CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: Accuracy, complications and radiation dose

Prosch, Helmut; Stadler, Alfred; Schilling, Matthias; Bürklin, Sandra; Eisenhuber, Edith; Schober, Ewald; Mostbeck, G.

doi:10.1016/j.ejrad.2011.01.064

Cited by 65 publications

(62 citation statements)

References 12 publications

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“…CT-fluoroscopy offers the advantages of a near real-time imaging feedback as the needle is being inserted. It is, however, associated with an increased patient and operator dose [22, 64, 65]. These methods can be used interchangeably, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…For core biopsy we found a trend that suggested CT-fluoroscopy might result in a higher major complication rate (OR: 1.62; 95 % CI: 0.81–3.23 %; p = 0.171). CT-fluoroscopy is generally reported to have a lower complication rate due to shorter procedure time and fewer needle passes [22, 33, 64]. However, if CT-fluoroscopy is indeed used more frequently in cases of hard-to-reach lesions, it could potentially bias the results, as it generally takes longer to sample these.…”

Section: Discussionmentioning

confidence: 99%

“…The biopsy site down technique has been cause for some debate; although some papers report no difference in complication rate when repositioning the patient after the procedure [64], others have demonstrated a considerable reduction in pneumothorax and/or chest tube placement rate in case of patient repositioning [65]. O’Neill et al [66] suggested that the critical factor for success is to immediately roll the patient over after biopsy, calling it rapid needle-out patient-rollover .…”

Section: Discussionmentioning

confidence: 99%

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Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

et al. 2016

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ObjectivesTo meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors.MethodsFour databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis.ResultsFor core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3–43.5 %) and 24.0 % (95 % CI: 18.2–30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4–7.4 %) and 4.4 % (95 % CI: 2.7–7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified.ConclusionsIn CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications.Key Points• Minor complications are common in CT-guided lung biopsy • Major complication rate is low in CT-guided lung biopsy • CT-guided lung biopsy complications occur more often in core biopsy than FNA • Major complication rate is similar in core biopsy and FNA • Risk factors for FNA are larger needle diameter, smaller lesion size Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4357-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

et al. 2016

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“…Further modifications in CT guided biopsy technique have been shown to affect the biopsy complication rate, for example CT fluoroscopy mode versus 3 slice biopsy mode and spiral acquisition versus biopsy mode. The spiral acquisition mode generally entails a longer procedure time (and increased patient dose), thus contributing to the increased complication rate during the procedure [16]. Our institution uses the 3 slice biopsy mode, minimising the procedure time and thereby reducing the risk of complications through the prolonged procedure time.…”

Section: Discussionmentioning

confidence: 99%

Patient reported experiences of CT guided lung biopsy: a prospective cohort study

Winn

Spratt

Wright

et al. 2014

Multidisciplinary Respiratory Medicine

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BackgroundCT guided lung biopsy is a commonly performed procedure to obtain tissue for a histological diagnosis in cases of suspected lung cancer.MethodsThis is a prospective cohort study to obtain information directly from patients about their experiences of the biopsy procedure, thus obtaining a more accurate picture of complications compared with previously performed retrospective reviews. Patients participated in a post-procedure telephone interview and information was gathered about any procedural complications and personal experiences. We also compared the patient reported complications with those obtained from a retrospective review of hospital databases, analogous to previously performed retrospective studies.ResultsIn our patient group, reported procedural complication rates were 10% pneumothorax rate (4% requiring a chest drain) and 10% haemoptysis. Post-procedural pain and shortness of breath showed positive correlation, with one patient experiencing prolonged pain. No statistical difference was found between the patient reported complication rates and those obtained from retrospective review of the hospital database.ConclusionsOur study demonstrates CT guided lung biopsy is a safe procedure and is generally well tolerated. Some patients may experience significant and lasting pain and therefore should be counselled about this pre-procedure.

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“…Using CT fluoroscopic guidance, an RF needle may be introduced into any size and site of bony lesion. Alternatively, CT fluoroscopy gives patients much radiation exposure [10], and the influences of this radiation exposure to young patients are still unknown. However, in this case two nidi were very small and close location.…”

Section: Discussionmentioning

confidence: 99%

CT fluoroscopy-guided radiofrequency ablation of osteoid osteoma with double nidi

Miyazaki

Kurabayashi

et al. 2011

Jpn J Radiol

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Osteoid osteoma (OO) is a common benign bone tumor, usually found in children and young adults. Fewer than 30 cases of multicentric OO in a single bone have been reported in the world literature. We present the case of a 17-year-old boy with OO in the left tibia, containing double nidi. Plain radiography and computed tomography (CT) revealed two adjacent nidi surrounded by bony sclerosis within the distal left tibia. The tumor was successfully treated using two separate CT fluoroscopy-guided percutaneous radiofrequency ablations during a single session. The patient achieved complete pain relief the next day, and has remained asymptomatic for 9 months since treatment.

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CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: Accuracy, complications and radiation dose

Cited by 65 publications

References 12 publications

Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

Patient reported experiences of CT guided lung biopsy: a prospective cohort study

CT fluoroscopy-guided radiofrequency ablation of osteoid osteoma with double nidi

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