule. <b><i>Results:</i></b> Twenty-six patients with a total of 29 nodules were enrolled. Mean nodule size was 13 mm (±4 mm) in maximal axial dimension, 83% (<i>n</i> = 24) were located in the peripheral third of the chest, and 17% (<i>n</i> = 5) had a bronchus sign. F-ENB guidance resulted in needle-in-lesion in 21 of 29 nodules (72%). Mean needle tip-to-nodule distance for nonhits was 1.75 mm (±1.35 mm). There were no complications. <b><i>Conclusion:</i></b> F-ENB resulted in a needle-in-lesion biopsy in greater than 70% of nodules despite features traditionally associated with poor diagnostic yield (size, absence of bronchus sign). Mean distance between needle tip and target for nonhits was less than 2 mm. These data suggest F-ENB alignment is accurate for small peripheral nodules.


2008 ◽  
Vol 149 (23) ◽  
pp. 1059-1065 ◽  
Author(s):  
Szabolcs Halász ◽  
Tamás Puskás

A többszeletes spirál-CT-berendezések széles körű alkalmazása és a perfúziós szoftverek bevezetése lehetővé tette az agyi véráramlás CT-vizsgálatát. Cél és módszerek: A szerzők ismertetik az agyi perfúziós CT-vizsgálatok elvét, technikáját, amelyet az elmúlt másfél évben 96 betegükön végzett vizsgálatuk tapasztalataival egészítenek ki. A folyamatos technikai fejlődés eredményeként a közeljövőben lehetővé válik a teljes agy perfúziós CT-vizsgálata. Következtetések: Az agy perfúziós CT-vizsgálata gyors, viszonylag olcsó és a stroke kórismézésében pontos diagnózist eredményez.


Sign in / Sign up

Export Citation Format

Share Document