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Title: Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study

Abstract

PurposePatients with thoracic malignancies often have more than one site of pulmonary, nodal or pleural disease within one hemithorax. In addition, large heterogeneous lesions may comprise distinct, mixed pathological entities. Histological analysis of these lesions can alter tumour staging and treatment options. We investigated the feasibility, safety and benefit of performing image-guided percutaneous lung biopsy (PLB) of two lesions in the same hemithorax at a single sitting.Materials and MethodsTen consecutive outpatients with two or more potential disease foci within the same hemithorax were analysed over a 15-month period. The mean age of the patients was 66 years (range 46–81 years). Patients underwent CT-guided coaxial 20G   core biopsy of both lesions, with separate coaxial punctures for each lesion. Patients were managed as per established local institution ambulatory lung biopsy protocol using small-calibre Heimlich-valve chest drain (HVCD) to treat significant post-PLB pneumothorax in an outpatient setting. Data regarding lesion characteristics, diagnoses and complications were recorded.ResultsAll 10 patients (n = 20 biopsies, 100% technical success) received informative histological diagnosis on both lesions. This altered management in all cases. Although a high rate of pneumothorax occurred (60%; 6/10), only two of these patients required treatment with HVCD. No other significant complications occurred in those patients with smallmore » asymptomatic pneumothoraces or those that required HVCD placement.ConclusionsDual-site lung biopsy, performed as a single procedure, is potentially a safe and effective technique for diagnosing patients with multiple thoracic lesions, and can provide useful staging information to guide patient management.« less

Authors:
;  [1];  [2];  [1];  [2];  [1]
  1. Royal Free London NHS Foundation Trust, Department of Radiology, Barnet Hospital (United Kingdom)
  2. Royal Free London NHS Foundation Trust, Department of Respiratory Medicine, Barnet Hospital (United Kingdom)
Publication Date:
OSTI Identifier:
22645221
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 5; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; CHEST; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; FEASIBILITY STUDIES; IMAGES; LUNGS; NEOPLASMS; PATIENTS; SAFETY

Citation Formats

Barnett, Joseph, Tavare, Aniket N., Khan, Sajid, Saini, Ashish, Creer, Dean D., and Hare, Samanjit S., E-mail: samhare@nhs.net. Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1558-0.
Barnett, Joseph, Tavare, Aniket N., Khan, Sajid, Saini, Ashish, Creer, Dean D., & Hare, Samanjit S., E-mail: samhare@nhs.net. Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study. United States. doi:10.1007/S00270-016-1558-0.
Barnett, Joseph, Tavare, Aniket N., Khan, Sajid, Saini, Ashish, Creer, Dean D., and Hare, Samanjit S., E-mail: samhare@nhs.net. Mon . "Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study". United States. doi:10.1007/S00270-016-1558-0.
@article{osti_22645221,
title = {Ipsilateral Dual-Site, Same-Sitting Percutaneous Lung Biopsy: A Feasibility Study},
author = {Barnett, Joseph and Tavare, Aniket N. and Khan, Sajid and Saini, Ashish and Creer, Dean D. and Hare, Samanjit S., E-mail: samhare@nhs.net},
abstractNote = {PurposePatients with thoracic malignancies often have more than one site of pulmonary, nodal or pleural disease within one hemithorax. In addition, large heterogeneous lesions may comprise distinct, mixed pathological entities. Histological analysis of these lesions can alter tumour staging and treatment options. We investigated the feasibility, safety and benefit of performing image-guided percutaneous lung biopsy (PLB) of two lesions in the same hemithorax at a single sitting.Materials and MethodsTen consecutive outpatients with two or more potential disease foci within the same hemithorax were analysed over a 15-month period. The mean age of the patients was 66 years (range 46–81 years). Patients underwent CT-guided coaxial 20G   core biopsy of both lesions, with separate coaxial punctures for each lesion. Patients were managed as per established local institution ambulatory lung biopsy protocol using small-calibre Heimlich-valve chest drain (HVCD) to treat significant post-PLB pneumothorax in an outpatient setting. Data regarding lesion characteristics, diagnoses and complications were recorded.ResultsAll 10 patients (n = 20 biopsies, 100% technical success) received informative histological diagnosis on both lesions. This altered management in all cases. Although a high rate of pneumothorax occurred (60%; 6/10), only two of these patients required treatment with HVCD. No other significant complications occurred in those patients with small asymptomatic pneumothoraces or those that required HVCD placement.ConclusionsDual-site lung biopsy, performed as a single procedure, is potentially a safe and effective technique for diagnosing patients with multiple thoracic lesions, and can provide useful staging information to guide patient management.},
doi = {10.1007/S00270-016-1558-0},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 40,
place = {United States},
year = {Mon May 15 00:00:00 EDT 2017},
month = {Mon May 15 00:00:00 EDT 2017}
}