DOI QR코드

DOI QR Code

CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

  • Lal, Hira (Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences) ;
  • Neyaz, Zafar (Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences) ;
  • Nath, Alok (Department of Pulmonary Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences) ;
  • Borah, Samudra (Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences)
  • Published : 2012.04.01

Abstract

Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.

Keywords

References

  1. Klein JS, Salomon G, Stewart EA. Transthoracic needle biopsy with a coaxially placed 20-gauge automated cutting needle: results in 122 patients. Radiology 1996;198:715-720 https://doi.org/10.1148/radiology.198.3.8628859
  2. Manhire A, Charig M, Clelland C, Gleeson F, Miller R, Moss H, et al. Guidelines for radiologically guided lung biopsy. Thorax 2003;58:920-936 https://doi.org/10.1136/thorax.58.11.920
  3. Cham MD, Henschke CI, Yankelevitz DF. Biopsy procedures of the lung, mediastnum, and chest wall. In: Kandarpa K, Machan L, eds. Handbook of interventional radiologic procedures, 4th ed. Philadelphia, USA: Wolters Kluwer/ Lippincott Williams & Wilkins, 2011:478-485
  4. Cham MD, Lane ME, Henschke CI, Yankelevitz DF. Lung biopsy: special techniques. Semin Respir Crit Care Med 2008;29:335- 349 https://doi.org/10.1055/s-2008-1081278
  5. Gupta S, Seaberg K, Wallace MJ, Madoff DC, Morello FA Jr, Ahrar K, et al. Imaging-guided percutaneous biopsy of mediastinal lesions: different approaches and anatomic considerations. Radiographics 2005;25:763-788 https://doi.org/10.1148/rg.253045030
  6. Moore EH. Technical aspects of needle aspiration lung biopsy: a personal perspective. Radiology 1998;208:303-318 https://doi.org/10.1148/radiology.208.2.9680552
  7. Tsai IC, Tsai WL, Chen MC, Chang GC, Tzeng WS, Chan SW, et al. CT-guided core biopsy of lung lesions: a primer. Am J Roentgenol 2009;193:1228-1235 https://doi.org/10.2214/AJR.08.2113
  8. Kinoshita F, Kato T, Sugiura K, Nishimura M, Kinoshita T, Hashimoto M, et al. CT-guided transthoracic needle biopsy using a puncture site-down positioning technique. Am J Roentgenol 2006;187:926-932 https://doi.org/10.2214/AJR.05.0226
  9. Wallace AB, Suh RD. Percutaneous transthoracic nnedle biopsy:special considerations and techniques used in lung transplant recipients. Semin Intervent Radiol 2004;21:247-258 https://doi.org/10.1055/s-2004-861559
  10. Cox JE, Chiles C, McManus CM, Aquino SL, Choplin RH. Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology 1999;212:165-168 https://doi.org/10.1148/radiology.212.1.r99jl33165
  11. Yamagami T, Kato T, Iida S, Hirota T, Nishimura T. Percutaneous needle biopsy for small lung nodules beneath the rib under CT scan fluoroscopic guidance with gantry tilt. Chest 2004;126:744-747 https://doi.org/10.1378/chest.126.3.744
  12. Paulson EK, Sheafor DH, Enterline DS, McAdams HP, Yoshizumi TT. CT fluoroscopy-guided interventional procedures: techniques and radiation dose to radiologists. Radiology 2001;220:161-167 https://doi.org/10.1148/radiology.220.1.r01jl29161
  13. Kim GR, Hur J, Lee SM, Lee HJ, Hong YJ, Nam JE, et al. CT fluoroscopy-guided lung biopsy versus conventional CT-guided lung biopsy: a prospective controlled study to assess radiation doses and diagnostic performance. Eur Radiol 2011;21:232- 239 https://doi.org/10.1007/s00330-010-1936-y
  14. Bandoh S, Fujita J, Fukunaga Y, Yokota K, Ueda Y, Okada H, et al. Cavitary lung cancer with an aspergilloma-like shadow. Lung Cancer 1999;26:195-198 https://doi.org/10.1016/S0169-5002(99)00080-X
  15. Collings CL, Westcott JL, Banson NL, Lange RC. Pneumothorax and dependent versus nondependent patient position after needle biopsy of the lung. Radiology 1999;210:59-64 https://doi.org/10.1148/radiology.210.1.r99ja1759
  16. Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. AJR 2011;196:W678-W682 https://doi.org/10.2214/AJR.10.4659
  17. Hare SS, Gupta A, Goncalves AT, Souza CA, Matzinger F, Seely JM. Systemic arterial air embolism after percutaneous lung biopsy. Clin Radiol 2011;66:589-596 https://doi.org/10.1016/j.crad.2011.03.005
  18. Oertel MF, Korinth MC, Reinges MH, Krings T, Terbeck S, Gilsbach JM. Pathogenesis, diagnosis and management of pneumorrhachis. Eur Spine J 2006;15 Suppl 5:S636-S643 https://doi.org/10.1007/s00586-006-0160-6

