1
|
Kim D, Han JY, Baek JW, Lee HY, Cho HJ, Heo YJ, Shin GW. Effect of the respiratory motion of pulmonary nodules on CT-guided percutaneous transthoracic needle biopsy. Acta Radiol 2023; 64:2245-2252. [PMID: 36575592 DOI: 10.1177/02841851221144616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) is highly affected by respiratory motion; however, respiratory motion of target nodule during the PTNB and its effect on CT-guided lung biopsy have not been studied. PURPOSE To investigate the effect of the respiratory motion of pulmonary nodules on CT-guided PTNB. MATERIAL AND METHODS We retrospectively reviewed the procedural CT scans of 426 pulmonary nodules that underwent PTNB during quiet breathing. Maximal and average respiratory motions were measured using the difference of table position of the targeted nodule between multiple procedural scans. Diagnostic performance, complications, and technical factors of PTNB in nodules with large motion (maximal motion >1 cm) were compared with those in nodules with small motion (≤1 cm). RESULTS The mean maximal and average respiratory motions between tidal volume breathing were 5.4 ± 4.4 and 2.7 ± 2.6 mm, respectively. Sensitivity and accuracy were 93.1% and 96.1% in nodules with large motion, compared with 94.7% and 95.9% in nodules with small motion, respectively. Respiratory targeting (P < 0.001), needle modulation (P < 0.001), motion artifact of target (P < 0.001), target disappearance from scans (P < 0.001), and number of performed CT scans (P < 0.001) were significantly higher in the large motion group, with no significant difference in radiation dose and complications between the groups. CONCLUSION The respiratory motion of pulmonary nodules during CT-guided PTNB may cause technical difficulties but does not affect diagnostic performance nor complications associated with PTNB.
Collapse
Affiliation(s)
- Dasom Kim
- Department of Radiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Ji-Yeon Han
- Department of Radiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Jin Wook Baek
- Department of Radiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Ho Young Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Hwa Jin Cho
- Department of Pathology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Young Jin Heo
- Department of Radiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Gi Won Shin
- Department of Radiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| |
Collapse
|
2
|
Yang S, Lou L, Wang W, Li J, Jin X, Wang S, Cai J, Kuang F, Liu L, Hadjouni M, Elmannai H, Cai C. Pneumothorax prediction using a foraging and hunting based ant colony optimizer assisted support vector machine. Comput Biol Med 2023; 161:106948. [PMID: 37207406 DOI: 10.1016/j.compbiomed.2023.106948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/21/2023]
Abstract
Although PNLB is generally considered safe, it is still invasive and risky. Pneumothorax, the most common complication of lung puncture, can cause shortness of breath, chest pain, and even life-threatening. Therefore, the auxiliary diagnosis for pneumothorax is of great clinical interest. This paper proposes an ant colony optimizer with slime mould foraging behavior and collaborative hunting, called SCACO, in which slime mould foraging behavior is combined to improve the convergence accuracy and solution quality of ACOR. Then the ability of ACO to jump out of the local optimum is optimized by an adaptive collaborative hunting strategy when trapped in the local optimum. As a first step toward Pneumothorax diagnostic prediction, we suggested an SVM classifier based on bSCACO (bSCACO-SVM), which uses the proposed SCACO's binary version as the basis for its feature selection algorithms. To demonstrate the SCACO performance, we first used the slime mould foraging behavior and adaptive cooperative hunting strategy, then compared SCACO with nine basic algorithms and nine variants, respectively. Finally, we verified bSCACO-SVM on various widely used public datasets and applied it to the Pneumothorax prediction issue, showing that it has robust classification prediction capacity and can be successfully employed for tuberculous pleural effusion diagnostic prediction.
Collapse
Affiliation(s)
- Song Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Lejing Lou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Wangjia Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Jie Li
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
| | - Xiao Jin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Shijia Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Jihao Cai
- Wenzhou Medical University Renji College, Wenzhou, China.
| | - Fangjun Kuang
- School of Information Engineering, Wenzhou Business College, Wenzhou, 325035, China.
| | - Lei Liu
- College of Computer Science, Sichuan University, Chengdu, Sichuan, 610065, China.
