Risk factors for complications of CT-guided lung biopsies

Rizzo, Stefania; Preda, Lorenzo; Raimondi, Sara; Meroni, Stefano; Belmonte, M. J. Gayán; Monfardini, Lorenzo; Veronesi, Giulia; Bellomi, Massimo

doi:10.1007/s11547-011-0619-9

Cited by 44 publications

(31 citation statements)

References 31 publications

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“…In this study, pneumothorax occurred in 29% of cases, within the range of 8%-64% reported in the literature (1)(2)(3)(4)(5)(6)(7)(17)(18)(19)(20). Pulmonary hemorrhage was relatively frequent in our experience (27%) compared to the incidence reported in the literature (15%-26%) (8).…”

Section: Discussionsupporting

confidence: 65%

CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?

Filippo

Saba²,

Silva³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSEWe aimed to assess the correlation between pulmonary hemorrhage and pneumothorax in computed tomography (CT)-guided transthoracic fine needle aspiration (TTFNA), particularly its possible value as protection against the development of pneumotorax. MATERIALS AND METHODSWe reviewed the CT images of 538 patients (364 males and 174 females, mean age 70 years, range 36-90 years) who underwent CT-guided TTFNA of pulmonary nodules between January 2008 and September 2013. The following CT findings were assessed: pulmonary hemorrhage (type 1, along the needle track; type 2, perilesional; low-grade, ≤6 mm; high-grade, >6 mm), pneumothorax, distance between the target nodule and the pleural surface, and emphysema. RESULTSPneumothorax occurred in 154 cases (28.6%) and pulmonary hemorrhage occurred in 144 cases (26.8%). The incidence of pneumothorax was lower in patients showing type 1 and high-grade pulmonary hemorrhage pattern. The incidence of pneumothorax in biopsies ≥30 mm from pleural surface was 26% (12/46) in cases showing this pattern, while it was 71.4% (30/42) when this pattern was not seen. Similarly, the incidence of pneumothorax in biopsies <30 mm from the pleural surface was 0% (0/28) in cases showing this hemorrhage pattern, while it was 19% (76/394) when this pattern was not seen. CONCLUSION Pulmonary hemorrhage during TTFNA is a frequent event that protects against pneumothorax. A bleeding greater than 6 mm along the needle track is associated with lower incidence of pneumothorax, especially in biopsies deeper than 3 cm.

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Section: Discussionsupporting

confidence: 65%

CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?

Filippo

Saba²,

Silva³

et al. 2014

Diagn Interv Radiol

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“…We have associated lesion size and malignant histological diagnosis with an increased risk of hemorrhage. Small lesion size and the extent of intrapulmonary needle trajectory are already considered risk factors for both pneumothorax and hemorrhage (30). Previous studies supported this association only as concerns pneumothorax, whereas bleeding risk was associated with CT signs of emphysema (31).…”

Section: Discussionmentioning

confidence: 95%

Computed tomography-guided needle aspiration and biopsy of pulmonary lesions: a single-center experience in 1000 patients

et al. 2013

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“…The New York Early Lung Cancer Action Project (ELCAP) group [11] reported good diagnostic performance for CT-guided biopsy (overall 82% sensitivity and 88% accuracy), although the results were less good for nodules <8 mm. However, CT-guided biopsy is highly operator dependent and sensitivity can be very low [28].…”

Section: Discussionmentioning

confidence: 99%

Positron emission tomography in the diagnostic work-up of screening-detected lung nodules

et al. 2014

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Low-dose computed tomography (CT) screening for lung cancer can reduce lung cancer mortality, but overdiagnosis, false positives and invasive procedures for benign nodules are worrying. We evaluated the utility of positron emission tomography (PET)-CT in characterising indeterminate screeningdetected lung nodules. 383 nodules, examined by PET-CT over the first 6 years of the COSMOS (Continuous Observation of Smoking Subjects) study to diagnose primary lung cancer, were reviewed and compared with pathological findings (surgically-treated patients) or follow-up (negative CT for ⩾2 years, considered negative); 196 nodules were malignant.The sensitivity, specificity and accuracy of PET-CT for differentially diagnosing malignant nodules were, respectively, 64%, 89% and 76% overall, and 82%, 92% and 88% for baseline-detected nodules. Performance was lower for nodules found at repeat annual scans, with sensitivity ranging from 22% for nonsolid to 79% for solid nodules ( p=0.0001). Sensitivity (87%) and specificity (73%) were high for nodules ⩾15 mm, better (sensitivity 98%) for solid nodules ⩾15 mm.PET-CT was highly sensitive for the differential diagnosis of indeterminate nodules detected at baseline, nodules ⩾15 mm and solid nodules. Sensitivity was low for sub-solid nodules and nodules discovered after baseline for which other methods, e.g. volume doubling time, should be used. @ERSpublications PET-CT is good at differentially diagnosing large, solid and baseline-detected lung nodules in the screening setting

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Risk factors for complications of CT-guided lung biopsies

Cited by 44 publications

References 31 publications

CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?

CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?

Computed tomography-guided needle aspiration and biopsy of pulmonary lesions: a single-center experience in 1000 patients

Positron emission tomography in the diagnostic work-up of screening-detected lung nodules

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