Ultrasound-guided percutaneous needle biopsy skill for peripheral lung lesions and complications prevention

(1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) examination vs. chest CT (gold standard) in the differentiation between malignant and benign peripheral lung lesions. (2) Methods: A total of 961 consecutive patients with subpleural pulmonary lesions were enrolled. All the patients received a CT scan with contrast; 762 patients underwent TUS-PTNB for suspicion of malignancy, and the remaining 199 enrolled patients underwent only TUS examination as a part of routine follow-up for known non-malignant subpleural consolidations. (3) Results: Among the 762 TUS-guided biopsies, there were 627 (82.28%) malignant lesions, 82 (10.76%) benign lesions, and 53 (6.96%) indeterminate lesions. The overall diagnostic accuracy was 93.04%. The rates of pneumothorax not requiring chest-tube insertion and self-limited hemoptysis were 0.79 and 0.26%, respectively. Patients were divided into two groups based on the benign or malignant nature of the subpleural consolidations. On TUS, both malignant and benign lesions showed mostly irregular margins and a hypoechoic pattern, but no differences were assessed in terms of sonographic margins and pattern between the two groups. There was poor agreement between TUS and chest CT in assessing air bronchograms and necrotic areas. The only finding in the detection of which TUS showed superiority compared to chest-CT was pleural effusion. (4) Conclusions: TUS-PNB was confirmed to be an effective and safe diagnostic method for peripheral pulmonary consolidation, but their sonographic pattern did not allow to rule out a malignant nature. A pre-operative evaluation on CT images, combined with the possibility of performing additional immunohistochemical and cytological investigations and the experience of the medical staff, may improve the diagnostic yield of TUS-guided biopsies.

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Ultrasound-Guided Percutaneous Needle Biopsy for Peripheral Pulmonary Lesions: Diagnostic Accuracy and Influencing Factors

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2018.01.016 ◽

2018 ◽

Vol 44 (5) ◽

pp. 1003-1011 ◽

Cited By ~ 4

Author(s):

Yu-Qing Guo ◽

Xin-Hong Liao ◽

Zhi-Xian Li ◽

Yuan-Yuan Chen ◽

Si-Da Wang ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Influencing Factors ◽

Needle Biopsy ◽

Percutaneous Needle Biopsy ◽

Ultrasound Guided ◽

Pulmonary Lesions ◽

Peripheral Pulmonary Lesions

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Diagnosing paediatric mediastinal lipoblastoma using ultrasound-guided percutaneous needle biopsy

Clinical Imaging ◽

10.1016/s0899-7071(01)00339-4 ◽

2002 ◽

Vol 26 (1) ◽

pp. 23-26 ◽

Cited By ~ 14

Author(s):

A.S.C. Ching ◽

S.F. Lee ◽

Y.L. Chan

Keyword(s):

Needle Biopsy ◽

Percutaneous Needle Biopsy ◽

Ultrasound Guided

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Percutaneous Needle Biopsy of Lung Lesions

CHEST Journal ◽

10.1378/chest.86.6.940 ◽

1984 ◽

Vol 86 (6) ◽

pp. 940-941 ◽

Cited By ~ 2

Author(s):

Eugene L. St. Louis ◽

Robert Hyland ◽

Robin R. Gray ◽

Michael Hutcheon ◽

Donald Jones ◽

...

Keyword(s):

Needle Biopsy ◽

Percutaneous Needle Biopsy ◽

Lung Lesions

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CT guided lung biopsy complications: a single centre prospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183416 ◽

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.

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Comparison of diagnostic yield and safety profile of radial endobronchial ultrasound-guided bronchoscopic lung biopsy with computed tomography-guided percutaneous needle biopsy in evaluation of peripheral pulmonary lesions: A randomized controlled trial

Lung India ◽

10.4103/lungindia.lungindia_208_17 ◽

2018 ◽

Vol 35 (1) ◽

pp. 9 ◽

Cited By ~ 3

Author(s):

JagdishChander Suri ◽

Ayush Gupta ◽

Dipak Bhattacharya ◽

ManasKamal Sen ◽

Shibdas Chakrabarti ◽

...

Keyword(s):

Needle Biopsy ◽

Lung Biopsy ◽

Diagnostic Yield ◽

Controlled Trial ◽

Endobronchial Ultrasound ◽

Percutaneous Needle Biopsy ◽

Ultrasound Guided ◽

Pulmonary Lesions ◽

Randomized Controlled ◽

Peripheral Pulmonary Lesions

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Safety and Diagnostic Yield of Radial Probe Endobronchial Ultrasound-Guided Biopsy for Peripheral Lung Lesions in Patients with Idiopathic Pulmonary Fibrosis: A Multicenter Cross-Sectional Study

Respiration ◽

10.1159/000520034 ◽

2021 ◽

pp. 1-7

Author(s):

Jaemin Lee ◽

Changhwan Kim ◽

Hee Yun Seol ◽

Hyeon Sung Chung ◽

Jeongha Mok ◽

...

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Diagnostic Yield ◽

Usual Interstitial Pneumonia ◽

Endobronchial Ultrasound ◽

Complication Rates ◽

Ultrasound Guided ◽

Cross Sectional ◽

Lung Lesions ◽

Peripheral Lung

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) is widely used for diagnosis of peripheral lung lesions (PLLs). To date, there have been no reports regarding the clinical outcomes of RP-EBUS-TBLB for PLLs in patients with idiopathic pulmonary fibrosis (IPF). Objectives: This study was performed between October 2017 and December 2019 to identify the safety and diagnostic performance of RP-EBUS-TBLB in IPF patients. Methods: Patients were divided into the usual interstitial pneumonia (UIP) group (n = 39, 4%), the probable UIP group (n = 12, 1%), and the noninterstitial lung disease (non-ILD) group (n = 903, 95%). Results: The diagnostic yield was significantly lower in the UIP group than in the non-ILD group (62% vs. 76%; p = 0.042), but there were no significant differences between the UIP and probable UIP groups (62% vs. 83%; p = 0.293) or the probable UIP and non-ILD groups (83% vs. 76%; p = 0.741). Multivariate logistic analysis showed that the mean diameter of PLLs, positive bronchus sign on CT, and “within the lesion” status on EBUS were independently associated with success of the procedure. Especially, the presence of the UIP pattern on CT (OR, 0.385; 95% CI: 0.172–0.863; p = 0.020) was independently associated with failed diagnosis. Among patients with UIP, “within the lesion” status on EBUS (OR, 25.432; 95% CI: 2.321–278.666; p = 0.008) was shown to be a factor contributing to a successful diagnosis. Overall, there were no significant differences in complication rates among the 3 study groups. Conclusion: RP-EBUS-TBLB can be performed safely with an acceptable diagnostic yield, even in patients with IPF.

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