CT-guided transthoracic needle biopsy of pulmonary lesions: comparison between the cutting needle and aspiration needle

Zhenguo, Huang; Sun, Hongzan; Wang, Cun-Li; Gao, Bao-xiang; Chen, He; Yang, Ming; Chen, Xiaoliang

doi:10.1259/bjr.20190930

“…In this study, univariate and multivariate analyses were conducted on the risk factors for pneumothorax and pulmonary hemorrhage, and it was found that needle tract length ≤ 50 mm, lateral position, and the distance of puncture needle passing through lung tissue ≥ 14 mm were independent risk factors for pneumothorax after puncture in patients with pulmonary nodules. The results of this study suggest that when the puncture needle tract is ≤50 mm, the risk of pneumothorax increases, which is contrary to the results of previous studies [ 24 , 25 ]. The reason may be that the shorter the puncture needle tract, the gas in the lung will pass through the needle in a short time, thus causing pneumothorax.…”

Section: Discussioncontrasting

confidence: 99%

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Liu

¹

,

Xiao

²

,

Xu

³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This study is aimed at investigating the efficacy and safety of multislice spiral CT-guided transthoracic lung biopsy in the diagnosis of pulmonary nodules of different sizes. Methods. Data of 78 patients with pulmonary nodules who underwent CT-guided transthoracic lung biopsy in our hospital from January 2020 to December 2021 were retrospectively analyzed, and they were divided into the small nodules group ( n = 12 ), medium nodules group ( n = 35 ), and large nodules group ( n = 31 ) according to the diameter of pulmonary nodules. The results of puncture biopsy and final diagnosis of pulmonary nodules of different sizes were compared. The incidence of complications in patients with pulmonary nodules of different sizes was compared. Univariate analysis was used to compare the incidence of complications in 78 patients. Logistic multiple regression analysis was used to analyze the independent risk factors of pneumothorax in patients with pulmonary nodule puncture. Logistic multiple regression analysis was used to analyze the independent risk factors of pulmonary hemorrhage in patients with pulmonary nodule puncture. Results. The diagnostic accuracy, sensitivity, and specificity were 83.33%, 100.00%, and 77.78% in small nodules group. The diagnostic accuracy, sensitivity, and specificity of medium nodules group were 85.71%, 100.00%, and 73.68%, respectively. The diagnostic accuracy, sensitivity, and specificity of large nodules group were 93.55%, 100.00%, and 33.33%, respectively. There was no significant difference in the incidence of pneumothorax among the three groups ( P > 0.05 ). The incidence of pulmonary hemorrhage in small nodule group was higher than that in the medium nodule group and large nodule group, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in the incidence of total complications among the three groups ( P > 0.05 ). There were statistically significant differences in clinical data such as the needle tract length, the puncture position, and the distance of the puncture needle passing through the lung tissue in patients with or without pneumothorax ( P < 0.05 ). There were statistically significant differences in needle tract length, distance of puncture needle passing through lung tissue, and size of pulmonary nodules in patients with or without pulmonary hemorrhage ( P > 0.05 ). Logistic multivariate analysis showed that needle tract length ≤ 50 mm , lateral decubitus position, and the distance of puncture needle passing through lung tissue ≥ 14 mm were independent risk factors for pneumothorax after puncture in patients with pulmonary nodules ( P < 0.05 ). The needle tract length > 50 mm , the distance of puncture needle passing through lung tissue ≥ 14 mm , and small nodules (pulmonary nodules diameter ≤ 10 mm ) were independent risk factors for pulmonary hemorrhage after puncture in patients with pulmonary nodules ( P < 0.05 ). Conclusion. Multislice spiral CT-guided transthoracic lung biopsy is effective in diagnosing pulmonary nodules of different sizes.

