Abstract
Background: Larger sample volume can be obtained in one needle pass using an aspiration-type semi-automatic cutting biopsy needle (STARCUT® aspirationtype needle; TSK Laboratory, Tochigi, Japan) in comparison to the conventional semi-automatic cutting biopsy needle.
Objective: To evaluate and compare the safety and effectiveness of aspiration-type semi-automatic cutting biopsy needles and non-aspiration-type biopsy needles when performing computed tomography (CT)-guided core needle biopsies (CNBs).
Methods: A total of 106 patients underwent CT-guided CNB for chest lesions between June 2013 and March 2020 at our hospital. Non-aspiration-type cutting biopsy needles were used in 47 of these patients, while aspiration-type needles were used in the remaining 59 patients. All needles used were 18- or 20-gauge biopsy needles. Parameters, like forced expiratory volume in 1-second percent (FEV1.0%), the maximum size of the target lesion, puncture pathway distance in the lung, number of needle passes, procedure time, diagnostic accuracy, and incidence of complications, were measured. Comparisons were made between the needle-type groups.
Results: No significant difference was observed in terms of diagnostic accuracy. However, the procedure time was shorter and a lesser number of needle passes were required with the aspiration-type cutting biopsy needle compared to the non-aspiration-type needle. Pneumothorax and pulmonary hemorrhage were the complications encountered, however, their incidence was not significantly different between the two types of needles.
Conclusion: The aspiration-type semi-automatic cutting biopsy needle had similar diagnostic accuracy as the non-aspiration-type biopsy needle, with added advantages of a lesser number of needle passes and shorter procedure time.
[1]
Yao X, Gomes MM, Tsao MS, Allen CJ, Geddie W, Sekhon H. Fine-needle aspiration biopsy versus core-needle biopsy in diagnosing lung cancer: A systematic review. Curr Oncol 2012; 19(1): 16-27.
[http://dx.doi.org/10.3747/co.19.871] [PMID: 22328844]
[http://dx.doi.org/10.3747/co.19.871] [PMID: 22328844]
[2]
Yamauchi Y, Izumi Y, Nakatsuka S, et al. Diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity pulmonary lesions. Eur J Radiol 2011; 79(2): e85-9.
[http://dx.doi.org/10.1016/j.ejrad.2011.03.088] [PMID: 21515009]
[http://dx.doi.org/10.1016/j.ejrad.2011.03.088] [PMID: 21515009]
[3]
Yamagami T, Yoshimatsu R, Miura H, et al. Diagnostic performance of percutaneous lung biopsy using automated biopsy needles under CT-fluoroscopic guidance for ground-glass opacity lesions. Br J Radiol 2013; 86(1022): 20120447.
[http://dx.doi.org/10.1259/bjr.20120447] [PMID: 23385998]
[http://dx.doi.org/10.1259/bjr.20120447] [PMID: 23385998]
[4]
Tian P, Wang Y, Li L, Zhou Y, Luo W, Li W. CT-guided transthoracic core needle biopsy for small pulmonary lesions: Diagnostic performance and adequacy for molecular testing. J Thorac Dis 2017; 9(2): 333-43.
[http://dx.doi.org/10.21037/jtd.2017.02.16] [PMID: 28275482]
[http://dx.doi.org/10.21037/jtd.2017.02.16] [PMID: 28275482]
[5]
Kim DY, Sun JS, Kim EY, Park KJ, You S. Diagnostic accuracy and safety of CT-guided percutaneous lung biopsy with a coaxial cutting needle for the diagnosis of lung cancer in patients with UIP pattern. Sci Rep 2022; 12(1): 15682.
[http://dx.doi.org/10.1038/s41598-022-20030-z] [PMID: 36127437]
[http://dx.doi.org/10.1038/s41598-022-20030-z] [PMID: 36127437]
[6]
Li QK, Ding YK, Liu Y, Xia FF, Li L, Fu YF. Diagnostic yield of computed tomography–guided percutaneous lung biopsy in patients with prior nondiagnostic transbronchial biopsy. J Comput Assist Tomogr 2020; 44(2): 305-9.
[http://dx.doi.org/10.1097/RCT.0000000000000999] [PMID: 32195810]
[http://dx.doi.org/10.1097/RCT.0000000000000999] [PMID: 32195810]
[7]
Komemushi A, Kanno S, Suzuki S, et al. Evaluation of an aspiration-type semiautomatic cutting biopsy needle. Minim Invasive Ther Allied Technol 2015; 24(4): 250-2.
[http://dx.doi.org/10.3109/13645706.2015.1021359] [PMID: 25744823]
[http://dx.doi.org/10.3109/13645706.2015.1021359] [PMID: 25744823]
[8]
Iguchi T, Hiraki T, Matsui Y, et al. Difference in specimen weights with semi-automatic cutting biopsy needles. Jpn J Radiol 2020; 38(6): 579-86.
