CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: Comparison between coaxial and single needle technique

Wu, Ren‐Chin; Tzeng, Wen-Sheng; Lee, Wei-Jing; Chang, Sheng‐Tsung; Chen, Chia-Huei; Fung, Jui-Lung; Wang, Yen‐Jen; Mak, Chee-Wai

doi:10.1016/j.ejrad.2011.05.032

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…Generally, it is implicited that pneumothorax is the most common complication of lung needle biopsy ( 16 , 17 ). In our study, the pneumothorax rate (16%) and consequential chest tube insertion rate (2%) of CT-guided CNB for pleural lesion were within the range of those in prior publications ( 10 , 12 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications

2015

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ObjectiveThe purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors.Materials and MethodsFrom September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [± standard deviation] age, 51.1 ± 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis.ResultsDiagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax.ConclusionCT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

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Section: Discussionmentioning

confidence: 99%

CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications

2015

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“…Moreover, smoking, the decubitus position and a longer length needle in the normal parenchyma were risk factors for a pneumothorax. It is generally considered that a pneumothorax is the most common complication of a needle biopsy of the lung (11,13). However, in the present study, the incidence of hemorrhage (32.9%) was higher than pneumothorax (17.5%) and also higher than the 1–27% reported in the literature (7,11,14).…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-guided core needle biopsy of lung lesions: Diagnostic yield and correlation between factors and complications

Wang

et al. 2013

Oncology Letters

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The aim of the present study was to determine the diagnostic accuracy of computed tomography (CT)-guided core needle biopsy (CNB) and to retrospectively analyze the correlation between the factors and complications of the procedure. Between January 2009 and June 2010, CNB was performed on 345 lung lesions in 343 patients. These patients were then followed up for at least two years. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the CNB diagnoses were calculated. The correlation between factors, such as smoking, positoin and maximal diameter, and the complications of pneumothorax and hemorrhage was analyzed by χ2 test. The sensitivity, specificity, accuracy, PPV and NPV of the CNB diagnoses were 97.3, 100, 97.7, 100 and 87.7%, respectively. A statistically significant correlation was found between pneumothorax and the factors of smoking (P=0.015) and position (P<0.01) and length of the needle in the normal parenchyma (P=0.011), as well as between hemorrhage and the maximal diameter (P=0.005) and length of the needle in the normal parenchyma (P<0.01) and the frequency of needle adjustments (P<0.01). A CT-guided core needle biopsy of the lung lesions provides a high diagnostic yield. Smoking, the decubitus position and a longer length of the needle in the normal parenchyma were found to represent risk factors for a pneumothorax. In addition, a small diameter and longer length of the needle in the normal parenchyma and a more frequent adjustment of the needle were poor predictive factors of hemorrhage.

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“…Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, effective and safe technique for the diagnosis of focal lung lesions ( 1 , 2 ) and has exhibited high diagnostic accuracy and specificity ( 3 ). No differences have been detected between single-needle transthoracic needle biopsy and a coaxial technique with regard to diagnostic accuracy ( 4 ). Conventional CT-guided transthoracic needle biopsy, however, is a method for locating lesion-edges that increases the dwell time of the needle within the lung while scanning prior to biopsy ( 3 , 5 – 8 ).…”

Section: Introductionmentioning

confidence: 99%

Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions

Wei

Zhou

et al. 2015

Experimental and Therapeutic Medicine

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Transthoracic needle biopsy is considered to be safe and effective for the diagnosis of focal lung lesions. The aim of the present study was to evaluate factors affecting the accuracy and safety of automated cutting needle lung biopsy (ACNB) using a new extrapleural locating (EPL) method. Computed tomography (CT)-guided needle biopsies were performed on 1,065 patients between March 2005 and May 2012 using the EPL method. The locating needle remained in the chest following extrapleural positioning, while the radiologist confirmed the puncture angle and distance between the locating needle and lesion. The biopsy instrument was advanced into the lung, and the core needle was subsequently fired into the lesion based on the direction indicated by the locating needle. Univariate and multivariate regression analyses were used to evaluate the diagnostic accuracy and safety of the procedure. The sensitivity, specificity, positive predictive value and negative predictive value of the extrapleural method were 91.9, 100, 100 and 82.9%, respectively, and the overall diagnostic accuracy was 94.2%. Significant risk factors affecting accuracy were younger age, atelectasis, hemoptysis and lesion depth (P<0.03). Multivariate logistic regression analysis revealed that the risk of malignant lesions receiving a false-negative diagnosis decreased for each additional year of subject age [odds ratio (OR), 0.97; P=0.027] and increased with each millimeter increase in lesion depth (OR, 1.03; P=0.008). Among the 1,106 lesions biopsied, 207 were associated with pneumothorax, 251 with hemorrhage and 58 with hemoptysis. Multivariate analysis revealed that lesion size and emphysema affected pneumothorax incidence, while age, lesion location and depth and emphysema significantly affected hemorrhage incidence (P<0.05). In conclusion, low-dose, CT-guided ACNB with the EPL method provides a safe and accurate diagnosis.

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CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: Comparison between coaxial and single needle technique

Cited by 15 publications

References 19 publications

CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications

CT-Guided Core Needle Biopsy of Pleural Lesions: Evaluating Diagnostic Yield and Associated Complications

Computed tomography-guided core needle biopsy of lung lesions: Diagnostic yield and correlation between factors and complications

Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions

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