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DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS

Year 2022, Volume: 24 Issue: 3, 539 - 547, 31.12.2022
https://doi.org/10.24938/kutfd.1146774

Abstract

Objective: Transthoracic needle biopsy is a diagnostic method that has proven its reliability in lung nodules and is frequently applied in daily practice. The diagnostic accuracy of biopsies performed with computed tomography navigation is quite high, even if the lesion sizes are smaller than 1 cm. We aimed to evaluate the diagnostic accuracy and complications of the computed tomography-guided percutaneous transthoracic needle biopsy procedure performed in our center.
Material and Methods: Patients who underwent computed tomography guided percutaneous transthoracic pulmonary nodule biopsy procedure between January 2017 and January 2020 were included in the study. The size and anatomic location of lesions, the distance between the pleura and the lesion, the angle of the needle with the pleura, the procedure time, the number of pathologic samples taken per patient, the total radiation dose, complications, and the pathological results of the lesions were analyzed from the patients’ computed tomography images and patients’ records.
Results: Among the 161 patients admitted for the transthoracic percutaneous needle biopsy procedure, 135 were male (mean age 64.3±11.1 years) and 26 were females (mean age 61.3±15.4 years). The pathological evaluation of 32 patients were reported as non-diagnostic. The diagnostic accuracy of computed tomography guided transthoracic biopsy was calculated as 80.1%. Major complications occurred in 10 patients (6.2%), and minor complications occurred in 60 patients (37.2%). The rate of procedure requiring chest tube insertion was 4.9%. The mean effective radiation dose of the patients per procedure was calculated as 5.26±3.25 mSv.
Conclusion: Computed tomography guided transthoracic biopsy procedure are a method with a high diagnostic accuracy rate, low rate of complications and can be preferred in all appropriate pulmonary nodules.

