Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran

Rabbani, Masoud; Sarrami, Amir Hossein

doi:10.4103/2277-9175.188939

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…In three patients, major pneumothorax occurred requiring therapy by a chest tube. With respect to technical success, diagnostic yield and complication rate associated with CT fluoroscopy-guided percutaneous core needle biopsies of mediastinal masses, our study agrees with other similar studies [ 3 , 5 , 6 , 11 , 12 , 14 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. For instance, de Margerie-Mellon et al reported a technical success rate of 100% and a diagnostic yield of 87% in 285 consecutive patients which is one of the largest studies on this subject.…”

Section: Discussionsupporting

confidence: 91%

Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

et al. 2021

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Purpose: To evaluate technical outcome, diagnostic yield and safety of computed tomographic fluoroscopy-guided percutaneous core needle biopsies in patients with mediastinal masses. Methods: Overall, 155 CT fluoroscopy-guided mediastinal core needle biopsies, performed from March 2010 to June 2020 were included. Size of lesion, size of needle, access path, number of success, number of biopsies per session, diagnostic yield, patient’s position, effective dose, rate of complications, tumor localization, size of tumor and histopathological diagnosis were considered. Post-interventional CT was performed, and patients observed for any complications. Complications were classified per the Society of Interventional Radiology (SIR). Results: 148 patients (age, 54.7 ± 18.2) underwent 155 CT-fluoroscopy-guided percutaneous biopsies with tumors in the anterior (114; 73.5%), middle (17; 11%) and posterior (24; 15.5%) mediastinum, of which 152 (98%) were technically successful. For placement of the biopsy needle, in 82 (52.9%) procedures a parasternal trajectory was chosen, in 36 (23.3%) a paravertebral access, in 20 (12.9%) through the lateral intercostal space and in 17 (11%) the thoracic anterior midline, respectively. A total of 136 (89.5%) of the biopsies were considered adequate for a specific histopathologic analysis. Total DLP (dose-length product) was 575.7 ± 488.8 mGy*cm. Mean lesion size was 6.0 ± 3.3 cm. Neoplastic pathology was diagnosed in 115 (75.7%) biopsies and 35 (23%) biopsy samples showed no evidence of malignancy. Minor complications were observed in 18 (11.6%) procedures and major pneumothorax requiring drainage insertion in 3 interventions (1.9%). Conclusion: CT fluoroscopy-guided percutaneous core needle biopsy of mediastinal masses is an effective and safe procedure for the initial assessment of patients with mediastinal tumors.

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Section: Discussionsupporting

confidence: 91%

Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

et al. 2021

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“… 6 The range of reported diagnostic yield in each study included in the meta-analysis ranged from 74% to 96%. 1 , 4 , 9 , 10 , 11 , 12 Possible reasons for this variability may reflect technical advances in pathology, imaging, and biopsy equipment along with the volume of procedures performed in each institution. The experience represented in the current study is based in a large quaternary referral center including radiologists with subspecialty training with image-guided biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to prior studies, there was no statistically significant variable which affected the diagnostic yield of the biopsy technique. 1 , 4 , 9 , 10 , 11 , 12 However, biopsy needle gauge has shown significance in one study assessing CT fluoroscopy–guided biopsy of anterior mediastinal masses. 24 In that study it was found that using a 20-gauge needle was a significant risk factor for diagnostic failure.…”

Section: Discussionmentioning

confidence: 99%

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Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy

Navin

Eickstaedt

Atwell

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective To retrospectively evaluate the safety and efficacy of percutaneous image-guided mediastinal mass core-needle biopsy. Patients and Methods Retrospective review of an institutionally maintained biopsy registry identified 337 computed tomography– or ultrasound-guided percutaneous mediastinal mass core needle biopsies between October 2002 and August 2017 in a single quaternary referral center. Mean patient age was 51 (range, 18 to 93) years. Procedural techniques, anticoagulation/antiplatelet therapy, and tumor anatomical characteristics were reviewed. Classification and gradation of complications was based on the Clavien-Dindo system. Diagnostic yield was defined as the ratio of diagnostic biopsy to all biopsies performed. Results Mean tumor size was 59.2 (range, 10 to 180) mm with 89.9% (n=303) of lesions located in the prevascular (anterior) mediastinum. There was a single major complication (0.3%) of a symptomatic pneumothorax requiring intervention. There were seven (2.1%) minor complications, including three bleeding complications. A transpleural approach was the only variable associated with an increased complication rate ( P <.01). Forty-one (12.2%) patients had a biopsy performed while taking an antiplatelet/anticoagulant agent within the therapeutic window, with a single case (0.3%) associated with a minor bleeding complication. Of 18 (5.3%) procedures performed without cessation of anticoagulant/antiplatelet therapy, there were no bleeding complications. Of all 337 biopsies, 322 (95.5%) were diagnostic. None of the analyzed variables were significantly associated with a nondiagnostic biopsy. Conclusion Image-guided percutaneous core-needle biopsy of mediastinal masses is a safe procedure with high diagnostic yield. Further prospective studies are required to assess the complication profile in higher risk patients.

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“…1 Reports have shown that PCNB is a widely accepted procedure which is reliable and minimally invasive, however occurrence of complications in this procedure does occur. 2,3 The accuracy of biopsy has been found to be better than cytology in the evaluation of mediastinal lesions. 4,5 The larger volume of tissue obtained by percutaneous coreneedle biopsy (PCNB) plays a vital role in enabling histopathological diagnosis and providing material for immunohistochemical and molecular analysis as required.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

et al. 2019

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Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry.

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Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran

Cited by 7 publications

References 16 publications

Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

Percutaneous CT Fluoroscopy-Guided Core Needle Biopsy of Mediastinal Masses: Technical Outcome and Complications of 155 Procedures during a 10-Year Period

Safety and Efficacy of Percutaneous Image-Guided Mediastinal Mass Core-Needle Biopsy

Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

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