| | - Myriam Hadjouni
- Department of Computer Sciences, College of Computer and Information Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Hela Elmannai
- Department of Information Technology, College of Computer and Information Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Chang Cai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
| |
Collapse
|
3
|
Is Free Breathing Possible During Computed Tomography-Guided Percutaneous Transthoracic Lung Biopsy? The Clinical Experience in 585 Cases. J Comput Assist Tomogr 2022; 46:294-299. [PMID: 35297585 DOI: 10.1097/rct.0000000000001274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to retrospectively evaluate the safety and accuracy of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions during quiet breathing. METHODS We investigated the diagnostic performance and complication rate of 585 procedures in 563 patients (357 men; mean age, 67.7 years), who underwent CT-guided PTNBs during quiet breathing, aided by a respiratory targeting technique from May 2017 to July 2019. Differences between the cases with and without respiratory targeting were analyzed. Logistic regression analyses were performed to examine the development of pneumothorax and hemoptysis. RESULTS Percutaneous transthoracic needle biopsy samples were successfully obtained in 574 of 585 procedures (98.1%). Final diagnoses included: 410 malignant cases, 119 benign cases, and 45 indeterminate cases. The sensitivity, specificity, and accuracy of diagnosis were 94.4%, 100%, and 95.7%, respectively. Use of respiratory targeting was associated with younger age (P = 0.004), smaller lesion size (P < 0.001), peripheral location (P = 0.003), shorter distance from the diaphragm (P < 0.001), lower lobe location (P < 0.001), prone position (P = 0.004), and visible motion artifact (P < 0.001). Pneumothorax and hemoptysis rates were 22.9% and 7.9%, respectively. Upon multivariate analysis, emphysema (P = 0.002) was the only independent risk factor for pneumothorax, whereas distance from the pleura greater than 2 cm (P < 0.001), tissue sampling 3 times or more (P = 0.003), and a less experienced operator (P < 0.001) were risk factors for hemoptysis. CONCLUSIONS Computed tomography-guided PTNB during quiet breathing with respiratory targeting yielded high diagnostic performance with a slightly higher rate of complications. Free-breathing PTNB can be applied in clinical practice, based on lesion location and risk factors for complications.
Collapse
|
4
|
Ultrasound-Guided Phrenic Nerve Block for Lung Nodule Biopsy: Single-Center Initial Experience. Acad Radiol 2022; 29 Suppl 2:S118-S126. [PMID: 34108113 DOI: 10.1016/j.acra.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES Biopsy of lung nodules in the lower lung fields can be difficult because of breathing motion. Ipsilateral phrenic nerve block (PNB) before biopsy should make the biopsy safer, easier, and more precisely targeted. We describe the use of ultrasound-guided PNB before lung nodule biopsy, including relevant anatomy and variations, complications, and technique, along with our first 40 cases. MATERIALS AND METHODS We retrospectively reviewed patients who underwent PNB before computed tomography (CT)- or ultrasound-guided lung nodule biopsy from April 2015 through March 2020. Patient demographics, CT fluoroscopy time, radiation dose, complications, diagnostic yield, and effectiveness of PNB were recorded. Effectiveness of PNB was based on direct observation of diaphragmatic motion. Control group data for biopsies during the same time frame were collected and matched with nodules ≤1 cm from the PNB group. RESULTS Among 40 patients identified, no complications occurred related to the PNB. Mean (SD) nodule size was 12.4 (6.2) mm. True-positive results were obtained in 39 patients (98%), with 1 false-negative after an ineffective PNB. PNB was effective in 70%. When CT fluoroscopy was used for the biopsy, radiation dose was significantly lower after an effective PNB than an ineffective PNB (p < .001). Effective PNB was significantly more common with injection of ≥4 mL of local anesthetic (p = .01). Comparison with 19 matched controls showed significantly fewer instances of pneumothorax (p = .02) and greater diagnostic success (p = .03) for the PNB group. CONCLUSION Ultrasound-guided PNB is safe and effective and can improve outcomes when used before lung nodule biopsy.
