US-guided Transthoracic Cutting Biopsy for Peripheral Thoracic Lesions Less than 3 cm in Diameter

Liao, Wen-Chieh; Chen, Ming-Zen; Chang, Yih‐Leong; Wu, Heuy-Dong; Yu, Chong‐Jen; Kuo, Ping-Hung; Yang, Pan‐Chyr

doi:10.1148/radiology.217.3.r00dc21685

Cited by 92 publications

(80 citation statements)

References 32 publications

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“…In our series, we found three cases in which post-procedual CT showed a thin blood layer around the lesion. Adequacy rate of peripheral pulmonary or pleural lesion biopsy performed with a non fine needle is reported to be between 89.5% and 97% with CT guidance (6,9,10,23) and between 76%and 96 % with US guidance (17,19,20). Our values are comparable with those reported in the literature.…”

Section: Resultssupporting

confidence: 86%

“…However, US has been described as a useful tool in the characterization of undetermined pleural or sub-pleural pulmonary nodules (13,16) when no aerated lung is interposed in between . Also, US can be used as a safe and effective method with which to guide biopsies of masses abutting the chest wall (5,(17)(18)(19)(20). Major advantages of this imaging modality are that US enables real time multiplanar monitoring of the procedure and can be performed at the patient bedside, without the use of ionizing radiation .…”

Section: Introductionmentioning

confidence: 99%

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Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

Abish¹,

Mohammed²

2014

IOSRJDMS

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Results: No significant difference was found for patient age (P = .741), sex (P = .900), lesion size (P = .206), or lesion origin (P = .788). Median time was 576 seconds for CT-guided biopsy (25th percentile, 418 seconds; 75th percentile, 714 seconds) and 311 seconds for US-guided biopsy (25th percentile, 152 seconds; 75th percentile, 480 seconds) (P < .001). Post-procedural pneumothorax was observed in 24 of 162 (14.8%) CTguided procedures and in five of 98 (5.1%) US-guided procedures (P = .025); hemorrhage occurred in two of

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Section: Resultssupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

Abish¹,

Mohammed²

2014

IOSRJDMS

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“…Pneumothorax reportedly occurs in 7e 15% of patients who undergo blind thoracentesis, but the frequency drops to 0.5% when US needle guidance is used [42,43]. In the past 10 years, we have performed 1480 diagnostic or therapeutic thoracenteses under US guidance.…”

Section: Invasive Pleural and Pulmonary Proceduresmentioning

confidence: 99%

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo

Filabozzi

Varriale

et al. 2008

Journal of Ultrasound

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Although numerous studies have been conducted on the use of ultrasonography (US) for the examination of thoracic structures, this procedure is not as widely accepted as abdominal US. The newer portable scanners can be used at the bedside to detect pleural malignancies and effusions, as well as peripheral lung nodules of the lung, even in seriously ill patients. Focal thickening of the pleura can be easily detected with US and further investigated with a US-guided biopsy. US guidance can also be used during percutaneous drainage of pleural effusion or transthoracic biopsy of peripheral lung lesions, thus reducing the incidence of procedure-related pneumothorax to almost zero. We review the current literature on thoracic US and present our clinical experience with the technique in large groups of patients with pleural and peripheral lung diseases.Sommario L'ecografia del torace non è ancora diffusa quanto quella addominale, nonostante una notevole quantità di studi ne attesti l'importanza. Le apparecchiature più recenti permettono di diagnosticare neoplasie, versamenti pleurici e noduli polmonari periferici al letto del paziente, anche nei casi più gravi. L'ispessimento pleurico focale è facilmente messo in luce dall'ecografia e può essere ulteriormente studiato tramite la biopsia ecoguidata. Questa può essere praticata anche su lesioni polmonari periferiche, riducendo quasi a zero il rischio di pneumotorace. In questo articolo esaminiamo la letteratura recente sull'ecografia del torace e presentiamo la nostra esperienza clinica su numerosi pazienti con patologia pleurica e della periferia polmonare. ª

