Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

Abstract

OBJECTIVE: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). METHODS: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. RESULTS: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively) CONCLUSIONS: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy.

Impact of preoperative biopsy on tumor spread through air spaces in stage I non-small cell lung cancer: a propensity score-matched study

“…Whether STAS is associated with preoperative invasive manipulation has not been reported. Currently, percutaneous needle biopsy (PNB) and bronchoscopic biopsy (BB) are the most commonly used preoperative biopsy techniques and are widely used in the pathological diagnosis of lung nodules suspected of being lung cancer [14][15][16]. However, there is debate as to whether preoperative biopsy can lead to the spread of lung cancer cells and affect patient prognosis.…”

Chinese expert consensus statement on issues related to small specimen sampling of lung cancer

“…With massive hemoptysis and poor response to medical treatment, interventional embolization should be considered. [ 56 ] Hemostatic tamponade combined with closed thoracic drainage is recommended. In cases with a marked decrease in hemoglobin level, we recommend blood transfusions to correct anemia.…”

“…The recommended treatment is symptomatic and supportive. If necessary, chest infection should be excluded by chest CT.[ 56 ] Air embolism is relatively rare but has a high mortality rate. The operator should take care to avoid the penetration of pulmonary vessels.…”

“…The recommended treatment is symptomatic and supportive. If necessary, chest infection should be excluded by chest CT.[ 56 ]…”

Transthoracic Puncture Biopsy in Diagnostics of Focal Lesions of the Lung

“…Причиной этого является высокий риск возникновения осложнений при наведении иглы и выполнения процедуры без применения рентгенологического контроля, который позволяет улучшить непосредственные результаты использования трансторакальной биопсии. Все чаще появляются публикации по использованию для наведения рентгеновской компьютерной томографии [7,9,11,13,14,25,26].…”