[http://dx.doi.org/10.1007/s11604-020-00935-3] [PMID: 32124166]
[http://dx.doi.org/10.1007/s11604-020-00935-3] [PMID: 32124166]
[9]
Zhan P, Zhu QQ, Miu YY, et al. Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: A systematic review and meta-analysis. Transl Lung Cancer Res 2017; 6(1): 23-34.
[http://dx.doi.org/10.21037/tlcr.2017.01.01] [PMID: 28331821]
[http://dx.doi.org/10.21037/tlcr.2017.01.01] [PMID: 28331821]
[10]
Han Y, Kim HJ, Kong KA, et al. Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis. PLoS One 2018; 13(1): e0191590.
[http://dx.doi.org/10.1371/journal.pone.0191590] [PMID: 29357388]
[http://dx.doi.org/10.1371/journal.pone.0191590] [PMID: 29357388]
[11]
Kim GR, Hur J, Lee SM, et al. CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: A prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 2011; 21(2): 232-9.
[http://dx.doi.org/10.1007/s00330-010-1936-y] [PMID: 20730613]
[http://dx.doi.org/10.1007/s00330-010-1936-y] [PMID: 20730613]
[12]
Heck SL, Blom P, Berstad A. Accuracy and complications in computed tomography fluoroscopy-guided needle biopsies of lung masses. Eur Radiol 2006; 16(6): 1387-92.
[http://dx.doi.org/10.1007/s00330-006-0152-2] [PMID: 16541227]
[http://dx.doi.org/10.1007/s00330-006-0152-2] [PMID: 16541227]
[13]
Huang MD, Weng HH, Hsu SL, et al. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: A single-center experience. Cancer Imaging 2019; 19(1): 51.
[http://dx.doi.org/10.1186/s40644-019-0240-6] [PMID: 31337425]
[http://dx.doi.org/10.1186/s40644-019-0240-6] [PMID: 31337425]
[14]
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(5): 360-3.
[http://dx.doi.org/10.3816/CLC.2009.n.049] [PMID: 19808195]
[http://dx.doi.org/10.3816/CLC.2009.n.049] [PMID: 19808195]
[15]
Matsui Y, Hiraki T, Iguchi T, et al. A clinical study evaluating an aspiration-type semi-automatic cutting biopsy needle (SCIRO-1702). Acta Med Okayama 2020; 74(3): 209-14.
[http://dx.doi.org/10.18926/AMO/59951] [PMID: 32577018]
[http://dx.doi.org/10.18926/AMO/59951] [PMID: 32577018]
[16]
Yeow KM, Su IH, Pan KT, 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.
[http://dx.doi.org/10.1378/chest.126.3.748] [PMID: 15364752]
[http://dx.doi.org/10.1378/chest.126.3.748] [PMID: 15364752]
[17]
Heerink WJ, de Bock GH, de Jonge GJ, Groen HJM, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: Meta-analysis. Eur Radiol 2017; 27(1): 138-48.
[http://dx.doi.org/10.1007/s00330-016-4357-8] [PMID: 27108299]
[http://dx.doi.org/10.1007/s00330-016-4357-8] [PMID: 27108299]
[18]
Freund MC, Petersen J, Goder KC, Bunse T, Wiedermann F, Glodny B. Systemic air embolism during percutaneous core needle biopsy of the lung: frequency and risk factors. BMC Pulm Med 2012; 12(1): 2.
[http://dx.doi.org/10.1186/1471-2466-12-2] [PMID: 22309812]
[http://dx.doi.org/10.1186/1471-2466-12-2] [PMID: 22309812]
[19]
Ohno Y, Hatabu H, Takenaka D, Imai M, Ohbayashi C, Sugimura K. Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules. Eur J Radiol 2004; 51(2): 160-8.
[http://dx.doi.org/10.1016/S0720-048X(03)00216-X] [PMID: 15246522]
[http://dx.doi.org/10.1016/S0720-048X(03)00216-X] [PMID: 15246522]
[20]
Tai R, Dunne RM, Trotman-Dickenson B, et al. Frequency and severity of pulmonary hemorrhage in patients undergoing percutaneous CT-guided transthoracic lung biopsy: Single-institution experience of 1175 cases. Radiology 2016; 279(1): 287-96.
[http://dx.doi.org/10.1148/radiol.2015150381] [PMID: 26479161]
[http://dx.doi.org/10.1148/radiol.2015150381] [PMID: 26479161]
[21]
Wallace MJ, Krishnamurthy S, Broemeling LD, et al. CT-guided percutaneous fine-needle aspiration biopsy of small (< or =1-cm) pulmonary lesions. Radiology 2002; 225(3): 823-8.
[http://dx.doi.org/10.1148/radiol.2253011465] [PMID: 12461267]
[http://dx.doi.org/10.1148/radiol.2253011465] [PMID: 12461267]
[22]
Loh SEK, Wu DDF, Venkatesh SK, et al. CT-guided thoracic biopsy: Evaluating diagnostic yield and complications. Ann Acad Med Singap 2013; 42(6): 285-90.
