Synchronous computed tomography-guided percutaneous biopsy and microwave ablation for highly suspicious malignant lung ground-glass opacities adjacent to mediastinum

Wang, Nan; Xu, Jingwen; Xue, Guoliang; Han, Cuiping; Zhang, Haitao; Zhao, Wenhua; Li, Zhichao; Cao, Pikun; Hu, Yanting; Wei, Zhigang; Ye, Xin

doi:10.1080/02656736.2023.2193362

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…However, neither radiotherapy nor LTA (unlike surgical resection) could provide histopathological information which is essential for guiding subsequent treatment decisions. Fortunately, this limitation has been partly addressed via synchronously conducting PTNB and LTA [21][22][23][24][25][26][27][28][29]. This has been supported by findings that the in vitro tissue architecture could be preserved, even for 1 month, for pathological assessments after ablation [24,36,37], and that the diagnostic accuracy and the rate of local control (74.3-100% and 74-100%, respectively) was comparable to that of our results.…”

Section: Discussionsupporting

confidence: 81%

“…Sequential PTNB and LTA which are performed on a separate session are time-consuming and costly, and bear a high risk of complications [19]. To address these limitations, Schneider et al [20] have initially proposed to perform PTNB and LTA synchronously for susceptible malignant solitary pulmonary lesion, which reportedly yielded a higher diagnostic yield and a lower rate of procedure-related complications as compared with the sequential procedures [21][22][23][24][25][26][27][28][29]. However, the studies on synchronous PTNB and LTA in GGNs remain scarce [22,24,[26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

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Synchronous Computed Tomography-Guided Percutaneous Transthoracic Needle Biopsy and Microwave Ablation for Highly Suspicious Malignant Pulmonary Ground-Glass Nodules

Chen,

Zeng,

Lin

et al. 2024

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Introduction: There is no consensus regarding the most appropriate management of suspected malignant pulmonary ground-glass nodules (GGNs). Objective: We aimed to explore the feasibility and safety of synchronous computed tomography-guided percutaneous transthoracic needle biopsy (PTNB) and microwave ablation (MWA) for patients highly suspicious of having malignant GGNs. Methods: We retrospectively reviewed medical records between July 2020 and April 2023 from our medical center. Eligible patients synchronously underwent PTNB and MWA (either MWA immediately after PTNB [PTNB-first group] or PTNB immediately after MWA [MWA-first group]) at the the physician’s discretion. We analyzed the rate of definitive diagnosis and technical success, the length of hospital stay, the postoperative efficacy, and periprocedural complications. Results: Of 65 patients who were enrolled, the rate of definitive diagnosis was 86.2%, which did not differ when stratified by the tumor size, the consolidation-to-tumor ratio, or the sequence of the two procedures (all p > 0.05). The diagnostic rate of malignancy was 83.1%. After the median follow-up duration of 18.5 months, the local control rate was 98.2% and the rate of completed ablation was 48.2%. The rate of perioperative minor and major complications was 44.6% and 6.2%, respectively. The most common adverse events included pain, cough, and mild hemorrhage. Mild hemorrhage took place significantly less frequently in the MWA-first group than in the PTNB-first group (16.7% vs. 45.5%, p < 0.05). Conclusion: Synchronous PTNB and MWA are feasible and well tolerated for patients highly suspicious of having malignant GGNs, providing an alternative option for patients who are ineligible for surgical resection.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Synchronous Computed Tomography-Guided Percutaneous Transthoracic Needle Biopsy and Microwave Ablation for Highly Suspicious Malignant Pulmonary Ground-Glass Nodules

Chen,

Zeng,

Lin

et al. 2024

Respiration

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“…Peng et al ( 6 ) recommend the use of percutaneous FNA as an alternative diagnostic method to CNB because of its low complication rate. Compared to studies using CNB pre-ablation, they find that the rates of pulmonary hemorrhage and pneumothorax immediately after biopsy are lower when using FNA ( 7 ). However, other studies report unclear or insignificant differences between the two techniques, indicating that center-specific factors may also influence post-biopsy complication rates ( 8 ).…”

mentioning

confidence: 95%