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Tuberculosis & Respiratory Diseases

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Vol.81 No.4
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CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2018, v.81 no.4, pp.330-338









& (2018). CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy. Tuberculosis & Respiratory Diseases, 81(4), 330-338.
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Abstract

Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)–guided per cutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

keywords
Lasers, Solitary Pulmonary Nodule, Lung Neoplasms, Biopsy, Needle

Reference

1.

1. DiBardino DM, Yarmus LB, Semaan RW. Transthoracic needle biopsy of the lung. J Thorac Dis 2015;7(Suppl 4):S304-16.

2.

2. Jin KN, Park CM, Goo JM, Lee HJ, Lee Y, Kim JI, et al. Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems. Eur Radiol 2010;20:2108-15.

3.

3. 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;271:291-300.

4.

4. Yan GW, Bhetuwal A, Yan GW, Sun QQ, Niu XK, Zhou Y, et al. A systematic review and meta-analysis of C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules. Pol J Radiol 2017;82:152-60.

5.

5. Zhuang YP, Wang HY, Zhang J, Feng Y, Zhang L. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions. Eur J Radiol 2013;82:182-6.

6.

6. 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:e43-8.

7.

7. Loh SE, Wu DD, Venkatesh SK, Ong CK, Liu E, Seto KY, et al. CT-guided thoracic biopsy: evaluating diagnostic yield and complications. Ann Acad Med Singapore 2013;42:285-90.

8.

8. Takeshita J, Masago K, Kato R, Hata A, Kaji R, Fujita S, 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;204:29-34.

9.

9. Yang W, Sun W, Li Q, Yao Y, Lv T, Zeng J, et al. Diagnostic accuracy of CT-guided transthoracic needle biopsy for solitary pulmonary nodules. PLoS One 2015;10:e0131373.

10.

10. Yaffe D, Koslow M, Haskiya H, Shitrit D. A novel technique for CT-guided transthoracic biopsy of lung lesions: improved biopsy accuracy and safety. Eur Radiol 2015;25:3354-60.

11.

11. Choi SH, Chae EJ, Kim JE, Kim EY, Oh SY, Hwang HJ, et al. Percutaneous CT-guided aspiration and core biopsy of pulmonary nodules smaller than 1 cm: analysis of outcomes of 305 procedures from a tertiary referral center. AJR Am J Roentgenol 2013;201:964-70.

12.

12. Choo JY, Park CM, Lee NK, Lee SM, Lee HJ, Goo JM. Percutaneous transthoracic needle biopsy of small (≤1 cm) lung nodules under C-arm cone-beam CT virtual navigation guidance. Eur Radiol 2013;23:712-9.

13.

13. Hwang HS, Chung MJ, Lee JW, Shin SW, Lee KS. C-arm conebeam CT-guided percutaneous transthoracic lung biopsy:usefulness in evaluation of small pulmonary nodules. AJR Am J Roentgenol 2010;195:W400-7.

14.

14. Larke FJ, Kruger RL, Cagnon CH, Flynn MJ, McNitt-Gray MM, Wu X, et al. Estimated radiation dose associated with lowdose chest CT of average-size participants in the National Lung Screening Trial. AJR Am J Roentgenol 2011;197:1165-9.

15.

15. Hiraki T, Mimura H, Gobara H, Iguchi T, Fujiwara H, Sakurai J, 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.

16.

16. Chami HA, Faraj W, Yehia ZA, Badour SA, Sawan P, Rebeiz K, et al. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT. Clin Radiol 2015;70:1382-7.

17.

17. Boskovic T, Stanic J, Pena-Karan S, Zarogoulidis P, Drevelegas K, Katsikogiannis N, et al. Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis 2014;6 Suppl 1:S99-107.

18.

18. van Haren-Willems J, Heijdra Y. Increasing evidence for gender differences in chronic obstructive pulmonary disease. Womens Health (Lond) 2010;6:595-600.

19.

19. Yeow KM, Tsay PK, Cheung YC, Lui KW, Pan KT, Chou AS. Factors affecting diagnostic accuracy of CT-guided coaxial cutting needle lung biopsy: retrospective analysis of 631 procedures. J Vasc Interv Radiol 2003;14:581-8.

20.

20. Ko JP, Shepard JO, Drucker EA, Aquino SL, Sharma A, Sabloff B, et al. Factors influencing pneumothorax rate at lung biopsy:are dwell time and angle of pleural puncture contributing factors? Radiology 2001;218:491-6.

21.

21. Khan MF, Straub R, Moghaddam SR, Maataoui A, Gurung J, Wagner TO, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy. Eur Radiol 2008;18:1356-63.

22.

22. Rotolo N, Floridi C, Imperatori A, Fontana F, Ierardi AM, Mangini M, et al. Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules. Eur Radiol 2016;26:381-9.

23.

23. Adiga S, Athreya S. Safety, efficacy, and feasibility of an ultralow dose radiation protocol for CT-guided percutaneous needle biopsy of pulmonary lesions: initial experience. Clin Radiol 2014;69:709-14.

24.

24. Lechuga L, Weidlich GA. Cone beam CT vs. fan beam CT: a comparison of image quality and dose delivered between two differing CT imaging modalities. Cureus 2016;8:e778.

25.

25. Schegerer AA, Lechel U, Ritter M, Weisser G, Fink C, Brix G. Dose and image quality of cone-beam computed tomography as compared with conventional multislice computed tomography in abdominal imaging. Invest Radiol 2014;49:675-84.

26.

26. Ravenel JG, Scalzetti EM, Huda W, Garrisi W. Radiation exposure and image quality in chest CT examinations. AJR Am J Roentgenol 2001;177:279-84.

27.

27. Hirota S, Nakao N, Yamamoto S, Kobayashi K, Maeda H, Ishikura R, et al. Cone-beam CT with flat-panel-detector digital angiography system: early experience in abdominal interventional procedures. Cardiovasc Intervent Radiol 2006;29:1034-8.

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