Imaging-guided chest biopsies: techniques and clinical results

Autor: Michele Anzidei, Andrea Porfiri, Fabrizio Andrani, Michele Di Martino, Luca Saba, Carlo Catalano, Mario Bezzi
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Insights into Imaging, Vol 8, Iss 4, Pp 419-428 (2017)
Druh dokumentu: article
ISSN: 1869-4101
DOI: 10.1007/s13244-017-0561-6
Popis: Abstract Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications. Teaching points • Imaging-guided biopsy is one of the main methods to obtain lung nodule specimens. • CT has the highest accuracy for diagnosis as an imaging guide. • Compared to FNAB, CNB has a higher accuracy for diagnosis. • Pneumothorax and parenchymal pulmonary haemorrhage care the most frequent complications. • Several clinical and technical variables can affect diagnostic accuracy and patient safety.
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