CT guided percutaneous lung biopsy: manipulation technique discussion and analysis of complicationsGong

Abstract

Abstract:ObjectiveTo explore the technique, complications and preventions of CT guided percutaneous lung biopsy in diagnosing lung neoplasms. Methods112 cases of lung neoplasms were performed CT guided percutaneous lung biopsy with shallow breathing. All pathological results and complications were recorded and then followed clinical followup. Results106 cases were diagnosed malignant tumors in the initial pathology and 6 cases nonmalignant tumor. After second biopsies of the 6 cases, 4 cases were confirmed malignant and 2 cases nonmalignant. Of the 2 “benign” cases, 1 was indicated malignant during followup. The pathological diagnosis accuracy rate was 95.54% (107/112) after the initial biopsies. 24 cases appeared pneumothorax, 8 cases hemoptysis or tumor hemorrhage, 1 cases pleural reaction. ConclusionCT guided lung biopsy is an ideal lung neoplasm diagnostic method with good tolerance, high diagnostic accuracy and less complications combined with shallow breathing, and it needs clear indications, wellregulated puncture technique, skilled operation with care.

Key words:Lung neoplasms,Tomography, spiral computed,Biopsy,Breathing exercise

GONG Wei-Hong, WANG Jun-Ye, ZHAO Hai-Yan, ZHANG Zhong-Min, ZHANG Chuan-Jian, YAN Li, CHEN Wen-Jun, SUN Li-Jun. CT guided percutaneous lung biopsy: manipulation technique discussion and analysis of complicationsGong[J]. Journal of International Oncology, 2014, 41(11): 869-872.

References

1］ Gelbman BD, Cham MD, Kim W, et al. Radiographic and clinical characterization of false negative results from CTguided needle biopsies of lung nodules［J］.J Thorac Oncol, 2012, 7(5):815820. ［2］ Gangopadhyay M, Chakrabarti I, Ghosh N, et al. Computed tomography guided fine needle aspiration cytology of mass lesions of lung: our experience［J］. Indian J Med Paediatr Oncol, 2011, 32(4):192196. ［3］王国范, 左文述, 张利民, 等. CT定位下细针肺穿刺术的临床应用［J］. 中华医学杂志, 2001, 81(5):301302. ［4］萧淑华, 林劲松, 刘斌, 等. 手动式及弹枪式经皮肺穿刺活检方法的对比研究［J］. 中华结核和呼吸杂志, 2011, 34(3):179181. ［5］唐光健, 孙静涛, 王仁贵, 等. 胸膜外定位法CT导引下经肺穿刺活检［J］. 中华放射学杂志, 2008, 42(12):13071310. ［6］彭敏, 许文兵, 施举红, 等. CT引导下经皮肺活检在弥漫性实质性肺疾病的临床应用［J］. 中华结核和呼吸杂志, 2012, 35(3):171175. ［7］ Brooks DR, Austin JH, Heelan RT, et al. Influence of type of cigarette on peripheral versus central lung cancer［J］. Cancer Epidemiol Biomarkers Prev, 2005, 14(3):576581. ［8］ Lauren GC, Christopher H, Robert P, et al. Lung cancer: diagnosis and management［J］. Am Fam Physician, 2007, 75(1):5663. ［9］ Yildirim E, Kirbas I, Harman A, et al. CTguided cutting needle lung biopsy using modified coaxial technique: factors effecting risk of complications［J］. Eur J Radiol, 2009, 70(1):5760. ［10］ Wagner JM, Hinshaw JL, Lubner MG, et al. CTguided lung biopsies: pleural blood patching reduces the rate of chest tube placement for postbiopsy pneumothorax［J］. AJR Am J Roentgenol, 2011, 197(4): 783788. ［11］ Wu CC, Maher MM, Shepard JA. Complications of CTguided percutaneous needle biopsy of the chest: prevention and management［J］. AJR Am J Roentgenol, 2011, 196(6):W678682. ［12］ Takao H, Hidefumi M, Hideo G, et al. Incidence of and risk factors for pneumothorax and chest tube placement after CT fluoroscopyfuided percutaneous lung biopsy: retrospective analysis of the procedures conducted over a 9year period［J］. Am J Roentgenol, 2010, 194(3):809814. ［13］ Covey AM, Gandhi R, Brody LA, et al. Factors associated with pneumothorax and pneumothorax requiring treatment after percutaneous lung biopsy in 443 consecutive patients［J］. J Vasc Interv Radiol, 2004, 15(5):479483. ［14］ Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CTguided transthoracic biopsy［J］. Eur Radiol 2008, 18(7):13561363. ［15］ Smayra T, Braidy C, MenassaMoussa L, et al. Risk factors of pneumothorax and hemorrhage in lung biopsy: a single institution experience［J］. J Med Liban, 2012, 60(1):413.

