CT-guided percutaneous transthoracic lung biopsy: First experience in Ibadan, Nigeria

Abstract

Percutaneous lung biopsy had been described in the nineteenth century by Leyden, but image- guided needle chest biopsy only gained widespread acceptance in the 1970s. Currently, tissue sampling of a thoracic lesion is indicated when the diagnosis cannot be obtained by the non-invasive techniques and cytological diagnosis will modify the stage of the disease or influence the therapeutic strategy. Cytology obtained by small-gauge needle aspiration biopsy confirms the nature of the lesion in 80 - 95% of cases and carry a low incidence of major complications. The purpose of this report was to provide information on our first experience with CT-guided biopsy and show that with some innovativeness much can be achieve with limited resources and good team work. We performed a CT of the thorax using appropriately placed improvised metal markers, which determined the optimal cutaneous entry point. We then re-checked the location of the lesion scanning intermittently at 5mm slice thickness; we marked the entry point with a pen and cleaned the surface with methylated spirit. A local anaesthetic was subcutaneously injected around marked area. We used a 21G aspiration needle to obtain cytology sample then 18G Trucut biopsy needle to obtain histology specimen. The length of the needle was chosen based on predetermined distance of the target lesion from the skin estimated from the CT images. Our patient was a 51-year-old Nigerian female with a peripherally located nodule in the posterior aspect of the right lung. She had CT-guided biopsy of the nodule. The procedure was well tolerated with no complication of pneumothorax. The histology report provided the basis for treatment regimen. Our experience indicates that percutaneous transthoracic CT-guided needle biopsy is feasible and a safe procedure in our hospital for evaluation of undetermined lung lesions.

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

“…Our institution uses the 3 slice biopsy mode, minimising the procedure time and thereby reducing the risk of complications through the prolonged procedure time. The majority of the published studies to date are also from centres using the 3 slice biopsy mode, thus our practice is in concordance with other institutions [6,[8][9][10][11][17][18][19][20][21].…”

Auditing the findings of computed tomographic angiographic examinations using 160-slice scanner: Analysis of 5-year experiences from Northwestern Nigeria

“…This is consistent with earlier reports by Anas and Muhammad[ 8 ] in 2012 in Kano northern Nigeria, Adekanmi and Osobu[ 10 ] in 2020, and Ogbole et al . [ 9 ] in 2010 both in Ibadan, south-western Nigeria, which also showed a male preponderance of 1.3, 1.3, and 1.6, respectively. This is, however, different from the study by Man et al .…”

“…[ 7 ] Previous studies have shown that most CTA studies were predominantly requested for the evaluation of cranial lesions. [ 8 9 ] Adekanmi and Osobu[ 10 ] had reported that most patients had cranial/cerebral CTA, followed by pulmonary artery CTA, and then lower limb CTA. The least requested CTA examinations were hepatic and cardiac CTAs.…”

Sensitivity of computed tomography-guided transthoracic biopsies in a Nigerian tertiary institution

“…The methodology employed in this study is generally similar to that recommended by most authors. [ 2 4 6 7 8 9 11 12 13 14 ] Sensitivity of CT-guided percutaneous transthoracic lung biopsy has been put at 76%–96%. [ 2 13 14 15 ] Bozbaş et al ., in a 10-year experience reported a sensitivity of 87.5% following CT-guided transthoracic lung biopsy and a complication rate of 25.1%.…”