Collapse
|
5
|
Yang L, Liang T, Du Y, Guo C, Shang J, Pokharel S, Wang R, Niu G. Nomogram model to predict pneumothorax after computed tomography-guided coaxial core needle lung biopsy. Eur J Radiol 2021; 140:109749. [PMID: 34000599 DOI: 10.1016/j.ejrad.2021.109749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/25/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To develop a predictive model to determine risk factors of pneumothorax in patients undergoing the computed tomography (CT)1-guided coaxial core needle lung biopsy (CCNB). METHODS A total of 489 patients who underwent CCNBs with an 18-gauge coaxial core needle were retrospectively included. Patient characteristics, primary pulmonary disease, target lesion image characteristics and biopsy-related variables were evaluated as potential risk factors of pneumothorax which was determined on the chest X-ray and CT scans. Univariate and multivariate logistic regressions were used to identify the independent risk factors of pneumothorax and establish the predictive model, which was presented in the form of a nomogram. The discrimination and calibration of the model were evaluated as well. RESULTS The incidence of pneumothorax was 32.91 % and 31.42 % in the development and validation groups, respectively. Age, emphysema, pleural thickening, lesion location, lobulation sign, and size grade were identified independent risk factors of pneumothorax at the multivariate logistic regression model. The forming model produced an area under the curve of 0.718 (95 % CI = 0.660-0.776) and 0.722 (95 % CI = 0.638-0.805) in development and validation group, respectively. The calibration curve showed good agreement between predicted and actual probability. CONCLUSIONS The predictive model for pneumothorax after CCNBs had good discrimination and calibration, which could help in clinical practice.
Collapse
Affiliation(s)
- Linyun Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Yonghao Du
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Chenguang Guo
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Jin Shang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Saugat Pokharel
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Rong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China.
| | - Gang Niu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China.
| |
Collapse
|
6
|
Hong W, Yoon SH, Goo JM, Park CM. Cone-Beam CT-Guided Percutaneous Transthoracic Needle Lung Biopsy of Juxtaphrenic Lesions: Diagnostic Accuracy and Complications. Korean J Radiol 2021; 22:1203-1212. [PMID: 33938644 PMCID: PMC8236357 DOI: 10.3348/kjr.2020.1229] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/10/2020] [Accepted: 12/21/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. MATERIALS AND METHODS In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. RESULTS The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. CONCLUSION The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.
Collapse
Affiliation(s)
- Wonju Hong
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University Hospital, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea.
| |
Collapse
|
7
|
Yu W, An Z, Wang Z, Lv W, Hu J. [CT-guided Percutaneous Lung Puncture for the Diagnosis of Solid Pulmonary Nodules: A Single-center Experience Summary]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 23:414-418. [PMID: 32517442 PMCID: PMC7309544 DOI: 10.3779/j.issn.1009-3419.2020.103.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
背景与目的 探究经皮肺穿刺对于实性肺小结节(直径≤15 mm)的诊断价值。 方法 本研究回顾性地纳入了2014年1月-2018年12月于本中心行经皮肺穿刺的20例实性肺小结节患者,其中男性11例,女性9例。病灶最大直径介于0.5 cm-1.5 cm之间,排除严重脏器功能不全,有凝血障碍患者。 结果 20例患者全部取材成功,19例患者均获得明确的病理诊断,其中11例患者找到恶性肿瘤细胞,明确为肺恶性肿瘤,5例为肺慢性炎,2例纤维组织增生,1例找到肺软骨组织,1例未见肿瘤细胞。穿刺后少量气胸1例,穿刺侧少量胸腔积液患者1例。 结论 经皮肺穿刺对于实性肺小结节的诊断具有较高的有效性以及安全性。
Collapse
Affiliation(s)
- Wenfeng Yu
- Department of Thoracic Surgery, the First Affiliated Hospital of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhou An
- Department of Thoracic Surgery, the First Affiliated Hospital of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhitian Wang
- Department of Thoracic Surgery, the First Affiliated Hospital of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Wang Lv
- Department of Thoracic Surgery, the First Affiliated Hospital of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jian Hu
- Department of Thoracic Surgery, the First Affiliated Hospital of Zhejiang University, Zhejiang University School of Medicine, Hangzhou 310003, China
| |
Collapse
|
8
|
Chae KJ, Hong H, Yoon SH, Hahn S, Jin GY, Park CM, Goo JM. Non-diagnostic Results of Percutaneous Transthoracic Needle Biopsy: A Meta-analysis. Sci Rep 2019; 9:12428. [PMID: 31455841 PMCID: PMC6711972 DOI: 10.1038/s41598-019-48805-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/12/2019] [Indexed: 02/06/2023] Open
Abstract
Non-diagnostic results can affect the diagnostic performance of percutaneous transthoracic needle biopsy (PTNB) but have not been critically meta-analyzed yet. To meta-analyze the incidence and malignancy rate of non-diagnostic results, 3-by-2 table approaches rather than the conventional 2-by-2 approaches are needed to know its impact on the diagnostic performance of PTNB. A systematic literature search identified studies evaluating the diagnostic performance of PTNB with extractable outcomes. A total of 143 studies with 35,059 biopsies were included. The pooled incidence of non-diagnostic results was 6.8% (95% CI, 6.0-7.6%; I2 = 0.91). The pooled malignancy rate of non-diagnostic results was 59.3% (95% CI, 51.7-66.8%; I2 = 0.80), and was correlated with the prevalence of malignancy (correlation coefficient, 0.66; 95% CI, 0.42-0.91). Pooled percentage decrease of sensitivity and specificity due to non-diagnostic results were 4.5% (95% CI, 3.2-5.7%; I2 = 0.64) and 10.7% (95% CI, 7.7-13.7%; I2 = 0.70), respectively, and the pooled incidence of non-diagnostic results was 4.4% (95% CI, 3.2-5.8%; I2 = 0.83) in lesions ultimately diagnosed as malignancies and 10.4% (95% CI, 7.5-13.8%; I2 = 0.74) in benign disease. In conclusion, non-diagnostic results averagely occurred in 6.8% of PTNB and more than half of the results were malignancies. The non-diagnostic results decreased specificity and sensitivity by 10.7% and 4.5%, respectively, demanding efforts to minimize the non-diagnostic results in PTNB.