[http://dx.doi.org/10.47102/annals-acadmedsg.V42N6p285] [PMID: 23842769]
[http://dx.doi.org/10.47102/annals-acadmedsg.V42N6p285] [PMID: 23842769]
[23]
Zhu J, Qu Y, Wang X, et al. Risk factors associated with pulmonary hemorrhage and hemoptysis following percutaneous CT-guided transthoracic lung core needle biopsy: A retrospective study of 1,090 cases. Quant Imaging Med Surg 2020; 10(5): 1008-20.
[http://dx.doi.org/10.21037/qims-19-1024] [PMID: 32489925]
[http://dx.doi.org/10.21037/qims-19-1024] [PMID: 32489925]
[24]
Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol 2008; 18(7): 1356-63.
[http://dx.doi.org/10.1007/s00330-008-0893-1] [PMID: 18351356]
[http://dx.doi.org/10.1007/s00330-008-0893-1] [PMID: 18351356]
[25]
Nour-Eldin NEA, Alsubhi M, Naguib NN, et al. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients. Eur J Radiol 2014; 83(10): 1945-52.
[http://dx.doi.org/10.1016/j.ejrad.2014.06.023] [PMID: 25063212]
[http://dx.doi.org/10.1016/j.ejrad.2014.06.023] [PMID: 25063212]
[26]
Nour-Eldin NEA, Alsubhi M, Emam A, 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.
[http://dx.doi.org/10.1007/s00270-015-1167-3] [PMID: 26148648]
[http://dx.doi.org/10.1007/s00270-015-1167-3] [PMID: 26148648]
[27]
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.
[http://dx.doi.org/10.1259/bjr.20190866] [PMID: 31860329]
[http://dx.doi.org/10.1259/bjr.20190866] [PMID: 31860329]
[28]
Yildirim E, Kirbas I, Harman A, et al. CT-guided cutting needle lung biopsy using modified coaxial technique: Factors effecting risk of complications. Eur J Radiol 2009; 70(1): 57-60.
[http://dx.doi.org/10.1016/j.ejrad.2008.01.006] [PMID: 18294798]
[http://dx.doi.org/10.1016/j.ejrad.2008.01.006] [PMID: 18294798]
[29]
Asai N, Kawamura Y, Yamazaki I, et al. Is emphysema a risk factor for pneumothorax in CT-guided lung biopsy? Springerplus 2013; 2(1): 196.
[http://dx.doi.org/10.1186/2193-1801-2-196] [PMID: 23741641]
[http://dx.doi.org/10.1186/2193-1801-2-196] [PMID: 23741641]
[30]
Ayyappan AP, Souza CA, Seely J, Peterson R, Dennie C, Matzinger F. Ultrathin fine-needle aspiration biopsy of the lung with transfissural approach: Does it increase the risk of pneumothorax? AJR Am J Roentgenol 2008; 191(6): 1725-9.
[http://dx.doi.org/10.2214/AJR.08.1110] [PMID: 19020242]
[http://dx.doi.org/10.2214/AJR.08.1110] [PMID: 19020242]
[31]
Takeshita J, Masago K, Kato R, et al. CT-guided fine-needle aspiration and core needle biopsies of pulmonary lesions: A single-center experience with 750 biopsies in Japan. AJR Am J Roentgenol 2015; 204(1): 29-34.
[http://dx.doi.org/10.2214/AJR.14.13151] [PMID: 25539234]
[http://dx.doi.org/10.2214/AJR.14.13151] [PMID: 25539234]
[32]
Filippo MD, Saba L, Silva M, et al. CT-guided biopsy of pulmonary nodules: Is pulmonary hemorrhage a complication or an advantage? Diagn Interv Radiol 2014; 20(5): 421-5.
[http://dx.doi.org/10.5152/dir.2014.14019] [PMID: 25163758]
[http://dx.doi.org/10.5152/dir.2014.14019] [PMID: 25163758]
[33]
Brandén E, Wallgren S, Högberg H, Koyi H. Computer tomography-guided core biopsies in a county hospital in Sweden: Complication rate and diagnostic yield. Ann Thorac Med 2014; 9(3): 149-53.
[http://dx.doi.org/10.4103/1817-1737.134069] [PMID: 24987473]
[http://dx.doi.org/10.4103/1817-1737.134069] [PMID: 24987473]
[34]
Sachdeva M, Ronaghi R, Mills PK, Peterson MW. Complications and yield of computed tomography-guided transthoracic core needle biopsy of lung nodules at a high-volume academic center in an endemic coccidioidomycosis area. Lung 2016; 194(3): 379-85.
[http://dx.doi.org/10.1007/s00408-016-9866-3] [PMID: 26980483]
[http://dx.doi.org/10.1007/s00408-016-9866-3] [PMID: 26980483]
