Percutaneous computed tomography-guided aspiration and biopsy of intrathoracic lesions: Results of 265 procedures

Abstract

Context:Percutaneous computed tomography (CT)-guided needle aspiration and biopsy technique have developed over time as a method for obtaining tissue specimen. Although this is a minimally invasive procedure, complications do occasionally occur.Aims:The aim of the study was to evaluate the diagnostic yield and complications of 265 percutaneous CT-guided aspiration and biopsy procedures performed on various intrathoracic lesions.Settings and Design:Data of percutaneous CT-guided aspiration and biopsy procedures of intrathoracic lesions performed over a 4 year period were retrospectively analyzed.Subjects and Methods:Procedure details, radiological images, and pathological and microbiological reports were retrieved from radiology records and hospital information system. Technical success, diagnostic yield, and complication rates were calculated.Results:Total 265 procedures were performed for lung (n = 179), mediastinum (n = 73), and pleural lesions (n = 13). Diagnostic yield for lung, mediastinal, and pleural lesions was 80.7%, 74.2, and 75%, respectively, for core biopsy specimens. Major complication was noted in only one procedure (0.4%). Minor complications were noted in 13.6% procedures which could be managed conservatively.Conclusions:Percutaneous CT-guided aspiration and biopsy procedures for intrathoracic lesions are reasonably safe with good diagnostic yield. Complications are infrequent and conservatively managed in most of the cases.

CT guided lung biopsy complications: a single centre prospective study

“…In a study conducted in Lucknow, India the incidence of pulmonary haemorrhage after CT guide PTCN was reported to be 3.4% which is much lower than that reported from our study. 9 The second reported complication in our study was pneumothorax (21.9 %) which is in accordance to study conducted earlier (17-26.6%). [1][2][3][4] However pneumothorax rate of 9.4 % had been reported from Lucknow, India.…”

“…[1][2][3][4] Mild haemoptysis was reported in 15.6% of patients which is slightly higher than the reported incidence from Lucknow (3.4%). 9 There was no reported case of air embolism or tumour seeding which could be because of lesser number of patients in our sample size. The incidence of haemothorax reported was 3.1% which is slightly higher than reported incidence of 0.4% in study conducted in Lucknow.…”

“…The incidence of haemothorax reported was 3.1% which is slightly higher than reported incidence of 0.4% in study conducted in Lucknow. 9 However, none required an ICT and recovered spontaneously. Mild cough was reported in 6.3% of patients after 24 hours of procedure which eventually remitted after one week.…”

“…[1][2][3][4] However pneumothorax rate of 9.4 % had been reported from Lucknow, India. 9 The reason behind lower rate of pneumothorax may be inclusion of mediastinal biopsies in which chances of involvement of aerated lung is lesser. Pneumothorax rate of 19.6% was reported in a study conducted in Chennai using an automated guiding apparatus which is in accordance to our study.…”

Evaluation of trans thoracic invasive diagnostic procedures in 50 adult patients of mediastinal diseases

“…The percutaneous transthoracic FNAC and/or biopsy of the mediastinal lesion under local anesthesia are minimally invasive, cost-effective, easy to perform, and associated with reduced complication rates when performed under ultrasound or CT scan guidance [13]. The accuracy of transthoracic biopsy in the diagnosis of mediastinal lesions ranges from 75% to 90% [14,15,16] The diagnostic accuracy of mediastinal lesions approached in the present study was 89.9% that is similar to the diagnostic yield in studies by Shaheen et al [17] and Güllüoglu et al, [18] superior compare to studies by Morrissey et al [19] (77%), Assaad et al [20] (82%), Rosenberger and Adler [21] (83%), Adler et al [22] (79%), Pedersen et al [23] (81%), Dubashi et al [24] (50%), and Neyaz et al [25] (74%) and inferior to the studies by Nasit et al [26] (97%) and Annessi et al [6] (100%).…”