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Li S, Yu LL, Li L, Tang XM, He P, Gu P. Ultrasound-guided core-needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis. Clin Radiol 2023; 78:755-762. [PMID: 37558538 DOI: 10.1016/j.crad.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/11/2023]
Abstract
AIM To evaluate the diagnostic value and safety of ultrasound-guided core-needle biopsy for peripheral pulmonary lesions (PPLs). MATERIALS AND METHODS PubMed, EMBASE, and the Cochrane Library for relevant were searched for studies published up to June 2022. The diagnostic accuracy of US-guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of PPLs was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and the area under the summary receiver operating characteristic curves value (SROC). RESULTS The search included 12 original studies (3,830 procedures). For US-guided PTNB, the pooled sensitivity and specificity for the diagnosis of PPLs were 0.93 (95% confidence interval [CI]: 0.91-0.94) and 0.99 (95% CI: 0.96-1.00), respectively. The pooled estimates of the PLR, NLR, and DOR were 134.88 (95% CI: 24.88-731.74), 0.07 (95% CI: 0.06-0.09), and 1,814.95 (95% CI: 333.62-9,873.76), respectively. The area under the SROC curve was 0.95 (95% CI: 0.93-0.97). The overall complication rate was 3.6% (136 of 3,830), including self-limited haemoptysis and asymptomatic pneumothorax, and only six cases of pneumothorax requiring chest tube drainage and one case of severe bleeding were reported. CONCLUSIONS US-guided core-needle biopsy is an excellent diagnostic tool for PPLs, with high accuracy and excellent technical performance and safety.
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Affiliation(s)
- S Li
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - L-L Yu
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - L Li
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - X-M Tang
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - P He
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China
| | - P Gu
- Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, 637000, Nanchong, China.
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Mark A, Karam AR, Grand DJ. Review of CT-guided trans-osseous biopsies. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:2612-2622. [PMID: 34132879 DOI: 10.1007/s00261-021-03167-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 01/18/2023]
Abstract
Percutaneous image-guided biopsy is an invaluable technique in the management of a myriad of different conditions; however, percutaneous access to some targets remains challenging. Trans-osseous biopsy provides safe, high-yield access to many challenging lesions in the chest, abdomen, and pelvis which might otherwise require more invasive procedures, such as mediastinoscopy or surgery to establish a histological diagnosis. Additionally, trans-osseous biopsy is well tolerated and may reduce the risk of injury to intervening vital structures as compared to other percutaneous techniques. In this article we review the indications, technical challenges, alternative techniques, and potential complications of trans-sternal, trans-costal, trans-scapular, trans-vertebral, trans-iliac, and trans-sacral biopsies.
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Affiliation(s)
- Andrew Mark
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA
| | - Adib R Karam
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA.
| | - David J Grand
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA
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Rossi UG, Rossi GA. Pulmonary anatomy, pathology and treatment: What will be the artificial intelligence and deep-learning role on them? Lung Cancer 2021; 159:181-182. [PMID: 33992442 DOI: 10.1016/j.lungcan.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Umberto G Rossi
- Department of Radiological Area - Interventional Radiology Unit, E.O. Galliera Hospital, Mura delle Cappuccine, 14, Genova, 16128, Italy.
| | - Giovanni A Rossi
- Department of Neuro-Muscolar and Respiratory Diseases - Pneumology Unit, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, Genova, 16147, Italy
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4
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Wu J, Zhang MG, Chen J, Ji WB. Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study. J Cardiothorac Surg 2021; 16:55. [PMID: 33766083 PMCID: PMC7993473 DOI: 10.1186/s13019-021-01446-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs. MATERIALS AND METHODS From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Of these patients, 14 had SBPNs and underwent the TSCL procedure. RESULTS A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4 ± 2.4 mm. The technical success rate of the scapula puncture was 100%. No complications occurred near the scapula. The technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2 ± 2.7 min. Two patients (14.3%) developed asymptomatic pneumothorax after TSCL. The technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean duration of the VATS was 90.0 ± 42.4 min and the mean blood loss was 62.9 ± 37.2 ml. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign disease (n = 1). CONCLUSIONS Preoperative CT-guided TSCL is a safe and simple procedure that can facilitate high success rates of VATS-guided WR of SBPNs.
