Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Diagnostic Value of CT-guided Percutaneous Co-axial Trans-thoracic Biopsy (PCTTB) and Evaluation of the Pathologic Examination

Author(s): Mehmet Hamdi Şahan, Mikail Inal, Nuray Bayar Muluk*, Adil Doğan and Pınar Atasoy

Volume 15, Issue 5, 2019

Page: [479 - 488] Pages: 10

DOI: 10.2174/1573405614666180704150335

Price: $65

Abstract

Background: We investigated thoracic masses with Computed Tomography (CT)- guided Percutaneous Co-Axial Trans-Thoracic Biopsy (PCTTB).

Methods: The retrospective data of 86 patients to whom CT-guided PCTTB had been applied were obtained. Eighty-four cases and their pathologic results were included in the study. Localization and appearance of the lesions, pathologic results, and complications were evaluated.

Results: Diagnostic sensitivity of CT-guided PCTTB was 97.6%. In 60.7% of the cases, malign lesions and, in 39.3% of the cases, benign lesions were diagnosed. The mass size was on average greater than 2 cm, and one mass was detected as being more than ≥2 masses. Mainly, irregular contours were observed. Most of the malign tumors were primary malign tumors on both sides (91.7% on the right side and 88.9% on the left side). Squamous Cell Carcinoma (SCC) was the most often detected malign tumor on the right side, and adenocarcinoma was the most often detected malign tumor on the left side. In masses localized on the left inferior lobe, metastasis was often detected. When the number of the mass was ≥2 and the mass had the appearance of consolidation, metastasis was usually detected. Small and large masses were mainly localized on right and left upper lobes. In the small mass group, 75.0% of the cases were benign, and, in the large mass group, 64.5% of the cases were malign (p=0.031, χ2=4.666). Pneumothorax was the most commonly occurring complication (23.8%). In masses localized on the right lower lobe, the pneumothorax ratio increased in benign masses compared to malign masses. The hemorrhage detection rate was 13.0%, and hemoptysis occurred in 14.2% of the cases. Hemorrhage was detected during 11.8% of the large mass biopsies. In females, hemorrhage occurred more often than in males (p=0.026, r= 0.244).

Conclusion: CT-guided PCTTB is a safe method to utilize for lung biopsies. Co-axial method increased the diagnostic accuracy of CT-guided percutaneous trans-thoracic biopsies. A single cut also decreased the complication rates.

Keywords: Lung mass, malign, squamous cell carcinoma, adenocarcinoma, metastasis, complications, pneumothorax, hemorrhage, hemoptysis.

Graphical Abstract

[1]
Herth FJF, Eberhardt R, Ernst A. The future of bronchoscopy in diagnosing, staging and treatment of lung cancer. Respiration 2006; 73: 399-409.
[2]
Cheng YC, Tsai SH, Cheng Y, et al. Percutaneous transthoracic lung biopsy: Comparison between C-Arm cone-beam CT and conventional CT guidance. Transl Oncol 2015; 8(4): 258-64.
[3]
Hiraki T, Mimura H, Gobara H, et al. CT fluoroscopy-guided biopsy of 1,000 pulmonary lesions performed with 20-gauge coaxial cutting needles: Diagnostic yield and risk factors for diagnostic failure. Chest 2009; 136: 1612-7.
[4]
Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-84.
[5]
Kaur R, Juneja M, Mandal AK. A comprehensive review of denoising techniques for abdominal CT images. Multimedia Tools Appl 2018; 77: 22735-70.
[6]
Berquist TH, Bailey PB, Cortese DA, et al. Transthoracic needle biopsy: accuracy and complication in relation to location and type of lesion. Mayo Clin Proc 1980; 55: 475-81.
[7]
Sinner WN. Complications of percutaneous transthoracic needle aspiration biopsy. Acta Radiol Diagn 1976; 17: 813-28.
[8]
Laurent F, Montaudon M, Latrabe V, et al. Percutaneous biopsy in lung cancer. Eur J Radiol 2003; 45: 60-8.
[9]
Wang Y, Jiang F, Tan X, et al. CT-guided percutaneous transthoracic needle biopsy for paramediastinal and nonparamediastinal lung lesions: Diagnostic yield and complications in 1484 patients. Medicine 2016; 95(31)e4460
[10]
Heerink WJ, de Bock GH, de Jonge GJ, et al. Complication rates of CT-guided transthoracic lung biopsy: Meta-analysis. Eur Radiol 2017; 27(1): 138-48.
[11]
Sinner WN. Pulmonary neoplasms diagnosed with transthoracic needle biopsy. Cancer 1979; 43: 1533-40.
[12]
Klein JS, Zarka MA. Transthoracic needle biopsy. J Thorac Imaging 1997; 12: 232-49.
[13]
Hirose T, Mori K, Machida S, et al. Computed tomographic fluoroscopy-guided transthoracic needle biopsy for diagnosis of pulmonary nodules. Jpn J Clin Oncol 2000; 30: 259-62.
[14]
Tomiyama N, Yasuhara Y, Nakajima Y, et al. CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsiesin Japan. Eur J Radiol 2006; 59(1): 60-4.
[15]
Chakrabarti B, Earis JE, Pandey R, et al. Risk assessment of pneumothorax and pulmonary haemorrhage complicating percutaneous co-axial cutting needle lung biopsy. Respir Med 2009; 103(3): 449-55.
[16]
Richardson CM, Pointon KS, Manhire AR, et al. Percutaneous lung biopsies: A survey of UK practice based on 5444 biopsies. Br J Radiol 2002; 75: 731-5.
[17]
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.
[18]
Laurent F, Latrabe V, Vergier B, et al. Percutaneous CT-guided biopsy of the lung: Comparison between aspiration and automated cutting needles using a coaxial technique. Cardiovasc Intervent Radiol 2000; 23: 266-72.
[19]
Manhire A, Charig M, Clelland C, et al. Guidelines for radiologically guided lung biopsy. Thorax 2003; 58: 920-36.
[20]
Tsukada H, Satou T, Iwashima A, et al. Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. AJR Am J Roentgenol 2000; 175: 239-43.
[21]
Loubeyre P, Copercini M, Dietrich PY. Percutaneous CT-guided multisampling core needle biopsy of thoracic lesions. AJR Am J Roentgenol 2005; 185: 1294-8.
[22]
Anderson JM, Murchison J, Patel D. CT-guided lung biopsy: Factors influencing diagnostic yield and complication rate. Clin Radiol 2003; 58: 791-7.
[23]
Ohno Y, Hatabu H, Takenaka D, et al. CT-guided transthoracic needle aspiration biopsy of small (b or =20 mm) solitary pulmonary nodules. Am J Roentgenol 2003; 180: 1665-9.

Rights & Permissions Print Cite
Article Metrics
22
2
© 2024 Bentham Science Publishers | Privacy Policy