References

  • Lee SM, Park CM, Lee KH, Bahn YE, Kim JI, Goo JM. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules: clinical experience in 1108 patients. Radiology. 2014; 271(1):291–300
  • Nour-Eldin NE, Alsubhi M, Emam A, Lehnert T, Beeres M, Jacobi V et al. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients. Cardiovasc Intervent Radiol. 2016;39(2):261-70
  • Li Y, Du Y, Yang HF, Yu JH, Xu XX. CT-guided percutaneous core needle biopsy for small (≤20 mm) pulmonary lesions. Clin Radiol. 2013;68(1):43-8
  • Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology. 2003;229(2):475-81
  • Liu XL, Li W, Yang WX, Rui MP, Li Z, Lv L, Yang LP. Computed tomography-guided biopsy of small lung nodules: diagnostic accuracy and analysis for true negatives. J Int Med Res. 2020;48(2):300060519879006
  • Hwang HS, Chung MJ, Lee JW, Shin SW, Lee KS. C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy: usefulness in evaluation of small pulmonary nodules. AJR Am J Roentgenol. 2010;195(6):400-7
  • Choi JW, Park CM, Goo JM, Park YK, Sung W, Lee HJ et al. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (≤ 20 mm) lung nodules: diagnostic accuracy and complications in 161 patients. AJR Am J Roentgenol. 2012;199(3):322-30
  • Tsukada H, Satou T, Iwashima A, Souma T. Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR. 2000;175(1):239–43
  • Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C, Sugimura K. CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 2003;180(6):1665-9
  • Huang MD, Weng HH, Hsu SL, Hsu LS, Lin WM, Chen CW et al. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: a single-center experience. Cancer Imaging. 2019;19(1):51
  • Turgut B, Duran FM, Bakdık S, Arslan S, Tekin AF, Esme H. Effectiveness of autologous blood injection in reducing the rate of pneumothorax after percutaneous lung core needle biopsy. Diagn Interv Radiol. 2020;26(5):470-5
  • Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27(1):138-48
  • Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:199–202.
  • Heck SL, Blom P, Berstad A. Accuracy and complications in computed tomograpy guided needle biopsies of lung masses. Eur Radiol. 2006; 16(6):1387–92
  • Kothary N, Lock L, Sze DY, Hofmann LV. Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy. Clin Lung Cancer. 2009;10:360–3
  • Loubeyre P, Copercini M, Dietrich PY. Percutaneous CT-guided multisampling core needle biopsy of thoracic lesions. AJR. 2005;185(5):1294–8
  • Mazzone PJ, Lam L. Evaluating the Patient With a Pulmonary Nodule: A Review. JAMA. 2022;327(3):264-73
  • Kim J, Chee CG, Cho J, Kim Y, Yoon MA. Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: a systematic review and meta-analysis. Br J Radiol. 2021;94(1127):20210065
  • Cox JE, Chiles C, McManus CM, Aquino SL, Choplin RH. Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology. 1999;212(1):165–8
  • Dennie CJ, Matzinger FR, Marriner JR, Maziak DE. Transthoracic needle biopsy of the lung: results of early discharge in 506 outpatients. Radiology. 2001;219(1):247–51
  • Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology. 2003;229(2):475–81
  • Huo YR, Chan MV, Habib AR, Lui I, Ridley L. Pneumothorax rates in CT-Guided lung biopsies: a comprehensive systematic review and meta-analysis of risk factors. Br J Radiol. 2020;93(1108):20190866
  • Maybody M, Muallem N, Brown KT, Moskowitz CS, Hsu M, Zenobi CL et al. Autologous Blood Patch Injection versus Hydrogel Plug in CT-guided Lung Biopsy: A Prospective Randomized Trial. Radiology. 2019;290(2):547-54.
  • Sabatino V, Russo U, D'Amuri F, Bevilacqua A, Pagnini F, Milanese G et al. Pneumothorax and pulmonary hemorrhage after CT-guided lung biopsy: incidence, clinical significance and correlation. Radiol Med. 2021;126(1):170-7
  • De Filippo M, Saba L, Silva M, Zagaria R, Concari G, Nizzoli R et al. CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage? Diagn Interv Radiol. 2014;20(5):421-5
  • Yeow KM, Su IH, Pan KT, Tsay PK, Lui KW, Cheung YC et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest. 2004;126(3):748-54
  • Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS et al. Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol. 2010;194(3):784-9
  • Prutsky G, Domecq JP, Salazar CA, Accinelli R. Antifibrinolytic therapy to reduce haemoptysis from any cause. Cochrane Database Syst Rev. 2012;4:CD008711
  • Zhang HM, Huo XB, Wang HL, Zhang X, Fu YF. Computed tomography-guided cutting needle biopsy for lung nodules: A comparative study between low-dose and standard dose protocols. Medicine (Baltimore). 2021;100(3):e24001

Akciğer Nodüllerinden BT Kılavuzluğunda İğne Biyopsisi Gerçekleştirilen 161 Hastada Tanısal Doğruluk ve Komplikasyonlar

Year 2022, Volume: 24 Issue: 3, 539 - 547, 31.12.2022
https://doi.org/10.24938/kutfd.1146774