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Affiliation(s)
- Juan Wu
- Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
| | - Min-Ge Zhang
- Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
| | - Jin Chen
- Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
| | - Wen-Bin Ji
- Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.
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Liu X, Cao W, Xu QS. Computed tomography-guided coil localization for scapula-blocked pulmonary nodules: A trans-scapular approach. Medicine (Baltimore) 2021; 100:e24333. [PMID: 33592879 PMCID: PMC7870158 DOI: 10.1097/md.0000000000024333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/17/2020] [Indexed: 01/05/2023] Open
Abstract
To evaluate the clinical efficiency, feasibility, and safety of computed tomography (CT)-guided trans-scapular coil localization (TSCL) approach to treating scapula-blocked pulmonary nodules (SBPNs).In total, 105 patients with pulmonary nodules underwent CT-guided CL and subsequent video-assisted thoracoscopic surgery (VATS)-guided wedge resection (WR) between January 2016 and July 2020. Six of these patients (5.7%) had SBPNs that led them to undergo CT-guided TSCL. Rates of technical success and localization-related complications were then recorded and analyzed.CT-guided TSCL was associated with a 100% technical success rate, with one coil being placed per patient. The median CT-guided TSCL duration was 15 min. No patients experienced any complications associated with this procedure, and subsequent VATS-guided WR of SBPNs was 100% technically successful. In two patients with invasive adenocarcinoma, additional lobectomy was performed. Median VATS duration and intraoperative blood loss were 120 min and 150 mL, respectively.In summary, these results indicate that CT-guided TSCL could be easily and safely implemented to achieve high success rate when performing the VATS-guided WR of SBPNs.
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Affiliation(s)
| | - Wei Cao
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
| | - Qing-Song Xu
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
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6
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Percutaneous left atrial cardiac biopsy under multidectector computed tomography guidance. Anatol J Cardiol 2021; 25:56-57. [PMID: 33382048 DOI: 10.14744/anatoljcardiol.2020.53840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Should We Perform Transthoracic Trucut Lung Biopsies of Pleural-Based Lung Masses Under Ultrasound Guidance or Computed Tomography Guidance? Ultrasound Q 2020; 36:49-53. [PMID: 30855419 DOI: 10.1097/ruq.0000000000000435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We aimed to emphasize which method should be prioritized by comparing the ultrasound and computed tomography (CT) guidance for percutaneous transthoracic biopsy of pleural-based lung lesions in terms of comorbidity, diagnostic success, time, and costs.Approximately 700 biopsy procedures performed between 2014 and 2018 were retrospectively reviewed. The files of these patients and picture archiving and communication system were scanned.Size and localization of the lesion, pathological diagnosis, comorbidity status, pneumothorax complications at the end of the procedure, and whether or not a thoracic tube was placed due to pneumothorax were recorded. Fisher exact test and Pearson χ test were used for statistical analysis.A total of 181 patients who underwent the pleural-based biopsy procedure, the subject of study, were included in the study. One hundred (55.2%) of the biopsy procedures of these patients were performed under the guidance of tomography, and 81 (44.8%) were performed under the guidance of ultrasound (US). Median size of the lesions is 38 mm (25%-75%, 33-55 mm). Pneumothorax complications were observed in 6 patients (6%) who had CT-guided procedures and 4 patients (4.9%) who had US-guided procedures. Of the patients who developed pneumothorax, 2.8% were inserted thoracic tubes owing to the complication. Diagnostic efficacy of our procedures is 99.8% in US-guided procedures and 97% in CT-guided transthoracic biopsy. The average duration of US-guided transthoracic biopsy procedures is 17 minutes, and the average duration of CT-guided biopsy procedures is 35 minutes.
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8
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Zhang JH, Zhou SQ, Xia FF, Wang T. Computed Tomography-Guided Trans-scapular Coil Localization for Pulmonary Nodules. Thorac Cardiovasc Surg 2020; 69:679-682. [PMID: 33225439 DOI: 10.1055/s-0040-1718772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of the study is to evaluate the feasibility, safety, and effectiveness of preoperative computed tomography (CT)-guided trans-scapular coil localization (TSCL) of scapula-blocked pulmonary nodules (PNs). METHODS Between November 2015 and May 2020, 11 patients underwent preoperative CT-guided TSCL procedures owing to PN occlusion by scapula. RESULTS A 100% technical success rate was achieved for CT-guided TSCL, with one coil being used for each PN. One patient (9.1%) developed pneumothorax. Successful video-assisted thoracoscopic surgery (VATS)-guided wedge resection of these scapula-blocked PNs was conducted in all patients. CONCLUSION CT-guided TSCL can be simply and safely used to facilitate successful VATS-guided wedge resection of scapula-blocked PNs.
