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 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 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 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.

Full core technology versus notch sampling technology: evaluation of the diagnostic accuracy and the risk of a pneumothorax after transthoracic needle biopsy of suspicious lung lesions

2020 ◽  
pp. 028418512098157
Author(s):  
Christophe Schroeder ◽  
Laura I Loebelenz ◽  
Johannes T Heverhagen ◽  
Gerd Noeldge ◽  
Michael P Brönnimann ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Minimal Invasive ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Core Technology ◽  
Significant Difference ◽  
Full Core

Background Percutaneous needle biopsy of the lung (PCBL) under image guidance has become a safe and effective minimal invasive method to obtain a specimen related histological diagnosis of pulmonary lesions. Purpose To evaluate the diagnostic yield and safety of two different coaxial biopsy technologies: full core and notch sampling technology. The former allowing the removal of full punch cylinders and the latter using a cutting-edge mechanism. Material and Methods A retrospective analysis of 48 consecutive PCBL procedures has been carried out for this prognostic study, involving patients with a documented pulmonary nodule or mass lesion on previous computed tomography (CT) scans. The study population included 38 men and 10 women (mean age = 67 years). Of these 48 patients who underwent a procedure with a co-axial cutting system, 24 have been performed with notch sampling technology and 24 with full core technology. Results Out of the 48 biopsy procedures, 46 yielded specimens were adequate for histopathological evaluation, consistent with a technical success rate of 96%. The most common induced image-guided biopsy complication was a pneumothorax, occurring in 14 patients (35%). Seven patients with a pneumothorax were attributed to the full core technology and seven to the notch sampling technology (odds ratio = 1, 95% confidence interval = 0.28–3.51, P = 1). Conclusion In the setting of full core versus notch sampling percutaneous CT-guided coaxial needle biopsy of the lung, no significant difference in the diagnostic accuracy and the incidence of pneumothoraces could be shown, while both technologies have an excellent diagnostic performance.

scholarly journals Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Factors affecting diagnostic yield

2007 ◽  
Vol 112 (8) ◽  
pp. 1142-1159 ◽  
Author(s):  
A. M. Priola ◽  
S. M. Priola ◽  
A. Cataldi ◽  
L. Errico ◽  
M. Di Franco ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions ◽  
Factors Affecting

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.

Accuracy of CT-guided transthoracic needle biopsy of lung lesions: Results of 612 consecutive procedures

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18022-18022
Author(s):  
U. Ricardi ◽  
A. M. Priola ◽  
S. M. Priola ◽  
S. Novello ◽  
A. Cataldi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Inflammatory Cells ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Lesion Size ◽  
Maximum Diameter ◽  
Transthoracic Needle Biopsy ◽  
Ct Guided ◽  
Lung Lesions

18022 Background: CT-guided transthoracic needle biopsy (TNB) is commonly used in diagnostic work-up of lung lesions. The availability of a on-site pathologist at the time of the procedure ameliorate its sensitivity, reduce the number of biopsies and false negatives. Methods: 612 procedures (608 patients with a CT-documented central or peripheral pulmonary lesion) performed at S. Luigi Hospital between November 2002 and August 2005 were prospectively analyzed; 66% males, median age was 66 years (range 29–87). Ineligibility criteria for the procedure included severe coagulopathy, previous contralateral pneumonectomy, lesions with a maximum diameter less than 5 mm or the impossibility to understand the procedure or to maintain the clinostatism for the time of the procedure. The on-site pathologist assigned to each specimen a semiquantitative score: 0 for bloody sample without other cells, 1 for aspecific benign or inflammatory cells, 2 for malignant cells without histotype characterization and 3 for well established benign or malignant histotype. Results: Most of the procedures was performed by fine needle aspiration biopsy, while in a minority of cases a tru-cut biopsy was requested. In 57.2% of the cases a single transthoracic access (range 1–4) was used and in 31% the procedure was repeated on the basis of the radiologist/pathologist judgment. In 154 patients a surgical resection was subsequently performed, while 454 were patients non-surgical. A score of 3 was obtained in 71% of cases (88% malignancies), 2 in 12.5%, 1 in 7.5% and 0 in 9%. A definitive diagnosis was made in 83.5% of procedures, while a score of 0–1 was assigned in 101 cases. Among 458 malignancies there were 411 lung cancer, 7 non-epithelial cancers and 40 metastases with only 1 false positive. The diagnostic accuracy for benign and malignant lesions was 67% and 92%, respectively (Pearson’s test p<0.005) with overall diagnostic accuracy of 83.3%. The variables affecting diagnostic accuracy were final diagnosis (benign 67%, malignant 92%, p<0.001) and lesion size (lesion 5 cm 78%, p<0.05). The presence of cavitation or necrotic areas and location of the lesion didn’t affect the diagnostic accuracy. Conclusion: In consecutive cases of CT-guided TNB final diagnosis and lesion size affect diagnostic accuracy. No significant financial relationships to disclose.

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 &lt; 0.001), hard Mass consistency was significantly highly associated with conclusive results (p &lt; 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 &lt; 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.

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