Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021, 165(4):390-394 | DOI: 10.5507/bp.2020.040

Biopsy of lung lesions under CT control

Miloslav Marela, Radek Padrb, Libor Filaa, Dmitry Rakitaa, Fernando Casas Mendeza, Linda Capkovac, Vaclav Capekd, Radim Pavlikb
a Department of Pulmonology, University Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
b Department of Radiology, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
c Department of Pathology and Molecular Medicine, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
d Bioinformatics Centre, University Hospital Motol, and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic

Objectives: With the increasing number of detected lung nodules and the need for morphological verification, the number of CT- controlled biopsies is increasing. The aim of this study was to assess the risks and benefits of these biopsies.

Methods: This is a prospective and observational study. We evaluated 101 punctures performed on a group of 90 consecutive patients in the Department of Radiology.

Results: In patients with a mean age of 66 years, with mostly accidentally detected lung nodules, we observed complications 38 times. The most common were minor pneumothoraxes or insignificant bleedings. In 6 patients, the complications were more serious, 5 times the pneumothoraxes required chest drainage, once massive hemoptysis was recorded. The lesions were successfully biopsied 78 times, the target was missed 23 times. The diagnosis of lung cancer (LC) was confirmed in 60 patients, 49 LCs were verified by puncture under CT control. 42% (25/60) of patients with LC were diagnosed in TNM stages I and II. 23% (14/60) of patients with LC were treated surgically. The remaining 30 patients most often suffered from lung metastazes (13/30), in 8 of them an inflammatory lung disease was diagnosed. 69 patients underwent bronchoscopy, in only 19% (13/69) it contributed to the diagnosis. In a model "screening like" group of 49 patients with only randomly detected lung deposits, we diagnosed LC in 76% (37/49). 49% (18/37) were in TNM stage I and II, 11 were treated surgically.

Conclusions: CT-controlled biopsy of lung lesions is an effective and safe diagnostic method.

Keywords: CT-controlled biopsy, lung nodules, lung cancer

Received: May 26, 2020; Revised: September 4, 2020; Accepted: September 8, 2020; Prepublished online: September 17, 2020; Published: November 23, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Marel, M., Padr, R., Fila, L., Rakita, D., Casas Mendez, F., Capkova, L., Capek, V., & Pavlik, R. (2021). Biopsy of lung lesions under CT control. Biomedical papers, 165(4), 390-394. doi: 10.5507/bp.2020.040
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Barnett J, Belsey J, Tavare AN, Saini A, Patel A, Hayward M, Hare SS. Pre-surgical lung biopsy in management of solitary pulmonary nodules: a cost effectiveness analysis. J Med Econ 2019;22(12):1307-11. Go to original source...
    2. Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. AJR Am J Roentgenol 2011;196(6):W678-82. Go to original source... Go to PubMed...
    3. Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC. Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 2010;21(7):969-75. Go to original source... Go to PubMed...
    4. Tsai PC, Yeh YC, Hsu PK, Chen CK, Chou TY, Wu YC. CT-Guided Core Biopsy for Peripheral Sub-solid Pulmonary Nodules to Predict Predominant Histological and Aggressive Subtypes of Lung Adenocarcinoma. Ann Surg Oncol 2020; May 3 doi: 10.1245/s10434-020-08511-9. Online ahead of print Go to original source... Go to PubMed...
    5. Shen H. Low-dose CT for lung cancer screening: opportunities and challenges. Front Med 2018;12(1):116-21. Go to original source... Go to PubMed...
    6. Huang MD, Weng HH, Hsu SL, Hsu LS, Lin WM, Chen CW, Tsai YH. Accuracy and complications of CT-guided pulmonary core biopsy in small nodules: a single-center experience. Cancer Imaging 2019;23;19(1):51. Go to original source...
    7. Dominguez-Konicky L, Karam AR, Furman MS, Grand DJ. CT-guided biopsy of pulmonary nodules ≤10 mm: Diagnostic yield based on nodules' lobar and segmental distribution. Clin Imaging 2020;66:7-9. Go to original source...
    8. Marel M, Krejbich F, Stranska P. Bronchoscopic findings and their connection with other characteristics in 272 patients with lung cancer at the 1st Pulmonary Clinic, 1st Faculty of Medicine, Charles University and General Hospital Prague in the years 2004-2006. Stud Pneumol Phthiseol 2008;68(2):60-74.
    9. Hsia DW, Jensen KW, Curran-Everett D, Musani AI. Diagnosis of lung nobles with peripheral/radial endobronchial ultrasound - guided transbronchial biopsy. J Bronchology Intern Pulmonol 2012;19(1):5-11. Go to original source...
    10. Infante M, Cavuto S, Lutman FR, Brambilla G, Chiesa G, Ceresoli G, Passera E, Angeli E, Chiarenza M, Aranzulla G, Cariboni U, Errico V, Inzirillo F, Bottoni E, Voulaz E, Alloisio M, Destro A, ROncali M, Santoro A, Ravasi G; DANTE Study Group. A Randomized Study of Lung Cancer Screening with Spiral Computed Tomography. Three-year Results from the DANTE Trial. Am J Respir Crit Care Med 2009;180:445-53. Go to original source...
    11. The National Lung Screening Trial Research Team. Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. N Engl J Med 2011;365:395-409. Go to original source...
    12. Walter JE, Heuvelmans MA, de Bock GH, Yousaf-Khan U, Groen HJM, van der Aalst CM, Nackaerts K, van Ooijen PMA, de Koning HJ, Vliegenthart R, Oudkerk M. Relationship between the number of new nodules and lung cancer probability in incidence screening rounds of CT lung cancer screening: The NELSON study. Lung Cancer 2018;125:103-8. Go to original source... Go to PubMed...
    13. Winokur RS, Pua BB, Sullivan BW, Madoff DC. Percutaneous lung biopsy: technique, efficacy, and complications. Semin Intervent Radiol 2013;30(2):121-7. Go to original source... Go to PubMed...
    14. Yun S, Kang H, Park S, Kim BS, Park JG, Jung MJ. Diagnostic accuracy and complications of CT-guided core needle lung biopsy of solid and part-solid lesions. Br J Radiol 2018;91(1088):20170946. Go to original source...
    15. 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. Go to original source...
    16. Yoon SH, Park CM, Lee KH, Lim KY, Suh YJ, Im DJ, Hur J, Han DH, Kang MJ, Choo JY, Kim C, Kim JI, Hong H. Analysis of Complications of Percutaneous Transthoracic Needle Biopsy Using CT-Guidance Modalities In a Multicenter Cohort of 10568 Biopsies. Korean J Radiol 2019;20(2):323-31. Go to original source...
    17. Tongbai T, McDermott S, Kiranantawat N, Muse VV, Wu C, Omalley Shepard JA, Gilman MD. Non-Diagnostic CT-Guided Percutaneous Needle Biopsy of the Lung: Predictive Factors and Final Diagnoses. Korean J Radiol 2019;20(11):1515-26. Go to original source...
    18. Drumm O, Joyce EA, de Blacam C, Gleeson T, Kavanagh J, McCarthy E, McDermott R, Beddy P. CT-guided Lung Biopsy: Effect of Biopsy-side Down Position on Pneumothorax and Chest Tube Placement. Radiology 2019;292(1):190-6. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content