Collapse
Affiliation(s)
- Kum Ju Chae
- Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Hyunsook Hong
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
| | - Seokyung Hahn
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Gong Yong Jin
- Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| |
Collapse
|
9
|
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; 292:190-196. [PMID: 31084480 DOI: 10.1148/radiol.2019182321] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Supine or prone positioning of the patient on the gantry table is the current standard of care for CT-guided lung biopsy; positioning biopsy side down was hypothesized to be associated with lower pneumothorax rate. Purpose To assess the effect of positioning patients biopsy side down during CT-guided lung biopsy on the incidence of pneumothorax, chest drain placement, and hemoptysis. Materials and Methods This retrospective study was performed between January 2013 and December 2016 in a tertiary referral oncology center. Patients undergoing CT-guided lung biopsy were either positioned in (a) the standard prone or supine position or (b) the lateral decubitus position with the biopsy side down. The relationship between patient position and pneumothorax, drain placement, and hemoptysis was assessed by using multivariable logistic regression models. Results A total of 373 consecutive patients (mean age ± standard deviation, 68 years ± 10), including 196 women and 177 men, were included in the study. Among these patients, 184 were positioned either prone or supine depending on the most direct path to the lesion and 189 were positioned biopsy side down. Pneumothorax occurred in 50 of 184 (27.2%) patients who were positioned either prone or supine and in 20 of 189 (10.6%) patients who were positioned biopsy side down (P < .001). Drain placement was required in 10 of 184 (5.4%) patients who were positioned either prone or supine and in eight of 189 (4.2%) patients who were positioned biopsy side down (P = .54). Hemoptysis occurred in 19 of 184 (10.3%) patients who were positioned prone or supine and in 10 of 189 (5.3%) patients who were positioned biopsy side down (P = .07). Prone or supine patient position (P = .001, odds ratio [OR] = 2.7 [95% confidence interval {CI}: 1.4, 4.9]), emphysema along the needle path (P = .02, OR = 2.1 [95% CI: 1.1, 4.0]), and lesion size (P = .02, OR = 1.0 [95% CI: 0.9, 1.0]) were independent risk factors for developing pneumothorax. Conclusion Positioning a patient biopsy side down for percutaneous CT-guided lung biopsy reduced the incidence of pneumothorax compared with the supine or prone position. © RSNA, 2019.
Collapse
Affiliation(s)
- Orla Drumm
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Eimear A Joyce
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Catherine de Blacam
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Tom Gleeson
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - John Kavanagh
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Eoghan McCarthy
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Ronan McDermott
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| | - Peter Beddy
- From the Department of Radiology, St James's Hospital and Trinity College, James's Street, Dublin 8, Ireland (O.D., E.A.J., C.d.B., T.G., E.M., R.M., P.B.); and Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (J.K.)
| |
Collapse
|
10
|
Zhu D, Yu L, Chen H. A Case Analysis on CT Guided Percutaneous Lung Puncture Biopsy of Lymphocyte Mesenchymal Pneumonia. Comb Chem High Throughput Screen 2019; 21:806-810. [PMID: 30666907 DOI: 10.2174/1386207322666190122112025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/15/2018] [Accepted: 11/09/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the application and diagnostic value of high-resolution CT in the process of lymphocytic interstitial pneumonia clinical diagnosis, and analyze one case of CT-guided percutaneous lung biopsy lymphocytic interstitial pneumonia. METHODS The medical record of a patient with lymphocyte interstitial pneumonia (LIP) who came to the clinic on 2014-04-22 were analyzed and summarized retrospectively. RESULTS The patient was a 55 years old female farmer. The CT-guided percutaneous lung biopsy was performed at her first visit; on 2014-07-09, the patient returned to our outpatient clinic with the main complaint of "1 week of coughing and blood in sputum and phlegm". Pathology consultation report from the PLA General Hospital on 2014-07-29 showed: (right lower lung) pneumonic pseudo-tumor; Zhejiang First Hospital's pathology consultation report on 2014-08-11 showed: lymphocyte interstitial pneumonia. CONCLUSION The diagnosis of lymphocyte interstitial pneumonia (LIP) with high-resolution CT may be used to increase its clinical diagnosis rate, reduce misdiagnosis and improve early detection.
Collapse
Affiliation(s)
- Dan Zhu
- Department of Respiration, Jinhua Central Hospital, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang 321000, China
| | - Long Yu
- Department of Respiration, Jinhua Central Hospital, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang 321000, China
| | - Hui Chen
- Department of Respiration, Jinhua Central Hospital, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang 321000, China
| |
Collapse
|
11
|
Carrero E, Arguis P, Sánchez M, Sala-Blanch X. Ultrasound-guided phrenic nerve block for CT-guided percutaneous pulmonary fine-needle aspiration biopsy. J Vasc Interv Radiol 2015; 26:597-9. [PMID: 25805543 DOI: 10.1016/j.jvir.2014.11.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 11/22/2014] [Accepted: 11/23/2014] [Indexed: 10/23/2022] Open
Affiliation(s)
- Enrique Carrero
- Radiologic Anesthesia Unit, Department of Anesthesiology, University of Barcelona, Hospital Clínic, Spain
| | - Pedro Arguis
- Department of Anesthesiology, Thoracic Radiology Unit, University of Barcelona, Villarroel 170, Barcelona 08036, Spain
| | - Marcelo Sánchez
- Department of Anesthesiology, Thoracic Radiology Unit, University of Barcelona, Villarroel 170, Barcelona 08036, Spain
| | - Xavier Sala-Blanch
- Orthopedics and Ambulatory Surgery Unit, Department of Anesthesiology, University of Barcelona, Hospital Clínic, Spain; Department of Radiology, Hospital Clínic, Human Anatomy and Embryology Unit, Faculty of Medicine, University of Barcelona, Villarroel 170, Barcelona 08036, Spain
| |
Collapse
|
12
|
The Effect of Needle Gauge on the Risk of Pneumothorax and Chest Tube Placement After Percutaneous Computed Tomographic (CT)-Guided Lung Biopsy. Cardiovasc Intervent Radiol 2015; 38:1595-602. [DOI: 10.1007/s00270-015-1097-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
|
13
|
Heerink WJ, de Bock GH, de Jonge GJ, Groen HJM, Vliegenthart R, Oudkerk M. Effect of cerium on drug metabolizing activity in rat liver. Eur Radiol 1972; 27:138-148. [PMID: 27108299 PMCID: PMC5127875 DOI: 10.1007/s00330-016-4357-8] [Citation(s) in RCA: 421] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/05/2016] [Accepted: 04/05/2016] [Indexed: 12/11/2022]
Abstract
Objectives To meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors. Methods Four databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis. Results For core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3–43.5 %) and 24.0 % (95 % CI: 18.2–30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4–7.4 %) and 4.4 % (95 % CI: 2.7–7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified. Conclusions In CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications. Key Points • Minor complications are common in CT-guided lung biopsy • Major complication rate is low in CT-guided lung biopsy • CT-guided lung biopsy complications occur more often in core biopsy than FNA • Major complication rate is similar in core biopsy and FNA • Risk factors for FNA are larger needle diameter, smaller lesion size Electronic supplementary material The online version of this article (doi:10.1007/s00330-016-4357-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- W J Heerink
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | - G H de Bock
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - G J de Jonge
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - H J M Groen
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Pulmonary Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - R Vliegenthart
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - M Oudkerk
- Center for Medical Imaging-North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|