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“…The CT-guided biopsy method was consisted with our previous studies. [ 15 , 16 ] The severity of procedural complications was evaluated according to the Society of Interventional Radiology Standards of Practice Committee classification of complications [ 17 ], and procedure duration (defined as the interval time between the initial scout image and the end of the final CT scan) was also recorded. In addition, a repeat biopsy was considered when the patient’s clinical condition was obviously inconsistent with initial biopsy results (two patients) or when chemotherapy or targeted therapy regimens need to be adjusted (twenty patients).…”

Section: Methodsmentioning

confidence: 99%

Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Lin

¹

,

Xu

²

,

J

³

et al. 2022

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Objective The purpose of this study was to evaluate the usefulness of intraprocedural CT and prior PET/CT fusion imaging in improving the diagnostic yield of CT-guided transthoracic core-needle biopsy (CNB) in lung masses. Methods In total, 145 subjects with lung masses suspicious for malignancy underwent image-guided transthoracic CNB. According to imaging modality the subjects were divided into two groups. PET/CT images obtained no more than 14 days before the biopsy were integrated with intraprocedural CT images. The integrated or fused images were then used to plan the puncture sites. The clinical characteristics, diagnostic yield of CNB, diagnostic accuracy rate, procedure-related complications and procedure duration were recorded and compared between the two groups. Final clinical diagnosis was determined by surgical pathology or at least 6-months follow-up. The diagnostic accuracy of CNB was obtained by comparing with final clinical diagnosis. Results 145 subjects underwent CNB with adequate samples, including 76 in fusion imaging group and 69 in routine group. The overall diagnostic yield and diagnostic accuracy rate were 80.3% (53/66), 82.9% (63/76) for fusion imaging group, 70.7% (41/58), 75.4% (52/69) for routine group, respectively. In addition, the diagnostic yield for malignancy in fusion imaging group (98.1%, 52/53) was higher than that in routine group (81.3%, 39/48). No serious procedure-related complications occurred in both two groups. Conclusion CNB with prior PET/CT fusion imaging is particularly helpful in improving diagnostic yield and accurate rate of biopsy in lung masses, especially in heterogeneous ones, thus providing greater potential benefit for patients.

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“…(2) avoiding the heart and the large blood vessels; (3) avoiding pulmonary bullae and emphysematous region; (4) perpendicular to the pleura as much as possible; (5) the distance of traversing the lung tissues should be as short as possible; (6) away from the interlobar fissure as much as possible [8].…”

Section: Ptcnb Proceduresmentioning

confidence: 99%

Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation

Wang

¹

,

Zhang

²

,

Xu

³

et al. 2023

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Background Diagnosing persistent pulmonary consolidation still faces challenges. The purpose of this study is to compare the diagnostic yield and the complication rate between percutaneous transthoracic CT-guided coaxial needle biopsy (PTCNB) and transbronchial lung biopsy (TBLB) of persistent pulmonary consolidation. Materials From January 1, 2016, to December 31, 2020, we have retrospectively enrolled a total of 155 consecutive patients (95 males, 60 females) with persistent pulmonary consolidation who underwent both TBLB and PTCNB. According to the standard reference, the diagnostic yield, accuracy, sensitivity and specificity of PTCNB and TBLB were assessed and compared. Results According to the standard reference, the final biopsy diagnoses of 11 cases were confirmed true malignant based on the surgical resections, the remaining were confirmed by clinical and imaging follow-up for at least 12 months. The overall diagnostic accuracy, sensitivity and specificity of PTCNB for malignant diagnosis were 91.61%, 72.34% and 100%, whereas of TBLB were 87.74%, 59.57% and 100%. The diagnostic yield of PTCNB and TBLB were 50.32% and 25.16%, respectively. For the TBLB-based negative cases, PTCNB provided a definite diagnostic yield of 37.93%. There were 45 (29.03%), 22 (14.19%) and 13 (8.39%) patients who experienced pneumothorax, intrapulmonary hemorrhage and hemoptysis, respectively, in PTCNB, while there were only 5 (3.22%) cases of mild intraprocedural bleeding occurring in TBLB. Conclusions CT-guided co-axial needle biopsy is an effective and safe modality, associated with higher diagnostic yield and better diagnostic accuracy compared to transbronchial lung biopsy for malignancy presenting as persistent consolidation, especially as the complementary method for TBLB-based negative lung lesions. Key Points Both PTCNB and TBLB showed high diagnostic accuracy for malignancy. PTCNB had a higher diagnostic yield than TBLB for persistent pulmonary consolidation. PTCNB could provide a complementary diagnosis for TBLB-based negative lung consolidation.

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CT-guided transthoracic needle biopsy of pulmonary lesions: comparison between the cutting needle and aspiration needle

Cited by 8 publications

References 26 publications

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Efficacy and Safety Analysis of Multislice Spiral CT-Guided Transthoracic Lung Biopsy in the Diagnosis of Pulmonary Nodules of Different Sizes

Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation

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