Abstract

Amaç: Transtorasik iğne biyopsisi, akciğer nodüllerinde güvenilirliği kanıtlanmış ve günlük pratikte sıklıkla uygulanan bir tanı yöntemidir. Bilgisayarlı tomografi navigasyonu ile yapılan biyopsilerin tanısal doğruluğu, lezyon boyutları 1 cm'den küçük olsa bile oldukça yüksektir. Bu çalışmada merkezimizde yapılan bilgisayarlı tomografi eşliğinde perkütan transtorasik iğne biyopsisi işleminin tanısal doğruluğunu ve komplikasyonlarını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Ocak 2017-Ocak 2020 tarihleri arasında bilgisayarlı tomografi eşliğinde perkütan transtorasik pulmoner nodül biyopsi işlemi yapılan hastalar çalışmaya dahil edildi. Lezyonların boyutu ve anatomik yerleşimi, plevra ile lezyon arasındaki mesafe, iğnenin plevraya olan açısı, işlem süresi, hasta başına alınan patolojik örnek sayısı, toplam radyasyon dozu, komplikasyonlar ve patoloji sonuçları hastaların bilgisayarlı tomografi görüntüleri ile hasta kayıtlarından analiz edildi.
Bulgular: Transtorasik perkütan iğne biyopsi işlemine başvuran 161 hastanın 135'i erkek (ortalama yaş 64.3±11.1 yıl), 26'sı kadın (ortalama yaş 61.3±15.4 yıl) idi. 32 hastanın patolojik değerlendirmesi non-diagnostik olarak raporlandı. BT eşliğinde transtorasik biyopsi tanısal duyarlılığı %80.1 olarak hesaplandı. 10 hastada (%6.2) majör komplikasyon, 60 hastada (%37.2) minör komplikasyon gelişti. Göğüs tüpü takılmasını gerektiren işlem oranı %4.9 idi. Hastaların işlem başına aldıkları ortalama efektif radyasyon dozu 5.26±3.25 mSv (0.12-14.34 aralığında) olarak hesaplandı.
Sonuç: Bilgisayarlı tomografi eşliğinde transtorasik biyopsi prosedürü tanısal doğruluk oranı yüksek, komplikasyon oranı düşük ve uygun tüm pulmoner nodüllerde tercih edilebilecek bir yöntemdir.

References

  • Lee SM, Park CM, Lee KH, Bahn YE, Kim JI, Goo JM. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules: clinical experience in 1108 patients. Radiology. 2014; 271(1):291–300
  • Nour-Eldin NE, Alsubhi M, Emam A, Lehnert T, Beeres M, Jacobi V et al. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients. Cardiovasc Intervent Radiol. 2016;39(2):261-70
  • Li Y, Du Y, Yang HF, Yu JH, Xu XX. CT-guided percutaneous core needle biopsy for small (≤20 mm) pulmonary lesions. Clin Radiol. 2013;68(1):43-8
  • Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology. 2003;229(2):475-81
  • Liu XL, Li W, Yang WX, Rui MP, Li Z, Lv L, Yang LP. Computed tomography-guided biopsy of small lung nodules: diagnostic accuracy and analysis for true negatives. J Int Med Res. 2020;48(2):300060519879006
  • Hwang HS, Chung MJ, Lee JW, Shin SW, Lee KS. C-arm cone-beam CT-guided percutaneous transthoracic lung biopsy: usefulness in evaluation of small pulmonary nodules. AJR Am J Roentgenol. 2010;195(6):400-7
  • Choi JW, Park CM, Goo JM, Park YK, Sung W, Lee HJ et al. C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (≤ 20 mm) lung nodules: diagnostic accuracy and complications in 161 patients. AJR Am J Roentgenol. 2012;199(3):322-30
  • Tsukada H, Satou T, Iwashima A, Souma T. Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR. 2000;175(1):239–43
  • Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C, Sugimura K. CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. AJR Am J Roentgenol. 2003;180(6):1665-9
  • Huang MD, Weng HH, Hsu SL, Hsu LS, Lin WM, Chen CW et al. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: a single-center experience. Cancer Imaging. 2019;19(1):51
  • Turgut B, Duran FM, Bakdık S, Arslan S, Tekin AF, Esme H. Effectiveness of autologous blood injection in reducing the rate of pneumothorax after percutaneous lung core needle biopsy. Diagn Interv Radiol. 2020;26(5):470-5
  • Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27(1):138-48
  • Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:199–202.
  • Heck SL, Blom P, Berstad A. Accuracy and complications in computed tomograpy guided needle biopsies of lung masses. Eur Radiol. 2006; 16(6):1387–92
  • Kothary N, Lock L, Sze DY, Hofmann LV. Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy. Clin Lung Cancer. 2009;10:360–3
  • Loubeyre P, Copercini M, Dietrich PY. Percutaneous CT-guided multisampling core needle biopsy of thoracic lesions. AJR. 2005;185(5):1294–8
  • Mazzone PJ, Lam L. Evaluating the Patient With a Pulmonary Nodule: A Review. JAMA. 2022;327(3):264-73
  • Kim J, Chee CG, Cho J, Kim Y, Yoon MA. Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: a systematic review and meta-analysis. Br J Radiol. 2021;94(1127):20210065
  • Cox JE, Chiles C, McManus CM, Aquino SL, Choplin RH. Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology. 1999;212(1):165–8
  • Dennie CJ, Matzinger FR, Marriner JR, Maziak DE. Transthoracic needle biopsy of the lung: results of early discharge in 506 outpatients. Radiology. 2001;219(1):247–51
  • Geraghty PR, Kee ST, McFarlane G, Razavi MK, Sze DY, Dake MD. CT-guided transthoracic needle aspiration biopsy of pulmonary nodules: needle size and pneumothorax rate. Radiology. 2003;229(2):475–81
  • Huo YR, Chan MV, Habib AR, Lui I, Ridley L. Pneumothorax rates in CT-Guided lung biopsies: a comprehensive systematic review and meta-analysis of risk factors. Br J Radiol. 2020;93(1108):20190866
  • Maybody M, Muallem N, Brown KT, Moskowitz CS, Hsu M, Zenobi CL et al. Autologous Blood Patch Injection versus Hydrogel Plug in CT-guided Lung Biopsy: A Prospective Randomized Trial. Radiology. 2019;290(2):547-54.
  • Sabatino V, Russo U, D'Amuri F, Bevilacqua A, Pagnini F, Milanese G et al. Pneumothorax and pulmonary hemorrhage after CT-guided lung biopsy: incidence, clinical significance and correlation. Radiol Med. 2021;126(1):170-7
  • De Filippo M, Saba L, Silva M, Zagaria R, Concari G, Nizzoli R et al. CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage? Diagn Interv Radiol. 2014;20(5):421-5
  • Yeow KM, Su IH, Pan KT, Tsay PK, Lui KW, Cheung YC et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest. 2004;126(3):748-54
  • Atwell TD, Smith RL, Hesley GK, Callstrom MR, Schleck CD, Harmsen WS et al. Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol. 2010;194(3):784-9
  • Prutsky G, Domecq JP, Salazar CA, Accinelli R. Antifibrinolytic therapy to reduce haemoptysis from any cause. Cochrane Database Syst Rev. 2012;4:CD008711
  • Zhang HM, Huo XB, Wang HL, Zhang X, Fu YF. Computed tomography-guided cutting needle biopsy for lung nodules: A comparative study between low-dose and standard dose protocols. Medicine (Baltimore). 2021;100(3):e24001
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Özgün Araştırma
Authors

