scholarly journals Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Marianne Anastasia De Roza ◽  
Kien Hong Quah ◽  
Cheong Kiat Tay ◽  
Weiquan Toh ◽  
HuiHua Li ◽  
...  
Keyword(s):  
Patient Selection ◽  
Diagnostic Yield ◽  
Case Series ◽  
Flexible Bronchoscopy ◽  
Surgical Biopsy ◽  
Serious Adverse Events ◽  
Ct Guided ◽  
Lung Lesions ◽  
Peripheral Lung ◽  
The Impact

Background. Conventional flexible bronchoscopy has limited sensitivity in the diagnosis of peripheral lung lesions and is dependent on lesion size. However, advancement of CT imaging offers multiplanar reconstruction facilitating enhanced preprocedure planning. This study aims to report efficacy and safety while considering the impact of patient selection and multiplanar CT planning. Method. Prospective case series of patients with peripheral lung lesions suspected of having lung cancer who underwent flexible bronchoscopy (forceps biopsy and lavage). Endobronchial lesions were excluded. Patients with negative results underwent CT-guided transthoracic needle aspiration, surgical biopsy, or clinical-radiological surveillance to establish the final diagnosis. Results. 226 patients were analysed. The diagnostic yield of bronchoscopy was 80.1% (181/226) with a sensitivity of 84.2% and specificity of 100%. In patients with a positive CT-Bronchus sign, the diagnostic yield was 82.4% compared to 72.8% with negative CT-Bronchus sign (p=0.116). Diagnostic yield was 84.9% in lesions > 20 mm and 63.0% in lesions ≤ 20 mm (p=0.001). Six (2.7%) patients had transient hypoxia and 2 (0.9%) had pneumothorax. There were no serious adverse events. Conclusion. Flexible bronchoscopy with appropriate patient selection and preprocedure planning is more efficacious in obtaining a diagnosis in peripheral lung lesions compared to historical data. This trial is registered with ClinicalTrials.gov Identifier: NCT01374542.

scholarly journals Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 1012A
Author(s):  
Jongmin Lee ◽  
Hye Seon Kang ◽  
Wooho Ban ◽  
Sung Bae Cho ◽  
Myung Sook Kim ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Flexible Bronchoscopy ◽  
Lung Lesions ◽  
Peripheral Lung

scholarly journals Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

2017 ◽  
Vol 80 (3) ◽  
pp. 284 ◽  
Author(s):  
Hye Seon Kang ◽  
Jick Hwan Ha ◽  
Hyeon Hui Kang ◽  
Chang Dong Yeo ◽  
Chin Kook Rhee ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Flexible Bronchoscopy ◽  
Lung Lesions ◽  
Peripheral Lung

scholarly journals Diagnostic Yield of Flexible Bronchoscopy Without Fluoroscopic Guidance in Evaluating Peripheral Lung Lesions

2010 ◽  
Vol 17 (4) ◽  
pp. 317-322 ◽  
Author(s):  
Chin Kook Rhee ◽  
Hyun Hui Kang ◽  
Ji Young Kang ◽  
Jin Woo Kim ◽  
Yong Hyun Kim ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Flexible Bronchoscopy ◽  
Fluoroscopic Guidance ◽  
Lung Lesions ◽  
Peripheral Lung

Radial EBUS-Guided Cryobiopsy of Peripheral Lung Lesions With Flexible Bronchoscopy Without Using Guide-Sheath

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Manoj K. Goel ◽  
Ajay Kumar ◽  
Gargi Maitra ◽  
Balkar Singh ◽  
Sunita Ahlawat ◽  
...  
Keyword(s):  
Flexible Bronchoscopy ◽  
Lung Lesions ◽  
Peripheral Lung

Role of Ultrasound-Guided Tru-cut Biopsy in the Diagnosis of Peripheral Lung and Pleural Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Mohamed Wagih ◽  
Nehad Mohammed Osman ◽  
walid Heta ◽  
Fatma El-Zahraa Abdellatif
Keyword(s):  
Diagnostic Yield ◽  
Tube Placement ◽  
Consecutive Series ◽  
University Hospitals ◽  
Transthoracic Needle Biopsy ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
Guided Biopsy ◽  
High Flow Oxygen ◽  
Peripheral Lung

