Current role of computed tomography-guided transthoracic needle biopsy of metastatic lung lesions
Abstract
ABSTRACT
Aim: As part of the Catania symposium on lung metastasectomy we reviewed our practice of computed tomography (CT)-guided percutaneous transthoracic needle biopsy of pulmonary metastatic lesions with particular emphasis on diagnostic accuracy and nature of complications lesions. Materials & methods: 25 patients with metastatic lesions of the lung have been evaluated between May 2010 and February 2014. Inclusion criteria consisted of patients with histologically confirmed, metastatic disease of the lung, those receiving a CT-guided needle biopsy, were at least 18 years of age; and with adequate hepatic, renal and hematological function. We recorded also the size of the sampled lesions, their distance from the pleura, the complications encountered (pneumothorax and thoracostomy tube placement), the cytological diagnosis and the outcome in all the cases. Results: CT-guided percutaneous transthoracic needle biopsy were performed on 23 of 25 patients with suspected lung metastases. 17 males and six females with a mean age of 71.4 years. The mean size of lesions was 4.2 cm (range: 1 to 17 cm). For CT-guided needle biopsy, an 18 gauge semi-automatic needle biopsy device was used. Of 23 biopsies, 20 (87%) yielded a correct diagnosis with specific histological typing for metastasis. Pneumothorax was the most common complication occurring in four cases (5.7%). Conclusion: CT-guided percutaneous transthoracic needle biopsy is a firm, useful and safe technique for the diagnosis of suspected pulmonary metastases as it avoids open biopsy in most cases.
References
- 1 Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 354, 99–105 (1999).Crossref, Medline, CAS, Google Scholar
- 2 Aspiration needle biopsy of thoracic lesions. Ann. Thorac. Surg. 32, 154–161 (1981).Crossref, Medline, CAS, Google Scholar
- 3 . Diagnostic accuracy and safety of CT-guided percutaneous needle aspiration biopsy of the lung: comparison of small and large pulmonary nodules. Am. J. Roentgenol. 167, 105–109 (1996).Crossref, Medline, CAS, Google Scholar
- 4 CT-guided transthoracic needle aspiration biopsy of small (≤20 mm) solitary pulmonary nodules. Am. J. Roentgenol. 180, 1665–1669 (2003).Crossref, Medline, Google Scholar
- 5 . Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. Am. J. Roentgenol. 175(1), 239–243 (2000).Crossref, Medline, CAS, Google Scholar
- 6 . The role of gene regulatory networks in promoting cancer progression and metastasis. Future Oncol. 10(5), 735–748 (2014).Link, CAS, Google Scholar
- 7 . Additional value of ct-fluoroscopic biopsy of pulmonary lesions: a retrospective study of 69 patients. JBR-BTR 89, 298–302 (2006).Medline, CAS, Google Scholar
- 8 . Pulmonary metastasectomy for sarcoma: a systematic review of reported outcomes in the context of Thames Cancer Registry data. BMJ Open 2, e001736 (2012).Google Scholar
- 9 . Pulmonary metastasectomy: what is the practice and where is the evidence for effectiveness? Thorax
doi:10.1136/thoraxjnl-2013-204528 (2014).Crossref, Google Scholar - 10 . Pulmonary metastasectomy for colorectal cancer: making the case for a randomized controlled trial in the zone of uncertainty. J. Thorac. Cardiovasc. Surg. 146(4), 748–752 (2013).Crossref, Medline, Google Scholar
- 11 . Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC International). Colorectal Cancer 2(6), 505–513 (2013).Link, Google Scholar
- 12 . Computed tomography-guided percutaneous needle biopsy of pulmonary nodules: impact of nodule size on diagnostic accuracy. Clin. Lung Cancer 10(5), 360–363 (2009).Crossref, Medline, Google Scholar
- 13 . Extending surgery for pulmonary metastasectomy: what are the limits? J. Thorac. Oncol. 5(6), S155–S160 (2010).Crossref, Medline, Google Scholar
- 14 Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy. Future Oncol. 11(Suppl. 2), 25–29 (2014).Google Scholar
- 15 . Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann. Intern. Med. 155(3), 137–144 (2011).Crossref, Medline, Google Scholar