Cited by

  1. Percutaneous lung biopsy: comparison between an augmented reality CT navigation system and standard CT-guided technique vol.8, pp.5, 2012, https://doi.org/10.1007/s11548-013-0816-8
  2. Percutaneous lung biopsies: performance of an optical CT-based navigation system with a low-dose protocol vol.23, pp.11, 2012, https://doi.org/10.1007/s00330-013-2932-9
  3. Impact of immediate evaluation of touch imprint cytology from computed tomography guided core needle biopsies of mass lesions: Single institution experience vol.11, pp.None, 2014, https://doi.org/10.4103/1742-6413.134437
  4. Patient reported experiences of CT guided lung biopsy: a prospective cohort study vol.9, pp.None, 2012, https://doi.org/10.1186/2049-6958-9-53
  5. Transthoracic biopsy of lung masses: Non technical factors affecting complication occurrence vol.6, pp.2, 2015, https://doi.org/10.1111/1759-7714.12156
  6. CT-guided biopsy versus conventional Abram’s needle biopsy in malignant pleural effusion vol.64, pp.2, 2012, https://doi.org/10.1016/j.ejcdt.2015.01.001
  7. Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique vol.25, pp.5, 2012, https://doi.org/10.1007/s00330-014-3508-z
  8. Percutaneous computed tomography-guided aspiration and biopsy of intrathoracic lesions: Results of 265 procedures vol.33, pp.6, 2012, https://doi.org/10.4103/0970-2113.192863
  9. Computed tomography-guided percutaneous core needle biopsy for diagnosis of mediastinal mass lesions: Experience with 110 cases in two university hospitals in Isfahan, Iran vol.5, pp.None, 2016, https://doi.org/10.4103/2277-9175.188939
  10. Impact of touch imprint cytology on imaging‐guided core needle biopsies: An experience from a large academic medical center laboratory vol.44, pp.2, 2012, https://doi.org/10.1002/dc.23389
  11. Use of an Electromagnetic Navigation System on a Phantom as a Training Simulator for CT-Guided Procedures vol.14, pp.6, 2012, https://doi.org/10.1016/j.jacr.2016.12.029
  12. Using needle orientation sensing as surrogate signal for respiratory motion estimation in percutaneous interventions vol.13, pp.1, 2018, https://doi.org/10.1007/s11548-017-1644-z
  13. Respiratory motion estimation of the liver with abdominal motion as a surrogate vol.14, pp.6, 2012, https://doi.org/10.1002/rcs.1940
  14. Basic Interventional Procedures: Practice Essentials vol.29, pp.2, 2012, https://doi.org/10.4103/ijri.ijri_96_19
  15. Short‐duration post CT ‐guided thoracic biopsy monitoring‐ clinical experience with 440 patients vol.66, pp.2, 2012, https://doi.org/10.1002/jmrs.330
  16. Initial Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Lesions Performed by a Pulmonologist vol.8, pp.6, 2012, https://doi.org/10.3390/jcm8060821
  17. Esophageal ultrasound with ultrasound bronchoscope (EUS-B) guided transvascular needle aspiration (TVNA) vol.28, pp.None, 2012, https://doi.org/10.1016/j.rmcr.2019.100864
  18. C-arm Cone-beam CT-guided Needle Biopsies through the Erector Spinal Muscle for Posterior Thoracic Pulmonary Lesions vol.32, pp.3, 2012, https://doi.org/10.15369/sujms.32.193
  19. Diagnostic Value of Rapid On-Site Evaluation for CT-Guided Percutaneous Fine Needle Aspiration in the Diagnosis of Pulmonary Occupying Lesions vol.2020, pp.None, 2012, https://doi.org/10.1155/2020/9842768
  20. Computed tomography guided lung biopsy under general anaesthesia with apnoea: Preliminary experience vol.65, pp.6, 2012, https://doi.org/10.1111/1754-9485.13279