Value of Ultrasound in the Imaging-Guided Transthoracic Biopsy of Lung Lesions

Moreira, Bruno Lima; Guimarães, Marcos Duarte; Oliveira, Alex Dias de; Maciel, Macello José Sampaio; Bitencourt, Almir Galvão Vieira; Costa, Felipe D’Almeida; Chojniak, Rubens; Gross, Jefferson Luiz; Marchiori, Edson

doi:10.1016/j.athoracsur.2013.07.105

Cited by 6 publications

(3 citation statements)

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“…We agree with CT-guided technique when consolidation is deep and could not be correctly identified by TUS, but it is mandatory to underline that ultrasound has to be considered a valuable tool in detecting even small lesions adherent to the pleural surface [2, 3]. The procedure-related complications with TUS guidance are less frequent than reported in the review [4]. In our experience, in a case series [5], including 95 ultrasound-guided PTNB, there was no pneumothorax or hemothorax.…”

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confidence: 52%

Safety maximization of percutaneous transthoracic needle biopsy with ultrasound guide in subpleural lesions in the evaluation of pulmonary consolidation

et al. 2019

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The study by Kiranantawat et al. “Clinical role, safety and diagnostic accuracy of percutaneous transthoracic needle biopsy in the evaluation of pulmonary consolidation” highlights how “pulmonary consolidation can be safely evaluated with CT-guided percutaneous needle biopsy”. Even if we agree about the role of CT guidance, we would like to point out how Thoracic Ultrasound could be better than CT for biopsy of subpleural lesions that could easily be detected and reached with this “real-time” and quicker technique.

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confidence: 52%

Safety maximization of percutaneous transthoracic needle biopsy with ultrasound guide in subpleural lesions in the evaluation of pulmonary consolidation

et al. 2019

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“…MRI has some advantages in relation to other image guidance techniques. First, MRI provides unparalleled soft-tissue contrast and exquisite anatomic detail, enabling the identification of target lesions that cannot be observed with ultrasound or CT and the detailed visualization of anatomy surrounding the target [17]. This level of detail aids in preventing collateral damage to delicate structures that typically would not be well visualized using other imaging modalities.…”

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confidence: 99%

Functional imaging with diffusion-weighted MRI for lung biopsy planning: initial experience

et al. 2014

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BackgroundThe purpose of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography/computed tomography (PET/CT) in planning transthoracic CT-guided biopsies of lung lesions.MethodsThirteen patients with lung lesions suspicious for malignancy underwent CT-guided biopsy. Chest DW-MRI and apparent diffusion coefficient (ADC) calculation were performed to aid biopsy planning with fused images. MRI was indicated due to large heterogeneous masses, association with lung atelectasis/consolidation/necrosis, and/or divergent results of other biopsy type and histopathology versus clinical/radiological suspicion. Eight patients underwent PET/CT to identify appropriate areas for biopsy.ResultsMean patient (n = 9 males) age was 59 (range, 30 to 78) years. Based on DW-MRI results, biopsies targeted the most suspicious areas within lesions. All biopsied areas showed higher DW signal intensity and lower ADCs (mean, 0.79 (range, 0.54 to 1.2) × 10−3 mm2/s), suggesting high cellularity. In patients who underwent PET/CT, areas with higher 18-fluorodeoxyglucose concentrations (standard uptake value mean, 7.7 (range, 3.6 to 13.7)) corresponded to areas of higher DW signal intensity and lower ADCs. All biopsies yielded adequate material for histopathological diagnosis.ConclusionsFunctional imaging is useful for lung biopsy planning. DW-MRI and PET/CT increase overall performance and enable the collection of adequate material for specific diagnosis.

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“…It is also a cost-effective option that circumvents the need for expensive computed tomography (CT)-guided procedures. [11] The portability of ultrasound machines makes it possible for procedures to be performed wherever patients are located, unlike CT machines, which are not portable and are often unavailable in limited-resource or rural settings. CT machines also expose patients to unnecessary radiation.…”

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confidence: 99%