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Affiliation(s)
- Jian-Hua Zhang
- Department of Interventional Radiology, Fengjie People's Hospital, Chongqing, China
| | - Shi-Qing Zhou
- Department of ICU, Fengjie People's Hospital, Chongqing, China
| | - Feng-Fei Xia
- Department of Interventional Vascular Surgery, Binzhou People's Hospital, Binzhou, China
| | - Tao Wang
- Department of Radiology, Xuzhou City Centre Hospital, Xuzhou, China
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9
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Xian YT, Wu AL, Lin J, Teng F, Wang ZS, Xu XJ. Computed tomography-guided coil localization for scapular-blocked lung nodules. MINIM INVASIV THER 2020; 31:468-472. [PMID: 33140683 DOI: 10.1080/13645706.2020.1840396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the clinical efficacy, feasibility, and safety of the preoperative computed tomography (CT)-guided coil localization (CL) approach for scapula-blocked lung nodules (SBLNs). MATERIAL AND METHODS A total of 123 patients with LNs were treated via CT-guided CL and subsequent VATS-guided wedge resection from January 2015 to June 2020. Of these patients, 12 (9.8%) exhibited SBLNs and underwent CT-guided CL. Technical success of localization and video-assisted thoracoscopic surgery (VATS)-guided wedge resection, and localization-related complications were recorded and analyzed. RESULTS The technical success rate of CT-guided CL was 100%. Each patient was placed with one coil. The mean duration of CT-guided CL was 14.7 ± 2.7 min. One patient (8.3%) developed asymptomatic pneumothorax, which has not impacted the subsequent VATS procedure. Successful VATS-guided wedge resection of these SBLNs was achieved in all patients, with no instances of conversion to thoracotomy. Additional lobectomy was performed in three patients. The mean duration of the VATS procedure and blood loss were 143.8 ± 95.5 min and 110.0 ± 82.0 ml, respectively. CONCLUSIONS The approach of CT-guided CL could be safely and easily utilized to facilitate high rates of success when conducting the VATS-guided wedge resection of SBLNs.
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Affiliation(s)
- Yu-Tao Xian
- Department of Interventional Radiology, Ningbo First Hospital, Ningbo, China
| | - An-Le Wu
- Department of Interventional Radiology, Ningbo First Hospital, Ningbo, China
| | - Jia Lin
- Department of Interventional Radiology, Ningbo First Hospital, Ningbo, China
| | - Fei Teng
- Department of Interventional Radiology, Ningbo First Hospital, Ningbo, China
| | - Zi-Shan Wang
- Department of Thoracic Surgery, Ningbo First Hospital, Ningbo, China
| | - Xin-Jian Xu
- Department of Interventional Radiology, Jiangyin People's Hospital, Wuxi, China
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Rossi UG, Pescatori LC, Cariati M. CT-Guided Percutaneous Trans-scapular Lung Biopsy in the Diagnosis of Peripheral Pulmonary Lesion Nodules of the Superior Lobes Using Large Needles. Cardiovasc Intervent Radiol 2018; 41:1298-1299. [PMID: 29473095 DOI: 10.1007/s00270-018-1904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/10/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Umberto G Rossi
- Interventional Radiology Unit, Department of Diagnostic Imaging, E.O. Galliera Hospital, Mura delle Cappuccine, 14, 16128, Genoa, Italy.
