Hemoptysis complicating ultrasound-guided transthoracic needle lung biopsy: air bronchial sign is a risk predictor

Zhang, Yuxin; He, Lei; Zhou, Xinghua; Zhou, Dansha; Tang, Jiaxin; Tang, Qing

doi:10.21037/jtd-20-1247

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…Regarding CT features of US-guided PCNB-related complications, Zhang et al ( 30 ) reported that 20 of 209 patients had post-procedural hemoptysis, and air-bronchogram on CT was a risk factor for hemoptysis of US-guided PCNB. In this study, only one of 20 patients (5%) with air-bronchogram on CT had post-procedural hemoptysis.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided lung biopsy for small (≤2 cm) subpleural lung lesions: comparison of diagnostic yield and safety with larger lesions

Park¹,

Park²,

Shin³

et al. 2023

J Thorac Dis

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Background Ultrasound (US)-guided percutaneous core needle biopsy (PCNB) has been used to diagnose subpleural lung lesions with high diagnostic performance and acceptable complication rates. However, with regard to the role of US-guided needle biopsy for the diagnosis of small (≤2 cm) subpleural lesions, limited information is available. Methods From April 2011 to October 2021, a total of 572 US-guided PCNBs in 572 patients were retrospectively reviewed. The lesion size, pleural contact length (PCL), lesion location, and operator’s experience were analyzed. Computed tomography features including peri-lesional emphysema, air-bronchogram, and cavitary change were also included in image analysis. The patients were divided into three groups according to lesion size (lesions ≤2 cm vs. 2 cm< lesions ≤5 cm vs. lesions >5 cm). The sample adequacy, diagnostic success rate, diagnostic accuracy, and complication rate was calculated. For statistical analysis, one-way ANOVA, Kruskal-Wallis test, or the chi-square test were used. Results The overall sample adequacy, diagnostic success rate, and diagnostic accuracy were 96.2%, 82.9%, and 90.4%, respectively. In the subgroup analysis, sample adequacy (93.1% vs. 96.1% vs. 96.9%, P=0.307), diagnostic success rate (75.0% vs. 81.6% vs. 85.7%, P=0.079), and diagnostic accuracy (84.7% vs. 90.8% vs. 90.5%, P=0.301) were not significantly different. Operator’s experience (OR, 0.64; 95% CI: 0.49–0.80; P<0.001), lesion size (OR, 0.68; 95% CI: 0.54–0.83; P<0.001), PCL (OR, 0.68; 95% CI: 0.52–0.84; P=0.001), and presence of air-bronchogram (OR, 14.36; 95% CI: 4.18–48.53; P<0.001) were independently associated with complication rate. Conclusions US-guided PCNB performed by an experienced radiologist could be an effective and safe diagnostic approach for subpleural lesions, even in small lesions.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided lung biopsy for small (≤2 cm) subpleural lung lesions: comparison of diagnostic yield and safety with larger lesions

Park¹,

Park²,

Shin³

et al. 2023

J Thorac Dis

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“…The microvessel density (MVD) is considered an early indicator of angiogenesis, and quantitative assessment of MVD is an effective means of determining the angiogenesis of a tumour, which could be used to evaluate the therapeutic efficacy of treatment regimens for malignant tumours (8,9). However, assessment of MVD requires that pathological specimens be obtained through invasive procedures, such as needle biopsy, which may increase the risk of haemoptysis or pneumothorax (10). Some studies showed that several parameters of ultrasound or contrast-enhanced ultrasound (CEUS), such as blood flow velocity and area under the receiver (AUC) operating characteristic curve, were positively correlated with the MVD of tumours, suggesting that it may be possible to assess the MVD of tumours to some degree by ultrasound examination, which would thus allow early evaluation of the efficacy of therapeutic interventions (11,12).…”

Section: Introductionmentioning

confidence: 99%

Correlations between contrast-enhanced ultrasound and microvessel density in non-small cell lung cancer: A prospective study

Chen

Zhang²,

Tang³

et al. 2023

Front. Oncol.

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BackgroundImmunohistochemical microvessel density (MVD) is an early indicator of angiogenesis and it could be used to evaluate the therapeutic efficacy of non-small cell lung cancer (NSCLC). We sought to identify the ability of contrast-enhanced ultrasound (CEUS) in evaluating MVD of subpleural NSCLC.MethodsWe prospectively collected CEUS data of NSCLC confirmed by ultrasound-guided transthoracic needle biopsy from October 2019 to February 2021, The MVD of NSCLC counted by CD34-positive vessels of immunohistochemical staining. Microflow enhancement (MFE) of CEUS was divided into “dead wood”, “cotton”, and “vascular” patterns. Pathology subgroup and MVD between different MFE patterns were analyzed, respectively. The arrival time, time to peak, peak intensity (PI), and area under curve (AUC) derivefrom time-intensity curve of CEUS with MVD in NSCLC and its pathological subgroups (adenocarcinoma and squamous cell carcinoma) were subjected to correlation analysis.ResultsA total of 87 patients were included in this study, consisting of 53 cases of adenocarcinoma and 34 cases of squamous cell carcinoma with a mean MVD of 27.8 ± 12.2 mm–1. There was a significant statistical difference in MFE patterns between two pathological subgroups (p < 0.05). Besides, the MVD of “cotton” and “vascular” patterns were significantly higher than that of “dead wood” pattern (both of p < 0.05), whereas there was no significant difference in MVD between “cotton” pattern and “vascular” pattern. PI and AUC of CEUS were positively correlated with the MVD of NSCLC (r = 0.497, p < 0.001, and r = 0.367, p < 0.001, respectively). Besides, PI and AUC of CEUS were positively correlated with the MVD of squamous cell carcinoma (r = 0.802, and r = 0.663, respectively; both of p < 0.001). Only the PI was positively correlated with the MVD of lung adenocarcinoma (r = 0.288, p = 0.037).ConclusionsMFE patterns and quantitative parameters of CEUS had good correlation with MVD of NSCLC, especially in squamous cell carcinoma.

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“…Bleeding and pneumothorax are the most common complications of percutaneous US-guided lung biopsy. The incidence of hemoptysis ranged from 0.5 to 22%, and hemothorax is rare [2,3,5,6,[9][10][11]. Air bronchial sign was reported as a risk factor of hemoptysis [11].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of hemoptysis ranged from 0.5 to 22%, and hemothorax is rare [2,3,5,6,[9][10][11]. Air bronchial sign was reported as a risk factor of hemoptysis [11]. The pneumothorax incidence rate ranged from 0 to 5.8%, while the rate of chest tube drainage ranged from 0 to 1% [3,4,12].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided lung biopsy with coaxial technique: pleural contact length affects the occurrence of pneumothorax after first puncture

et al. 2021

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Purpose To assess prebiopsy characteristics influencing the occurrence of pneumothorax after first puncture of ultrasound (US)-guided lung biopsy with coaxial technique. Materials and methods From January 2007 to September 2018, 180 peripheral lung lesions in 174 patients who underwent B-mode US-guided lung biopsy with coaxial technique at single institution were included in this study. Technical success was defined as the ability to make a diagnosis using the acquired sample with/without an adverse event of pneumothorax. Statistical analyses of prebiopsy characteristics were performed to identify the most important cutpoint and to evaluate the effect on diagnostic accuracy. Results Of the 180 lesions (mean size, 37 mm ± 26.2; mean pleural contact length, 38.2 mm ± 34.4), technical success rate was 97.2% (175/180 lesions) and diagnostic accuracy rate was 91.6% (165/180 lesions). Pneumothorax occurred immediately after first puncture for seven of 180 lesions. Classification and regression tree analysis and Fisher’s exact test showed the proportion of the pneumothorax immediately after first puncture was higher in lesions with pleural contact length less than 9.78 mm (p = 0.002). No significant difference was shown between the pneumothorax and non-pneumothorax after first puncture in technical success and final diagnosis success rate. Conclusion Pleural contact length affects the occurrence of pneumothorax after first puncture of US-guided lung biopsy with coaxial technique.

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Hemoptysis complicating ultrasound-guided transthoracic needle lung biopsy: air bronchial sign is a risk predictor

Cited by 3 publications

References 22 publications

Ultrasound-guided lung biopsy for small (≤2 cm) subpleural lung lesions: comparison of diagnostic yield and safety with larger lesions

Ultrasound-guided lung biopsy for small (≤2 cm) subpleural lung lesions: comparison of diagnostic yield and safety with larger lesions

Correlations between contrast-enhanced ultrasound and microvessel density in non-small cell lung cancer: A prospective study

Ultrasound-guided lung biopsy with coaxial technique: pleural contact length affects the occurrence of pneumothorax after first puncture

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