Computed tomography–guided lung biopsy: a randomized controlled trial of low-dose versus standard-dose protocol

Fu, Yu‐Fei; Li, Guangchao; Xu, Qingsong; Shi, Yibing; Wang, Chen; Wang, Tao

doi:10.1007/s00330-019-06464-6

Cited by 30 publications

(58 citation statements)

References 27 publications

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“…We demonstrated comparable diagnostic yield, sensitivity, and overall accuracy of diagnosis between the LDCT and SDCT groups. These comparative results are in consistent with previous studies regarding LDCT-guided biopsy [4][5][6][7][8]. Moreover, the overall accuracy in diagnosis and sensitivity in both groups are also comparable to those in many previous studies regarding CT-guided LN biopsy [1,2,6].…”

Section: Discussionsupporting

confidence: 91%

“…In this study, we compared the feasibility, diagnostic performance, and radiation exposure between LDCT-guided and SDCT-guided CNB for LNs. Compared to the previous studies regarding LDCT-guided CNB for all lung lesions [ 4 , 5 , 7 , 8 ], this study only focused on LNs.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, low-dose CT (LDCT)-guided lung biopsy has gained popularity due to its reduced intra-operative radiation exposure [4][5][6][7][8]. However, most of the studies on LDCT-guided CNB included both lung masses and LNs.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols

Huang

Cheng

Li³

2021

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Introduction: Computed tomography (CT)-guided core needle biopsy (CNB) is an essential step in the management of lung nodules (LNs). Low-dose CT (LDCT)-guided CNB has been used to decrease the radiation exposure. Aim: To evaluate the technical success, safety, diagnostic capacity, and radiation exposure to patients between LDCT-guided and standard-dose CT (SDCT)-guided CNB for LNs. Methods: This is a retrospective, single-centre study. Patients who underwent LDCT-guided or SDCT-guided CNB for LNs from January 2015 to December 2017 were included. Data on technical success, diagnostic performance, complications, and radiation exposure were collected and analysed. Results: A total of 70 and 65 patients underwent LDCT-guided and SDCT-guided CNB procedure, respectively. The technical success rates were 100% in both groups. The diagnostic yield, sensitivity, specificity, and overall diagnostic accuracy in the LDCT and SDCT groups were 71.4% and 67.7% (p = 0.637), 97.8% and 93.2% (p = 0.625), 100%, and 100%, and 98.6% and 95.4% (p = 0.560), respectively. The independent risk factor of diagnostic failure was less sample tissues (p = 0.012; 95% confidence interval: 0.033-0.651). Pneumothorax was found in 9 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.369). Lung haemorrhage was found in 11 and 12 patients in the LDCT and SDCT groups, respectively (p = 0.671). The mean dose-length product was 38.3 ±17.0 mGy • cm and 376.0 ±118.7 mGy • cm in the LDCT and SDCT groups, respectively (p < 0.001). Conclusions: Compared to SDCT, LDCT-guided CNB can provide comparable safety and diagnostic performance for LNs while reducing exposure to radiation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols

Huang

Cheng

Li³

2021

wiitm

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“…Although most of PNs can be regularly followed up by CT according to the Fleischner Society or Lung-RADS guidelines [6,7], many intermediate or high risk PNs should be managed actively. Currently, lung biopsy or video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) are widely used to diagnose the PNs [8][9][10]. Although lung biopsy is a minimally invasive procedure that requires only local anaesthesia, it is associated with a diagnostic failure rate of around 10% [11].…”

Section: Introductionmentioning

confidence: 99%

Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study

Zhang

Chen

et al. 2021

J Cardiothorac Surg

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Background Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs. Materials and methods From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Of these patients, 14 had SBPNs and underwent the TSCL procedure. Results A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4 ± 2.4 mm. The technical success rate of the scapula puncture was 100%. No complications occurred near the scapula. The technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2 ± 2.7 min. Two patients (14.3%) developed asymptomatic pneumothorax after TSCL. The technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean duration of the VATS was 90.0 ± 42.4 min and the mean blood loss was 62.9 ± 37.2 ml. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign disease (n = 1). Conclusions Preoperative CT-guided TSCL is a safe and simple procedure that can facilitate high success rates of VATS-guided WR of SBPNs.

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“…CT-guided percutaneous needle biopsy for PPLs has been commonly performed in clinical practice. However, in addition to radiation exposure, it could not access real-time monitoring [13]. Besides, previous studies reported that the rate of post-procedure complications was high, including pneumothorax, hemorrhage and vasovagal reaction, which lengthened the period of hospitalization [14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ultrasound-guided Percutaneous Transthoracic Needle Biopsy for Peripheral Pulmonary Lesions: Comparison Between 16-gauge and 18-gauge Core Biopsy Needle- a Propensity Score Matching Analysis

Huang¹,

Ye²,

Qiu³

et al. 2020

Preprint

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Background: Definitive diagnosis of peripheral pulmonary lesions (PPLs) depends upon histologic proof obtained via pleural biopsy. Ultrasound-guided sampling is now standard practice. How to determine a suitable needle size and sampling times to improve efficacy and safety remained challenging. This study aimed to compare the efficacy for histology diagnosis and the resulting complications between 16-gauge and 18-gauge core biopsy needle in ultrasound-guided percutaneous transthoracic biopsy for PPLs.Materials and Methods:1169 patients (767 men, 402 women; mean age, 59.4±13.2 years) who received biopsy for PPLs between September2011 and February 2019 were included. Propensity score matching (PSM) analysis was performed to adjust the baseline differences, and the rate of successful specimen assessment and complications were compared between 16-gauge (249 patients) and 18-gauge (920 patients) group. The number of pleural surfaces crossed (NOPSC) was defined as the times visceral pleural surface was transgressed. Stratified analysis was made based on NOPSC.Results: The overall success rate was 92.0% (1076/1169). The overall complication rate was 9.6%, including pneumothorax, hemorrhage and vasovagal reaction, which occurred in 2.5% (29/1169), 6.6% (77/1169), and 0.5% (6/1169) of patients, respectively. When NOPSC was one, the success rate and complication rate in 16-gauge group were comparable to that of 18-gauge group (both P>0.05). When NOPSC was two, the success rate in 16-gauge group was significantly higher than that of 18-gauge group (P=0.017), while the complication rate was comparable (P>0.05). When NOPSC was more than two, the rate of vasovagal reaction was significantly higher in 16-gauge group than that of 18-gauge group (P=0.012).Conclusion: Higher success rate could be achieved using 16-gauge than 18-gauge core biopsy needle in ultrasound-guided percutaneous transthoracic needle biopsy for PPLs when NOPSC was two. However, the rate of vasovagal reaction would be increased by using 16-gauge needle when NOPSC was more than two.

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Computed tomography–guided lung biopsy: a randomized controlled trial of low-dose versus standard-dose protocol

Cited by 30 publications

References 27 publications

Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols

Computed tomography-guided core needle biopsy for lung nodules: low-dose versus standard-dose protocols

Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study

Efficacy and Safety of Ultrasound-guided Percutaneous Transthoracic Needle Biopsy for Peripheral Pulmonary Lesions: Comparison Between 16-gauge and 18-gauge Core Biopsy Needle- a Propensity Score Matching Analysis

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