US-guided transthoracic biopsy of peripheral lung lesions: pleural contact length influences diagnostic yield

Jeon, Kyung Nyeo; Bae, Kyungsoo; Park, Mi Jung; Choi, Ho Cheol; Shin, Hwa Seon; Shin, Sumin; Kim, Ho Cheol; Ha, Chang Yoon

doi:10.1177/0284185113494984

Cited by 51 publications

(39 citation statements)

References 22 publications

(40 reference statements)

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“…In addition, a good acoustic window may not be available with US if the contact area between the lesion and the pleura is small, but it may be feasible to guide the needle to such lesions under CT guidance. [24]…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

2016

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Background:Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities.Methods:A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups.Results:A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P < 0.0001).Conclusions:For pleural-based lesions the diagnostic accuracy of US guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

2016

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“…In recent years, ultrasound-guided transthoracic biopsy of mediastinal lesions has attracted clinical attention due to its advantages of being economic, convenient, safe, quick, and no radiation (1-3). However, conventional ultrasound (US) cannot clearly reveal the internal structures of the mediastinal lesions and the detection of superficial vessels or presence of internal necrotic tissue was limited (4). As a consequence, there is a risk of complications, such as bleeding, or false-negative results of biopsy.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of contrast-enhanced ultrasound in improving diagnostic accuracy rate of transthoracic biopsy of anterior-medial mediastinal lesions

Yang

Wang

et al. 2016

Chinese Journal of Cancer Research

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ObjectiveTo evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in transthoracic biopsy of anterior-medial mediastinal lesions.MethodsA total of 123 patients with anterior or middle mediastinum lesions required ultrasound guided transthoracic biopsy for pathological diagnosis. Among them, 72 patients received CEUS examinations before biopsy. After CEUS, 8 patients were excluded from biopsy and the rest 64 patients underwent biopsy (CEUS group). During the same period, 51 patients received biopsy without CEUS examination (US group). The ultrasonography characteristics, the number of biopsy puncture attempts, diagnostic accuracy rate and the incidence of complications were recorded and compared between the two groups.ResultsA large portion of necrosis area or superficial large vessels was found in 8 patients, so the biopsy was cancelled. The internal necrosis was demonstrated in 43.8% of the lesions in CEUS group and in 11.8% of US group (P>0.001). For thymic carcinoma, CEUS increased the detection rate of internal necrosis and pericardial effusion than conventional ultrasound (62.5% vs. 18.8%, P=0.012; 56.3% vs. 12.5%, P=0.023). The average number of punctures in CEUS group and US group was 2.36±0.70 and 2.21±0.51 times, respectively (P>0.05). The diagnostic accuracy rate of biopsy in CEUS group (96.9%, 62/64) was significantly higher than that in US group (84.3%, 43/51) (P=0.022). In US group, 2 patients suffered from mediastinal bleeding (3.9%), while no major complications occurred in CEUS group. ConclusionsCEUS examination provided important information before transthoracic mediastinum biopsy and improved diagnostic accuracy rate in biopsy of anterior and middle mediastinum lesions than conventional ultrasound.

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“…Jeon et al reported that the diagnostic accuracy of US-guided biopsy using B-mode was significantly increased for lesions in which the pleural-lesion contact area was ≥30 mm on the CT images [8]; moreover, for lesions with LPCAL values ≤ 30 mm, the diagnostic accuracy decreased from 98% to 85.4%. They concluded that US-guided biopsy of pulmonary lesions might be performed more easily when the lesion has a contact area as wide as the US window, which permits a flexible approach route.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy and Complication Rates of Fusion Images Created Using Real-Time Ultrasound with CT for Identification of Peripheral Lung Lesions in Patients Undergoing Biopsy

Imamine¹,

Kobayashi²,

Akuta³

et al. 2019

OJRad

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Background: Fusion image improves lesion detectability and can be an effective tool for percutaneous ultrasound (US)-guide procedure. We describe the clinical benefit of US-guided lung biopsy using fusion image. Purpose: To retrospectively compare the diagnostic accuracy and complication rates of US-guided lung biopsy with B-mode alone and those of a fusion image created using real-time US and computed tomography (CT). Materials and Methods: Between September, 2013 and September, 2016, 50 peripheral lung lesions in 50 patients (40 males, 10 females; median, 74 years old) were performed by US-guided percutaneous cutting needle biopsy using the B-mode alone or fusion image. Final diagnoses were based on surgical outcomes or clinical follow-up results for at least 12 months after biopsy. To assess prebiopsy characteristics, all lesions were divided into two groups: group 1 (identification on B-mode) and group 2 (identification on fusion image). Results: Of 50 peripheral lesions, 40 lesions (80%) were detected by means of B-mode alone (group 1), and 10 lesions (20%) were identified by fusion image (group 2). The diagnostic accuracy of group 1 was 90% (36/40 lesions), and the diagnostic accuracy of group 2 was 100% (10/10 lesions). Nodule type and the size of the lesions showed significant group wise differences (p < 0.001 and p = 0.02, respectively

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US-guided transthoracic biopsy of peripheral lung lesions: pleural contact length influences diagnostic yield

Abstract: In US-guided transthoracic biopsy of peripheral lung lesions, the LPCAL of the lesions is an important factor for a correct diagnosis.

Cited by 51 publications

References 22 publications

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

Clinical value of contrast-enhanced ultrasound in improving diagnostic accuracy rate of transthoracic biopsy of anterior-medial mediastinal lesions

Diagnostic Accuracy and Complication Rates of Fusion Images Created Using Real-Time Ultrasound with CT for Identification of Peripheral Lung Lesions in Patients Undergoing Biopsy

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