CT-guided Lung Biopsy: Factors Influencing Diagnostic Yield and Complication Rate

2003 ◽  
Vol 58 (10) ◽  
pp. 791-797 ◽  
Author(s):  
J.M Anderson ◽  
J Murchison ◽  
D Patel
Keyword(s):  
Complication Rate ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Ct Guided ◽  
Factors Influencing

scholarly journals Needle Gauge and Cytological Yield in CT-Guided Lung Biopsy

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
William Moore ◽  
Ayman Sawas ◽  
Cindy Lee ◽  
John Ferretti
Keyword(s):  
Complication Rate ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Lung Nodule ◽  
Needle Size ◽  
Ct Guided ◽  
Significant Difference ◽  
Small Gauge ◽  
The Difference ◽  
Number Of Passes

Rationale and Objectives. The aim of this study is to determine the effect of needle size on the diagnostic yield and complication rate of lung nodule biopsy. Materials and Methods. A total of 209 patients are included in a retrospective study. All patients underwent a needle lung biopsy under computer-tomography-guided guidance. Multiple different needle gauges are used in this study. Results. We found no correlation between the gauge of the needle and the incidence of complications or diagnostic yield associated with lung nodule biopsy. However, there was a statistically significant difference in the number of needle passes and the gauge of the needle (). Conclusion. Using a larger gauge needle does not correlate with an increase in complication rate. However, there is a statically significant decrease in the number of needle passes using a larger gauge needle. While the diagnostic yield comparing small gauge needle and large gauge needle was not statistically different, this lack of difference in yield could be related to the difference in number of passes. The use of larger needle is likely to decrease number of passes, thereby resulting in decreased procedure times.

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

2019 ◽  
Vol 8 (6) ◽  
pp. 821 ◽  
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.

Ultra-low-dose CT-guided lung biopsy in clinic: radiation dose, accuracy, image quality, and complication rate

2020 ◽  
pp. 028418512091762
Author(s):  
Ting Liang ◽  
Yonghao Du ◽  
Chenguang Guo ◽  
Yuan Wang ◽  
Jin Shang ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Complication Rate ◽  
Lung Biopsy ◽  
Ct Guided ◽  
Significant Difference ◽  
Group A ◽  
Mode Group ◽  
Dose Accuracy ◽  
Group B

Background Computed tomography (CT)-guided percutaneous lung biopsy is usually performed by helical scanning. However, there are no studies on radiation dose, diagnostic accuracy, image quality, and complications based on axial scan mode. Purpose To determine radiation dose, accuracy, image quality, and complication rate following an ultra-low-dose (ULD) protocol for CT-guided lung biopsy in clinic. Material and Methods A total of 105 patients were enrolled to receive CT-guided lung biopsy. The use of an ULD protocol (axial scan) for CT-guided biopsy was initiated. Patients were randomly assigned to axial mode (Group A) and conventional helical mode (Group B) CT groups. 64-slice CT was performed for CT-guided pulmonary biopsy with an 18-G coaxial cutting biopsy needle. The radiation dose, accuracy, image quality, and complication rate were measured. Results Ninety-seven patients were selected for the final phase of the study. There was no significant difference between the two groups for pulmonary nodule characteristics ( P > 0.05). The mean effective dose in group A (0.077 ± 0.010 mSv) was significantly reduced relative to group B (0.653 ± 0.177 mSv, P < 0.001). There was no significant difference in accuracy, image quality, and complication rate ( P > 0.050) between the two modes. Conclusion An ULD protocol for CT-guided lung nodule biopsy yields a reduction in the radiation dose without significant change in the accuracy, image quality, and complication rate relative to the conventional helical mode scan.

scholarly journals CT-guided percutaneous lung biopsy: Correlation between diagnostic yield, lung lesion size, and lobar distribution

2021 ◽  
Vol 5 ◽  
pp. 14
Author(s):  
Matthew Wilson ◽  
Adib R. Karam ◽  
Grayson L. Baird ◽  
Michael S. Furman ◽  
David J. Grand
Keyword(s):  
Retrospective Study ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Lesion Size ◽  
Lung Lesion ◽  
Target Size ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Significant Difference

Objectives: The aim of this retrospective study was to investigate the relationship between lung lesion lobar distribution, lesion size, and lung biopsy diagnostic yield. Material and Methods: This retrospective study was performed between January 1, 2013, and April 30, 2019, on CT-guided percutaneous transthoracic needle biopsies of 1522 lung lesions, median size 3.65 cm (range: 0.5– 15.5 cm). Lung lesions were localized as follows: upper lobes, right middle lobe and lingual, lower lobes superior segments, and lower lobes basal segments. Biopsies were classified as either diagnostic or non-diagnostic based on final cytology and/or pathology reports. Results were considered diagnostic if malignancy or a specific benign diagnosis was established, whereas atypical cells, non-specific benignity, or insufficient specimen were considered non-diagnostic. Results: The positive predictive value (PPV) of a diagnostic yield was 85%, regardless of lobar distribution. Because all PPVs were relatively high across locations (84–87%), we failed to find statistically significant difference in PPV between locations (P = 0.79). Furthermore, for every 1 cm increase in target size, the odds of a diagnostic yield increased by 1.42-fold or 42% above 85%. Although target size increased the diagnostic yield differently by location (between 1.4- and 1.8-fold across locations), these differences failed to be statistically significant, P = 0.55. Conclusion: Percutaneous transthoracic needle biopsy of lung lesions achieved high diagnostic yield (PPV: 84– 87%) across all lobes. A 42% odds increase in yield was achieved for every 1 cm increase in target size. However, this increase in size failed to be statistically significant between lobes.

scholarly journals Diagnostic yield of CT-guided lung biopsies: how can we limit negative sampling?