[1]	Liu Na, Kou Jieli, Yang Feng, Liu Taotao, Li Danping, Han Junrui, Yang Lizhou.Clinical value of serum miR-106b-5p and miR-760 combined with low-dose spiral CT in the diagnosis of early lung cancer[J]. Journal of International Oncology, 2024, 51(6): 321-325.
[2]	He Jiahui, Hu Qinyong.Comparative analysis of lung cancer incidence and mortality trends and risk factors in China and the United States based on GBD data[J]. Journal of International Oncology, 2024, 51(1): 29-36.
[3]	Fan Mengsi, Lu Yaping, Yan Li.Analysis of clinicopathologic features of false negative sentinel lymph nodes in patients with endometrial cancer[J]. Journal of International Oncology, 2023, 50(5): 274-279.
[4]	Zuo Xiaoping, Liu Xiaochuan, Wu Xiqiang, Li Zhou, Xia Tian, Liu Guofeng.Risk factors and prediction model construction of arrhythmia in elderly patients with early lung cancer after thoracoscopic pulmonary resection[J]. Journal of International Oncology, 2023, 50(12): 711-716.
[5]	Chen Yu, Xu Hua, Liu Hai, Chen Shixin.Construction of pathological classification prediction model for malignant pulmonary pure ground-glass nodule patients based on CT imaging[J]. Journal of International Oncology, 2023, 50(11): 655-660.
[6]	Song Tongjun, Deng Rui, Fei Lei, Lei Jinhua, Cao Fengjun.Comparison of the efficacy and safety of percutaneous needle biopsy of pulmonary or pleural lesions guided by CT and ultrasound[J]. Journal of International Oncology, 2022, 49(9): 526-531.
[7]	Yang Sha, Yang Xiaohua, Wang Suhua, Xue Xiaoyan, Xu Jun.Analysis of risk factors for deep vein thrombosis of lower extremity after thoracoscopic surgery for elderly lung cancer and establishment and validation of prediction model[J]. Journal of International Oncology, 2022, 49(9): 532-536.
[8]	Chen Huangjing, Zhu Pengfei, Zhang Qing, Chen Guifang, Yang Chunlin, He Ying.Comparative study on the clinical value of contrast-enhanced ultrasound- and CT-guided percutaneous puncture biopsy in peripheral lung masses[J]. Journal of International Oncology, 2022, 49(8): 459-463.
[9]	Cai Gangxiang, Li Jing, Xu Bin.Advances in neoadjuvant immunotherapy for lung cancer[J]. Journal of International Oncology, 2022, 49(6): 366-370.
[10]	Zhang Jingxian, Yi Dan, Li Xiaojiang.Application of antibody-drug conjugates in the treatment of non-small cell lung cancer[J]. Journal of International Oncology, 2022, 49(5): 296-301.
[11]	Gao Min, Feng Jing, Wang Li, Zhong Hai, Wen Yuting, Wan Bing, Zhang Xiuwei.Application of microbiota in the early diagnosis and adjunctive treatment of lung cancer[J]. Journal of International Oncology, 2022, 49(4): 247-251.
[12]	Gao Shile, Lu Donghui, Liu Meiqin, Xu Xingjun, Ma Huan, Zhang Yu.Clinical efficacy and optimal dose of apatinib combined with chemotherapy in patients with advanced non-small cell lung cancer[J]. Journal of International Oncology, 2022, 49(3): 140-145.
[13]	Xie Hongxia, Zuo Jinhui, Liao Dongying, Deng Renfen, Yao Yang, Jia Yingjie, Li Xiaojiang, Kong Fanming.Application of PD-L1 inhibitors in the treatment of non-small cell lung cancer[J]. Journal of International Oncology, 2022, 49(2): 111-115.
[14]	Huang Huayu, Song Qibin, Gong Hongyun, Song Jia.Analysis on the incidence and risk factors of pneumonia in patients with lung cancer receiving thoracic radiotherapy and immunotherapy[J]. Journal of International Oncology, 2022, 49(12): 718-723.
[15]	Zhang Hongjiao, Jiang Jie, Huang Wei.Research progress of functional imaging-assisted radiotherapy target delineation of lung cancer with atelectasis[J]. Journal of International Oncology, 2022, 49(1): 51-55.