Imaging guided thoracic interventions

Abstract

Interventional Radiology is a technique based medical specialty, using all available imaging modalities (¯uoroscopy, ultrasound, computed tomography, magnetic resonance, angiography) for guidance of interventional techniques for diagnostic or therapeutic purposes.Actual, percutaneous transthoracic needle biopsy includes core needle biopsy besides ®ne needle aspiration. Any pleural, pulmonary or mediastinal¯uid or gas collection is amenable to percutaneous pulmonary catheter drainage.Treatment of haemoptysis of the bronchial artery or pulmonary artery origin, transcatheter embolization of pulmonary arteriovenous malformations and pseudoaneurysms, angioplasty and stenting of the superior vena caval system and percutaneous foreign body retrieval are well established routine procedures, precluding unnecessary surgery. These techniques are safe and effective in experienced hands.Computed tomography is helpful in pre-and postoperative imaging of patients being considered for endobronchial stenting. Many procedures can be performed on an outpatient basis, thus increasing the cost-effectiveness of radiologically guided interventions in the thorax.

Transthoracic Ultrasound

“…Malignant lymph nodes usually appear plump, rounded, hypoechoic, with loss of the fatty hilum [4, 5, 6]. Irregularity in the borders of these lymph nodes suggests extracapsular spread.…”

“…Furthermore, US is increasingly used to guide interventional procedures of the chest, such as biopsy and placement of intercostal chest drains. Pathological modifications can be detected, if they are situated in the chest wall, the diaphragm or the upper chest aperture [4, 5]. …”

The challenge of NSCLC diagnosis and predictive analysis on small samples. Practical approach of a working group

“…The main indications for these techniques are to determine the nature of a thoracic nodule or mass. This may be in several clinical reasons: (i) diagnosis of a nodule in a patient with/without a clinical history of extrapulmonary primary malignancy; (ii) establish multiple primary malignancies; (iii) diagnosis residual nodule following radiotherapy or chemotherapy; (iv) tissue sampling for ancillary tests [42].…”

Endovascular treatment of a pulmonary artery pseudoaneurysm with a stent graft: report of two cases

“…Due to hemoptysis and risk of rupture and enlargement, therapy is required (3). Radiological intervention is a minimally invasive alternative to surgery and the only treatment option for a nonsurgical candidate.…”