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“…Anterior mediastinal lesions are clinically approachable under US guidance. US scan permits reliable identification of major vessels that should be avoided during the biopsy, the needle tip can be clearly visualized, and the needle can be advanced precisely within the lesion, allowing real-time imaging guidance and a quicker procedure (5). Previous studies found high diagnostic success rates for US-guided biopsies sized 1.5-10 cm (71% to 100%) (6)(7)(8).…”

mentioning

confidence: 99%

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

Mao²,

Ping³

et al. 2017

Diagn Interv Radiol

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A nterior mediastinal tumors are common in clinical settings. Common lesions include inflammatory vs. neoplastic lesions, benign vs. malignant lesions, and primary vs. metastatic lesions. Among these, lymphomas are medically treatable, thymomas are surgically treatable, and metastatic carcinomas are nonresectable (1). Primary mediastinal tumors represent only about 3% of the tumors within the chest wall. Metastatic carcinoma and non-Hodgkin's lymphoma are among common anterior mediastinal tumors. The rates of nonsurgical tumors such as lymphoma are higher than the rates of surgical diseases such as thymomas (2). Some anterior mediastinal tumors such as nonseminomatous germ cell tumors, thymic carcinomas, seminomas, lymphomas, and thymomas are quite similar in medical imaging appearance, but are quite different in treatment strategy; early and precise histopathologic diagnosis of anterior mediastinal lesions is essential for correct therapeutic decision, and remains an interesting diagnostic challenge (3).Several biopsy techniques and approaches have been previously described and are available to obtain specimens of anterior mediastinal lesions, including percutaneous image-guided core needle biopsy, parasternal anterior mediastinotomy, endoscopic ultrasonography (US)-guided biopsy, video-assisted thoracoscopic surgery, cervical mediastinoscopy, and open surgical procedures (1). Most of those procedures require intubation and general anesthesia. Open biopsy is associated with morbidity, chance of pleural dissemination, and poor long-term results. For these reasons, surgically strategies are not suitable for anterior mediastinum lesions (4).In general, US-guided percutaneous core needle biopsy is the first diagnostic choice because it is a minimally invasive, safe, and cost-effective procedure. I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to explore the value of contrast-enhanced ultrasonography (CEUS) in guidance of percutaneous biopsy of anterior mediastinal lesions. METHODSNinety patients with solitary anterior mediastinal lesions (55 males, 35 females; mean age, 46±4 years) were included. Patients were randomly divided into CEUS group (n=45) and conventional ultrasonography (US) group (n=45). Real-time US-guided core needle (16 G) percutaneous biopsies were performed in all lesions. The display of internal mammary arteries, internal necrosis, and active areas were recorded and compared. Biopsy success rate and diagnostic accuracy were compared between the two groups. RESULTSDisplay rate of unenhanced internal necrosis was higher in the CEUS group than in the US group (88.9% vs. 46.7%, P = 0.041). With real-time CEUS guidance, internal mammary arteries were effectively displayed and avoided during biopsies in 68.9% of the lesions (31/45). Of the lesions, 88.9% (80/90) were histologically proven, including 13 benign lesions and 67 malignancies. There was a significant difference in the rate of successful puncture attempts between the two groups (P = 0.041). CEUS gro...

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US-guided Transthoracic Cutting Biopsy for Peripheral Thoracic Lesions Less than 3 cm in Diameter

Abstract: US-guided transthoracic cutting biopsy appears to be a safe and effective method for diagnosing peripheral thoracic lesions less than 3 cm in diameter. The high diagnostic accuracy for benign lesions and metastatic lung cancer can help prevent surgery in many cases.

Cited by 92 publications

References 32 publications

Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

Intrathoracic tumors in contact with the chest wall – ultrasonographic and computed tomography guided biopsy comparative evaluation

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

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