| | - Lorenzo Carlo Pescatori
- Postraduation School of Radiodiagnostics, University of Milano, Piazza Edmondo Malan, 1, San Donato Milanese, 20097, Milan, Italy
| | - Maurizio Cariati
- Radiology and Interventional Radiology Unit, Advanced Technology Department of Diagnostic and Therapy, ASST Santi Paolo and Carlo - San Carlo Borromeo Hospital, Via Pio II, 3, 20153, Milan, Italy
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11
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Rebonato A, Maiettini D, Andolfi M, Fischer MJ, Vannucci J, Metro G, Basile A, Rossi M, Duranti M. CT-Guided Percutaneous Trans-scapular Lung Biopsy in the Diagnosis of Peripheral Pulmonary Lesion Nodules of the Superior Lobes Using Large Needles. Cardiovasc Intervent Radiol 2017; 41:284-290. [DOI: 10.1007/s00270-017-1768-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/09/2017] [Indexed: 12/19/2022]
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12
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Chehab M, Zintsmaster S, Jafri SZ, Richards M, Roy A. CT-guided Transosseous Soft Tissue Biopsy: Techniques, Outcomes and Complications in 50 Cases. Cardiovasc Intervent Radiol 2017; 40:1461-1468. [PMID: 28474111 DOI: 10.1007/s00270-017-1669-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 04/24/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes. MATERIALS AND METHODS Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun. Sampling accuracy was determined from the final pathology report as diagnostic or non-diagnostic. Complications included rates of pneumothorax, pneumomediastinum, hemoptysis, immediate admission, chest tube insertion, surgical consultation, 30-day readmission, fracture, osteomyelitis or tract seeding. RESULTS Number of diagnostic samples per bone included: sternum (n = 17, 34%), rib (n = 7, 14%), scapula (n = 6, 12%), transverse process (n = 4, 8%), vertebral body (n = 4, 8%), spinous process (n = 1, 2%), ilium (n = 7, 14%), sacrum (n = 4, 8%). Complications included 10 pneumothoraces in 39 cases that crossed the pleura, 8 pneumomediastinum in 17 transsternal cases, one immediate surgical consultation and one 30-day readmission. CONCLUSION Transosseous biopsy approach is a technically feasible means of obtaining core needle samples of soft tissue lesions. LEVEL OF EVIDENCE Case series, IV.
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Affiliation(s)
- Monzer Chehab
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA
| | - Stephen Zintsmaster
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA.
| | - Syed Zafar Jafri
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA
| | - Mark Richards
- Cleveland Clinic Regional Radiology, Akron General Hospital, 1 Akron General Ave, Akron, OH, 44307, USA
| | - Anindya Roy
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA
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Garnon J, Koch G, Rao P, Ramamurthy N, Caudrelier J, Cazzato RL, Tsoumakidou G, Gangi A. Optimising Pulmonary Microwave Ablation Using Trans-Scapular Access and Continuous Temperature Monitoring. Cardiovasc Intervent Radiol 2016; 39:791-794. [PMID: 26817761 DOI: 10.1007/s00270-016-1298-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/10/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Julien Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France.
| | - Guillaume Koch
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France
| | - Pramod Rao
- ICube, University of Strasbourg, France, 300 bd Sébastien Brant, 67412, Illkirch, France
| | - Nitin Ramamurthy
- Department of Radiology, Norfolk and Norwich University Hospital, Colney Ln, Norwich, NR4 7UY, UK
| | - Jean Caudrelier
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France
| | - Roberto Luigi Cazzato
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France
| | - Georgia Tsoumakidou
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France
| | - Afshin Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, France, 1, place de l'hôpital, 67000, Strasbourg, France
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Chami H, Faraj W, Yehia Z, Badour S, Sawan P, Rebeiz K, Safa R, Saade C, Ghandour B, Shamseddine A, Mukherji D, Haydar A. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT. Clin Radiol 2015; 70:1382-7. [DOI: 10.1016/j.crad.2015.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/28/2015] [Accepted: 08/04/2015] [Indexed: 11/30/2022]
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15
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Iguchi T, Hiraki T, Ishii H, Gobara H, Fujiwara H, Matsui Y, Kanazawa S. Transosseous Route for CT Fluoroscopy-Guided Radiofrequency Ablation of Lung Tumors. J Vasc Interv Radiol 2015; 26:1694-8. [PMID: 26432461 DOI: 10.1016/j.jvir.2015.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 07/20/2015] [Accepted: 08/12/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To retrospectively evaluate radiofrequency (RF) ablation of lung tumors performed via the transosseous approach. MATERIALS AND METHODS Twelve lung tumors (mean diameter, 1.0 cm; range, 0.4-1.6 cm) in 12 patients were treated by RF ablation via a transscapular and/or transrib route with the use of a bone biopsy needle under computed tomographic fluoroscopy guidance. Therapeutic outcomes evaluated included feasibility, safety, and local efficacy. Complications were assessed based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. RESULTS The transosseous route was successfully employed in all patients, and the electrode was successfully advanced into all tumors with this approach. The mean distance of penetrated bone was 0.57 cm (range, 0.19-1.16 cm). Complications occurred in eight RF ablation sessions, including six grade 1 events (two cases of pneumothorax and one case each of asymptomatic rib fracture 6 mo after treatment, neuralgia, pulmonary hemorrhage, and hemothorax), two grade 2 events (pneumonia and high fever), and one grade 3 event (pneumothorax requiring pleurodesis). No adverse events of grade ≥ 4 occurred. The mean and median tumor follow-up periods were 19.5 and 15.2 mo (range, 3.0-41.5 mo). Local progression occurred in two cases at 3 and 12 mo after treatment and was successfully treated with a second RF ablation procedure. The technique efficacy rates were 91.7% at 6 mo, 81.5% at 1 y, and 81.5% at 2 y. CONCLUSIONS The transosseous approach was feasible in computed tomographic fluoroscopy-guided RF ablation of select lung tumors when no other option was available.
