Diagnostic performance of CT-guided percutaneous transthoracic core needle biopsy using low tube voltage (100 kVp): comparison with conventional tube voltage (120 kVp)

Lee, Han Na; Lee, Sang Min; Choe, Jooae; Chae, Eun Jin; Do, Kyung-Hyun; Seo, Joon Beom

doi:10.1177/0284185117719589

Cited by 19 publications

(17 citation statements)

References 25 publications

(52 reference statements)

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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%

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

Huang

Cheng

Li³

2021

Videosurgery and Other Miniinvasive Techniques

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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%

“…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%

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

Huang

Cheng

Li³

2021

Videosurgery and Other Miniinvasive Techniques

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“…In addition, the tumor heterogeneity issue must be overcome. The present study has demonstrated as 97% (36), and the success rate of neck node biopsy has been reported to be as high as 95% (37). The diagnostic yield of endobronchial US has also been reported to be between 90% and 95% in centrally located lung masses or mediastinal lymph nodes (38,39).…”

Section: Discussionsupporting

confidence: 58%

Non–Small Cell Lung Cancer with Resistance to EGFR-TKI Therapy: CT Characteristics of T790M Mutation–positive Cancer

Koo¹,

Kim²,

Park³

et al. 2018

Radiology

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Purpose To evaluate the clinical and CT characteristics of T790M mutation-positive non-small cell lung cancer (NSCLC) after epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy failure. Materials and Methods A retrospective study of 304 patients with NSCLC who underwent rebiopsy after first-line EGFR-TKI therapy was conducted. Rebiopsy methods included CT- or fluoroscopy-guided lung biopsies (n = 105), endobronchial US- or bronchofibroscopy-guided biopsies (n = 66), pleural fluid analysis (n = 47), other solid organ biopsies (n = 43), US-guided axillary or supraclavicular lymph node biopsies (n = 31), and cerebrospinal fluid analysis (n = 12). CT findings at the initial diagnosis and rebiopsy were analyzed. Progression-free survival, the duration from the start of TKI therapy to rebiopsy, and survival were calculated. Results At rebiopsy, 144 (47.4%) patients were T790M mutation positive. The percentages of T790M mutation-positive NSCLCs were similar in 106 patients with rebiopsy of the lungs (53 [50%] of 106) and in 77 patients with rebiopsy of the primary lung lesions (36 [47%] of 77). T790M mutation positivity was associated with peripheral tumors (odds ratio [OR], 2.6; P = .01), pleural tag (OR, 5.0; P < .001), and air bronchogram (OR, 4.0; P = .006) at CT after TKI failure. The duration from the start of TKI therapy to rebiopsy was longer in T790M mutation-positive than in T790M mutation-negative patients (20.5 vs 13.6 months; P < .001). Cumulative survival from the time of rebiopsy to the last follow-up was significantly longer in patients with T790M mutation-positive lung cancers (P = .014). However, median survival time after rebiopsy was not statistically different between patients with and those without T790M mutation. Conclusion Peripheral tumor location with vascular convergence, the presence of a pleural tag, and air bronchogram of lung lesions at CT at the time of rebiopsy were significantly associated with T790M mutation in patients with non-small cell lung cancer after first-line epidermal growth factor receptor-tyrosine kinase inhibitor therapy failure. © RSNA, 2018 Online supplemental material is available for this article.

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“…In our study, the low‐dose CT‐guided lung biopsy (the tube voltage 120.0 kV, low‐tube current 20.0‐40.0 mA) was also maintaining high diagnostic accuracy and safety as a series of literature reported that ultra‐low‐dose protocol for CT‐guided percutaneous lung biopsy significantly reduced radiation dose and does not negatively impact patient safety. Therefore, radiation exposure during a procedure could be kept as low as possible 19‐21 . However, there are also some complications after percutaneous lung biopsy and the COPD patients should be paid more attention to the risk of pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

Zhou

Wang

Wei

et al. 2020

Clinical Respiratory J

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Background The feasibility of pneumothorax following low‐dose CT‐guided puncture lung biopsy in different severities of COPD has not been reported. Methods The data of the patients with pulmonary lesion who underwent low‐dose CT‐guided lung biopsy by one experienced operator in our hospital from January 1st to September 30th in 2019 were retrospectively collected. They were divided into COPD group and non‐COPD group. The risk factors, incidence and severity of pneumothorax with the severity of COPD and changes in MMRC score, treatment way and discharge time after pneumothorax were assessed. Results Two hundred and nineteen patients were retrospectively enrolled in this study with 64 in the COPD group and 155 in the non‐COPD group. The average age, MMRC score and the incidence of pneumothorax after biopsy were significantly higher in the COPD group (64.7 ± 1.27 years, 1.02 ± 0.13, 31.3%) than in the non‐COPD group (58.8 ± 1.16 years, 0.35 ± 0.06, 17.4%, P < 0.05). The incidence of pneumothorax between I‐II and III‐IV in COPD did not reach the significant difference (P = 0.863). COPD was the only independent risk factor for pneumothorax after biopsy in a multivariable regression (P < 0.05). MMRC score was significantly increased at post‐pneumothorax in the two groups (P < 0.001). There was no significant difference in diagnostic rate, severity of pneumothorax, the proportion of delayed pneumothorax, the changes in treatment way and discharge time between the two groups (P > 0.05). Conclusion Although the incidence of pneumothorax after low dose CT‐guided lung biopsy is increased in COPD, there was no difference in the severity of pneumothorax amongst the different severities of COPD and it is well‐tolerated without increasing medical burden.

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Diagnostic performance of CT-guided percutaneous transthoracic core needle biopsy using low tube voltage (100 kVp): comparison with conventional tube voltage (120 kVp)

Cited by 19 publications

References 25 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.

Non–Small Cell Lung Cancer with Resistance to EGFR-TKI Therapy: CT Characteristics of T790M Mutation–positive Cancer

Incidence, severity and tolerability of pneumothorax following low‐dose CT‐guided lung biopsy in different severities of COPD

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