Abstract Background Transthoracic needle biopsy is a well-established technique for diagnosing pulmonary lesions. Computed tomography (CT) is usually used as guidance. Ultrasound (US)-guided biopsy is a relatively affordable modality for diagnosis of peripheral lung lesions (PLLs; also known as peripheral pulmonary lesions [PPLs]) and peripheral pleural lesions. Objectives The purpose of this study was to study the diagnostic yield of US guidance sampling a consecutive series of peripheral lung and pleural lesions and potential factors influencing the diagnostic yield with recording the occurrence of any complications. Patients and Methods This was a prospective study that was conducted at Ain Shams University Hospitals upon a population of 60 patients, during the period from September 2018 to August 2019. A special puncture transducer is used to perform US-guided biopsy with visualization of the biopsy needle and the lesion; facilitating the sampling procedure. Results The use of US-guided transthoracic needle biopsies across 60 patients was shown to have a yield of 75% which found the occurrence of 45 conclusive and 15 non-conclusive results From this study population, 70% (n = 42/45) were found to have malignant manifestations, of which 26 were undifferentiated high grade adenocarcinoma, and 9 were moderately differentiated adenocarcinoma. As for complications arising from the biopsy procedure, twenty percent 20% (n = 12) of patients suffered from complications in the form of hemoptysis in 8 which was controlled by hemostatic measures and 4 patients acquired pneumothorax, three (¾) of them received high flow oxygen and conservative treatment and only one (1/4) patient had intercostal tube placement. Diagnostic yield was significantly increased with the presence of Wedge shaped hypoechoic lesions(p < 0.001), hard Mass consistency was significantly highly associated with conclusive results (p < 0.001), as well as a significant link between the longitudinal diameter of masses that had a mean length of 45.05mm ±12.93mm (#x0003D; 0.029).It also showed that more biopsies taken were highly significant correlation with conclusive outcomes (p < 0.001). Conclusion US-guided biopsy is a robust and accurate procedure to effectively diagnose peripheral lung lesions, with a low incidence of complications and gradually improving results with the mastery of the procedure.

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.

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 CT guided lung biopsy complications: a single centre prospective study

2018 ◽  
Vol 6 (9) ◽  
pp. 2943
Author(s):  
Mohd Farooq Mir ◽  
Muzafar Ahmed Naik ◽  
Javid Ahmed Malik
Keyword(s):  
Prospective Study ◽  
Needle Biopsy ◽  
Lung Biopsy ◽  
Pulmonary Haemorrhage ◽  
Complication Rates ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Peripheral Lung ◽  
Percutaneous Transthoracic Needle Biopsy

Background: Computed tomography (CT) guided percutaneous transthoracic needle biopsy of lung is a routine procedure in patients with suspected malignant lung lesions which are either peripheral or not amenable to biopsy on fibreoptic bronchoscopy.Methods: This prospective study was conducted to obtain complication rates based on patient and physician experience after CT guided lung biopsy of central and peripheral lung lesions.Results: In our study 96 patients were included with 78 patients with peripheral and 18 patients having central lung lesions. The reported post procedural complication rates of CT guided lung biopsy were pulmonary haemorrhage 33.3 %, pneumothorax 21.9%, haemoptysis 15.6%, cough 6.3%, haemothorax 3.1% and fever 3.1%. Two patients required inter costal tube drainage. There was no reported mortality of CT guided lung biopsy in our centre.Conclusions: Pulmonary haemorrhage and pneumothorax are the most common complications of percutaneous transthoracic needle biopsy of the lung, the former one is common with central and the latter one with peripheral lung lesions.

Transoesophageal endobronchial ultrasound-guided needle aspiration (EUS-B-NA) for poorly accessible thoracic lesions: a case series

2020 ◽  
Vol 13 (12) ◽  
pp. e239170
Author(s):  
David Quigley ◽  
Parthiban Nadarajan ◽  
Finbar O Connell
Keyword(s):  
Diagnostic Yield ◽  
Case Series ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
High Likelihood ◽  
Ultrasound Guided ◽  
Upper Airways ◽  
Ct Guided ◽  
Appropriate Treatment ◽  
Ct Guided Biopsy

Endobronchial ultrasound (EBUS) has long been a common diagnostic tool used in the diagnosis of pulmonary pathologies. In the last decade, increased interest has been shown in its usage via the oesophagus for sampling lesions inaccessible via the airways. We describe three cases in which we used this modality to biopsy lesions not visualised via conventional EBUS and which would be too risky to be attempted via a CT-guided biopsy with a high likelihood of complications. More focused education on using EBUS via the oesophagus for respiratory trainees could greatly improve overall clinical practice. It improves the diagnostic yield of lesions and prevents subsequent referral to gastrointestinal colleagues which may delay diagnosis especially during the COVID-19 pandemic as was the case in our patient cohort where services are already limited. EBUS, due to its smaller size, is less irritant to the upper airways and requires less sedation than endoscopic ultrasound (EUS) scopes. It is also shorter than an EUS scope improving manoeuvrability. Each of our cases resulted in early histological diagnosis and subsequent appropriate treatment.

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