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Affiliation(s)
- Toshihiro Iguchi
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan.
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
| | - Hiroaki Ishii
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
| | - Hideo Gobara
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
| | - Hiroyasu Fujiwara
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
| | - Yusuke Matsui
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho kita-ku, Okayama 700-8558, Japan
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16
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Sconfienza LM, Mauri G, Grossi F, Truini M, Serafini G, Sardanelli F, Murolo C. Pleural and peripheral lung lesions: comparison of US- and CT-guided biopsy. Radiology 2012. [PMID: 23204543 DOI: 10.1148/radiol.12112077] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To retrospectively compare the outcome of computed tomography (CT) and ultrasonography (US) guidance when sampling a consecutive series of peripheral lung or pleural lesions. MATERIALS AND METHODS Institutional review board approval was obtained, and the informed consent requirement was waived. From January 2000 to August 2011, 711 thoracic biopsies were performed at two institutions. Among these, 273 lesions in 273 patients (115 men, 158 women; mean age, 65 years ± 11 [standard deviation]; 86 pleural lesions; 187 pulmonary lesions) had pleural origin or were peripherally located in the lung with a small amount of pleural contact. These lesions were sampled with either CT (170 patients; mean age, 64 years ± 12; 55 pleural lesions, 115 peripheral pulmonary lesions) or US (103 patients; mean age, 67 years ± 10; 31 pleural lesions, 72 peripheral pulmonary lesions) guidance by using an 18-gauge modified Menghini needle. Procedure duration, postprocedural pneumothorax or hemorrhage, and sample adequacy were recorded. Fisher exact test, log-rank test, and Mann-Whitney U test were performed. RESULTS No significant difference was found for patient age (P = .741), sex (P = .900), lesion size (P = .206), or lesion origin (P = .788). Median time was 556 seconds for CT-guided biopsy (25th percentile, 408 seconds; 75th percentile, 704 seconds) and 321 seconds for US-guided biopsy (25th percentile, 157 seconds; 75th percentile, 485 seconds) (P < .001). Postprocedural pneumothorax was observed in 25 of 170 (14.7%) CT-guided procedures and in six of 103 (5.8%) US-guided procedures (P = .025); hemorrhage occurred in two of 170 (1.2%) CT-guided procedures and in one of 103 (1.0%) US-guided procedures (P = .875). Technical success was achieved in 100 of 103 US-guided procedures (97.1%) and in 164 of 170 CT-guided procedures (96.5%) (P = .999). CONCLUSION With pleural or peripheral lung lesions, US guidance is comparable to CT guidance in terms of sample accuracy, while allowing for a significant reduction in procedure time and postprocedural pneumothorax and being free from ionizing radiation.
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Affiliation(s)
- Luca Maria Sconfienza
- Servizio di Radiologia, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, Piazza Malan 2, 20097 San Donato Milanese, Milan, Italy.
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Sangha BS, Skarsgard ED, Heran MKS. Transscapular microcoil lung nodule localization. J Vasc Interv Radiol 2012; 23:659. [PMID: 22341634 DOI: 10.1016/j.jvir.2011.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bippan S Sangha
- Department of Radiology, University of British Columbia, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada V6H 3V4
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