Biopsy of lung lesions under CT control.

Miloslav Marel,Libor Fila,Radek Padr,Fernando Casas Mendez,Radim Pavlik,Dmitry Rakita,Linda Capkova,Vaclav Capek

doi:10.5507/bp.2020.040

Abstract

With the increasing number of detected lung nodules and the need for morphological verification, the number of CT- controlled biopsies is increasing. The aim of this study was to assess the risks and benefits of these biopsies. This is a prospective and observational study. We evaluated 101 punctures performed on a group of 90 consecutive patients in the Department of Radiology. In patients with a mean age of 66 years, with mostly accidentally detected lung nodules, we observed complications 38 times. The most common were minor pneumothoraxes or insignificant bleedings. In 6 patients, the complications were more serious, 5 times the pneumothoraxes required chest drainage, once massive hemoptysis was recorded. The lesions were successfully biopsied 78 times, the target was missed 23 times. The diagnosis of lung cancer (LC) was confirmed in 60 patients, 49 LCs were verified by puncture under CT control. 42% (25/60) of patients with LC were diagnosed in TNM stages I and II. 23% (14/60) of patients with LC were treated surgically. The remaining 30 patients most often suffered from lung metastazes (13/30), in 8 of them an inflammatory lung disease was diagnosed. 69 patients underwent bronchoscopy, in only 19% (13/69) it contributed to the diagnosis. In a model "screening like" group of 49 patients with only randomly detected lung deposits, we diagnosed LC in 76% (37/49). 49% (18/37) were in TNM stage I and II, 11 were treated surgically. CT-controlled biopsy of lung lesions is an effective and safe diagnostic method.

Highlights

IntroductionIn addition to purely pneumological methods (bronchoscopy, Endobronchial ultrasound (EBUS)-guided biopsy of lung nodules using endobronchial ultrasound), newer methods performed by interventional radiologists are increasingly being used in the diagnosis of lung lesions[1,2,3,4]
In addition to purely pneumological methods, newer methods performed by interventional radiologists are increasingly being used in the diagnosis of lung lesions[1,2,3,4]
Pulmonary nodules were detected in our group of 90 patients by a random chest X-ray 4 times, the symptoms were the reason for radiological examination 29 times and 57 nodules were found during X-ray or computer tomography (CT) examination indicated for the control of other diseases

Summary

Introduction

In addition to purely pneumological methods (bronchoscopy, EBUS-guided biopsy of lung nodules using endobronchial ultrasound), newer methods performed by interventional radiologists are increasingly being used in the diagnosis of lung lesions[1,2,3,4]. Their importance will increase with the growing number of early diagnosed lung nodules. We have observed this increase in clinical practice quite intensively in recent years. We wanted to assess the effectiveness of bronchoscopy for the diagnosis of these lesions and on a model set of “screening like” pulmonary lesions determine what diagnostic benefit can be expected from different methods and what treatment will be indicated

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