Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
Autor: | A. Varriale, Evaristo Maiello, Antonio Mirijello, Maria Arcangela Grimaldi, Donato Lacedonia, Carla Maria Irene Quarato, Lucia Dimitri, Paolo Graziano, Salvatore De Cosmo, Marco Taurchini, A. Simeone, Elio Perrone, Marco Sperandeo, Gianmaria Ferretti, Concetta Di Micco |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Medicine (General)
medicine.medical_specialty Pleural effusion Clinical Biochemistry specificity transthoracic ultrasound Malignancy Article R5-920 Pulmonary consolidation medicine transthoracic ultrasound-guided percutaneous needle biopsy Lung Percutaneous needle biopsy business.industry Ultrasound chest computed tomography Gold standard (test) sensitivity medicine.disease medicine.anatomical_structure Pneumothorax peripheral pulmonary lesions diagnostic accuracy Radiology medicine.symptom business |
Zdroj: | Diagnostics; Volume 11; Issue 9; Pages: 1641 Diagnostics, Vol 11, Iss 1641, p 1641 (2021) Diagnostics |
ISSN: | 2075-4418 |
DOI: | 10.3390/diagnostics11091641 |
Popis: | (1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) examination vs. chest CT (gold standard) in the differentiation between malignant and benign peripheral lung lesions. (2) Methods: A total of 961 consecutive patients with subpleural pulmonary lesions were enrolled. All the patients received a CT scan with contrast; 762 patients underwent TUS-PTNB for suspicion of malignancy, and the remaining 199 enrolled patients underwent only TUS examination as a part of routine follow-up for known non-malignant subpleural consolidations. (3) Results: Among the 762 TUS-guided biopsies, there were 627 (82.28%) malignant lesions, 82 (10.76%) benign lesions, and 53 (6.96%) indeterminate lesions. The overall diagnostic accuracy was 93.04%. The rates of pneumothorax not requiring chest-tube insertion and self-limited hemoptysis were 0.79 and 0.26%, respectively. Patients were divided into two groups based on the benign or malignant nature of the subpleural consolidations. On TUS, both malignant and benign lesions showed mostly irregular margins and a hypoechoic pattern, but no differences were assessed in terms of sonographic margins and pattern between the two groups. There was poor agreement between TUS and chest CT in assessing air bronchograms and necrotic areas. The only finding in the detection of which TUS showed superiority compared to chest-CT was pleural effusion. (4) Conclusions: TUS-PNB was confirmed to be an effective and safe diagnostic method for peripheral pulmonary consolidation, but their sonographic pattern did not allow to rule out a malignant nature. A pre-operative evaluation on CT images, combined with the possibility of performing additional immunohistochemical and cytological investigations and the experience of the medical staff, may improve the diagnostic yield of TUS-guided biopsies. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |