Matthew H Lee1,2, Meghan G Lubner1, J Louis Hinshaw1, Perry J Pickhardt1. 1. 1 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI. 2. 2 Present address: Department of Radiology, Naval Medical Center Camp Lejeune, 100 Brewster Blvd, Camp Lejeune, NC 28547.
Abstract
OBJECTIVE: The purpose of this study was to compare efficacy and safety of biopsy guided by ultrasound (US) versus CT for lung lesions with pleural contact. MATERIALS AND METHODS: Among 1269 image-guided thoracic biopsies obtained at our institution between 2004 and 2016, 150 were US-guided for lung lesions with pleural contact (78 men, 72 women; mean age, 67 years). Of those, 94 were performed using US only; 56 had initial CT localization. A comparison cohort of 100 consecutive CT-guided biopsies for lung lesions with pleural contact was identified (60 men, 40 women; mean age, 65 years). Biopsy type, number of passes, sample adequacy, final pathologic results, complications, procedural time, lesion diameter, and pleural contact were recorded. Fisher exact and t tests were used for statistical analysis. RESULTS: US-guided biopsy was associated with fewer complications (7%) than CT-guided procedures (24%; p < 0.001). Mean procedure times (± SD) were shorter with US only (31 ± 16 min) than with CT only (45 ± 26 min; p < 0.001) or US with CT localization (45 ± 18 min; p < 0.001). Procedural times were longer for patients with small lesions and those with lesser pleural contact. Sample adequacy was best when core biopsy was performed with US and CT. Fewer passes were performed with US guidance than with CT guidance (mean, 3.1 ± 1.8 vs 4.4 ± 1.9, respectively, p < 0.001), with a trend toward improved pathologic adequacy (98% vs 93%, respectively, p = 0.122). Subgroup analysis showed fewer complications for lesions 31-50 mm (p = 0.029), improved sample adequacy for lesions 10-30 mm (p = 0.0032), and shorter procedural times for lesions 10-30 mm (p = 0.0001) with US than with CT. CONCLUSION: US guidance should be considered for biopsy of peripheral lung and pleural lesions larger than 10 mm, because it is safer, faster, and possibly more accurate than CT guidance.
OBJECTIVE: The purpose of this study was to compare efficacy and safety of biopsy guided by ultrasound (US) versus CT for lung lesions with pleural contact. MATERIALS AND METHODS: Among 1269 image-guided thoracic biopsies obtained at our institution between 2004 and 2016, 150 were US-guided for lung lesions with pleural contact (78 men, 72 women; mean age, 67 years). Of those, 94 were performed using US only; 56 had initial CT localization. A comparison cohort of 100 consecutive CT-guided biopsies for lung lesions with pleural contact was identified (60 men, 40 women; mean age, 65 years). Biopsy type, number of passes, sample adequacy, final pathologic results, complications, procedural time, lesion diameter, and pleural contact were recorded. Fisher exact and t tests were used for statistical analysis. RESULTS: US-guided biopsy was associated with fewer complications (7%) than CT-guided procedures (24%; p < 0.001). Mean procedure times (± SD) were shorter with US only (31 ± 16 min) than with CT only (45 ± 26 min; p < 0.001) or US with CT localization (45 ± 18 min; p < 0.001). Procedural times were longer for patients with small lesions and those with lesser pleural contact. Sample adequacy was best when core biopsy was performed with US and CT. Fewer passes were performed with US guidance than with CT guidance (mean, 3.1 ± 1.8 vs 4.4 ± 1.9, respectively, p < 0.001), with a trend toward improved pathologic adequacy (98% vs 93%, respectively, p = 0.122). Subgroup analysis showed fewer complications for lesions 31-50 mm (p = 0.029), improved sample adequacy for lesions 10-30 mm (p = 0.0032), and shorter procedural times for lesions 10-30 mm (p = 0.0001) with US than with CT. CONCLUSION: US guidance should be considered for biopsy of peripheral lung and pleural lesions larger than 10 mm, because it is safer, faster, and possibly more accurate than CT guidance.
Authors: Mario Ghosn; Waseem Cheema; Amy Zhu; Jennifer Livschitz; Majid Maybody; Franz E Boas; Ernesto Santos; DaeHee Kim; Jason A Beattie; Michael Offin; Valerie W Rusch; Marjorie G Zauderer; Prasad S Adusumilli; Stephen B Solomon Journal: Lung Cancer Date: 2022-01-06 Impact factor: 6.081
Authors: Julia d'Hooghe; Haizea Alvarez Martinez; Pia Iben Pietersen; Christian B Laursen; Nicole Hersch; Ádám Domonkos Tárnoki; Simon Walsh; Jouke Annema; Daniela Gompelmann Journal: ERJ Open Res Date: 2020-07-20
Authors: Soon Ho Yoon; Sang Min Lee; Chul Hwan Park; Jong Hyuk Lee; Hyungjin Kim; Kum Ju Chae; Kwang Nam Jin; Kyung Hee Lee; Jung Im Kim; Jung Hee Hong; Eui Jin Hwang; Heekyung Kim; Young Joo Suh; Samina Park; Young Sik Park; Dong Wan Kim; Miyoung Choi; Chang Min Park Journal: Korean J Radiol Date: 2020-11-19 Impact factor: 3.500