Yunus Yılmazsoy 0000-0001-7293-2059

Publication Date December 31, 2022
Submission Date July 21, 2022
Published in Issue Year 2022 Volume: 24 Issue: 3

Cite

APA Yılmazsoy, Y. (2022). DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 24(3), 539-547. https://doi.org/10.24938/kutfd.1146774
AMA Yılmazsoy Y. DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS. Kırıkkale Uni Med J. December 2022;24(3):539-547. doi:10.24938/kutfd.1146774
Chicago Yılmazsoy, Yunus. “DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24, no. 3 (December 2022): 539-47. https://doi.org/10.24938/kutfd.1146774.
EndNote Yılmazsoy Y (December 1, 2022) DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24 3 539–547.
IEEE Y. Yılmazsoy, “DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS”, Kırıkkale Uni Med J, vol. 24, no. 3, pp. 539–547, 2022, doi: 10.24938/kutfd.1146774.
ISNAD Yılmazsoy, Yunus. “DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 24/3 (December 2022), 539-547. https://doi.org/10.24938/kutfd.1146774.
JAMA Yılmazsoy Y. DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS. Kırıkkale Uni Med J. 2022;24:539–547.
MLA Yılmazsoy, Yunus. “DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 24, no. 3, 2022, pp. 539-47, doi:10.24938/kutfd.1146774.
Vancouver Yılmazsoy Y. DIAGNOSTIC ACCURACY AND COMPLICATIONS OF PERCUTANEOUS CT-GUIDED NEEDLE BIOPSY OF LUNG NODULES IN 161 PATIENTS. Kırıkkale Uni Med J. 2022;24(3):539-47.

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