Percutaneous lung biopsies: a survey of UK practice based on 5444 biopsies

Abstract

Percutaneous transthoracic lung biopsies are commonly performed for the investigation of lung masses. We describe current practice and complication rates in the UK. A postal questionnaire was sent to all centres in the British Thoracic Society directory. 157 replies (61% response rate) were received, providing data on 5444 biopsies. Mean number of biopsies performed per annum was 30.5 per centre; 8% of centres did not perform biopsies, 36% performed <25 biopsies per annum, 34% <50, 16% <100 and 6% >100. Consultant radiologists perform 91% of biopsies. Written consent was obtained at all centres. The operator obtained consent at 50% of centres. Written information for patients was provided at 35 (24%) centres. Biopsies are performed on a day case basis at 103 (71%) centres. Prior to biopsy the following were obtained routinely: CT scan (73% of centres), platelet count (73%), full clotting screen (70%), lung function (55%). Complications included pneumothorax (20.5% of biopsies), pneumothorax requiring chest drain (3.1%), haemoptysis (5.3%) and death (0.15%). The timing of post-procedure chest radiography was variable. Those centres that performed predominantly cutting needle biopsies had similar pneumothorax rates to centres performing mainly fine needle biopsies (18.9% vs 18.3%). There is great variation in practice throughout the UK. Most procedures are performed on a daycase basis. Small pneumothoraces are common but infrequently require treatment. National guidelines are needed to ensure consistency of standards.

Perkütan Transtorasik Akciger ve Kemik Biyopsileri

“…İntrapulmoner hemoraji %5-16,9 ve hemoptizi %1,25-5 oranlarında görülebilmektedir [20]. Lezyon derinliği en önemli risk faktörü olup 2 cm'den daha derin yerleşimde risk artmaktadır [21].…”

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

“…Unfortunately, both biological tests and imaging techniques are often poorly sensitive and not specific in transplant patients. Finally, biopsy represents a diagnostic alternative, but it is not free of further complications [4][5][6][7][8]. 18 F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is a noninvasive imaging tool with high diagnostic accuracy and therapeutic impact in oncological clinical practice [9,10].…”

An Unusual Cerebral Air Embolism Developing within the Posterior Circulation Territory after a Needle Lung Biopsy

“…Systemic air embolisms are a rare complication of CTNLB, with an incidence of 0.02-0.07% (3)(4)(5). There are two causative mechanisms for the development of air embolisms after CTNLB: a direct communication between the atmosphere and the pulmonary vein may occur when the needle tip is placed in the pulmonary vein (6) and a bronchovenous fistula can be created when the needle passes through the lung parenchyma (7).…”