2021 ◽  
Author(s):  
Marcello Andrea Tipaldi ◽  
Edoardo Ronconi ◽  
Miltiadis E Krokidis ◽  
Aleksejs Zolovkins ◽  
Gianluigi Orgera ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Imaging Features ◽  
Technical Success ◽  
Ct Guided ◽  
Fdg Uptake ◽  
Increased Risk ◽  
Ct Guided Biopsy ◽  
Lung Biopsies

Objectives: To investigate whether lesion imaging features may condition the outcome of CT-guided Lung Biopsy (CTLB) and to develop a scoring system of biopsy outcome prediction. Methods: This is a single center retrospective study on 319 CTLBs that were performed in 319 patients (167 males/ 152 females, mean age 68 ± 12.2). Uni- and multivariate analysis were performed aiming to assess the imaging features that are likely to be corelated to a negative biopsy outcome and patients were stratified in groups accordingly. Results: Technical success was 100%. 78% of the biopsies (250/319) led to a concrete histology report (218 malignant/ 32 benign). The remaining lesions led to concrete histology at a second attempt that occurred on a later time. Multivariate analysis revealed increased risk of inconclusive result for nodules with low FDG uptake (OR = 2.64, 95% CI 1.4–4.97; p = 0.003), for nodules with diameter smaller than 18 mm (OR = 2.03, 95% CI 1.14–3.62; p = 0.017) and for nodules that are located in one of the lung bases (OR = 1.96, 95% CI 1.06–3.62; p = 0.033). Three different groups of patients were identified accordingly with low (<30%), medium (30–50%) and high (>50%) probability of obtaining an inconclusive biopsy sample. Conclusions: This study confirms that percutaneous CT guided biopsy in nodules that are either small in diameter or present low PET-FDG uptake or are in one of the lung bases may lead to inconclusive histology. This information should be factored when planning percutaneous biopsies of such nodules in terms of patient informed consent and biopsy strategy. Advances in knowledge: Inconclusive histology after lung biopsy may be subject to factors irrelevant to technical success. Lung biopsy histology outcomes may be predicted and avoided after adequate planning

Diagnostic yield, accuracy, and complication rate of CT-guided biopsy for spinal lesions: a systematic review and meta-analysis

2021 ◽  
pp. neurintsurg-2021-017419
Author(s):  
Giorgos D Michalopoulos ◽  
Yagiz Ugur Yolcu ◽  
Abdul Karim Ghaith ◽  
Mohammed Ali Alvi ◽  
Carrie M Carr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Diagnostic Performance ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Ct Guided ◽  
Spinal Lesions ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

BackgroundCT-guided biopsy is a commonly used diagnostic procedure for spinal lesions. This meta-analysis aims to investigate its diagnostic performance and complications, as well as factors influencing outcomes.MethodsA systematic review of the literature was performed to identify studies reporting outcomes of CT-guided biopsies for spinal lesions. Diagnostic yield (ie, the rate of procedures resulting in a specific pathological diagnosis) and diagnostic accuracy (ie, the rate of procedures resulting in the correct diagnosis) were the primary outcomes of interest. Complications following biopsy procedures were also included.ResultsThirty-nine studies with 3917 patients undergoing 4181 procedures were included. Diagnostic yield per procedure was 91% (95% CI 88% to 94%) among 3598 procedures. The most common reason for non-diagnostic biopsies was inadequacy of sample. No difference in diagnostic yield between different locations and between lytic, sclerotic, and mixed lesions was found. Diagnostic yield did not differ between procedures using ≤13G and ≥14G needles. Diagnostic accuracy per procedure was 86% (95% CI 82% to 89%) among 3054 procedures. Diagnostic accuracy among 2426 procedures that yielded a diagnosis was 94% (95% CI 92% to 96%). Complication rate was 1% (95% CI 0.4% to 1.9%) among 3357 procedures. Transient pain and minor hematoma were the most common complications encountered.ConclusionIn our meta-analysis of 39 studies reporting diagnostic performance and complications of CT-guided biopsy, we found a diagnostic yield of 91% and diagnostic accuracy of 86% with a complication rate of 1%. Diagnostic yield did not differ between different locations, between lytic, sclerotic and mixed lesions, and between wide- and thin-bore needles.

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

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.

scholarly journals Optimization of the Lung Biopsy Procedure: A Primer

2021 ◽  
Author(s):  
Dayananda Lingegowda ◽  
Bharat Gupta ◽  
Anisha Gehani ◽  
Saugata Sen ◽  
Priya Ghosh
Keyword(s):  
Patient Safety ◽  
Practice Guidelines ◽  
Diagnostic Tool ◽  
Complication Rate ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
High Diagnostic Yield ◽  
Image Guided ◽  
Management Of Complications ◽  
Lung Biopsies

AbstractImage-guided lung biopsy plays a very important role in the diagnosis and management of lung lesions. As a diagnostic tool, it demands a high diagnostic yield and a low complication rate. It is imperative to balance the diagnostic yield and patient safety during lung biopsies. The aim of this article is to review the standard practice guidelines of lung biopsy, to describe the techniques used to minimize the complications associated with lung biopsy, and to describe the management of complications.

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