Abstract
Objective: The aim of the present study was to explore the diagnostic value and safety of color Doppler ultrasound (US)-guided transthoracic core needle biopsy (CNB) of peripheral lung, chest wall and mediastinal lesions using automated biopsy guns.Materials and methods: We analyzed clinical and image data, histopathologic and microbiologic details and complications from 121 patients with peripheral lung, chest wall and mediastinal lesions who underwent color Doppler US-guided transthoracic CNB in Ningbo First Hospital between January 2015 and June 2018.Results: Color Doppler US-guided transthoracic CNB performed with a freehand technique using automated biopsy guns had a sensitivity of 93.94%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 78.57%, and a diagnostic accuracy of 95.04%. Lesion size did not affect the diagnostic rate (P=0.40). No serious complications of the procedure were noted.Conclusion: Color Doppler US-guided transthoracic CNB of peripheral lung, chest wall and mediastinal lesions is a safe and inexpensive procedure. The diagnostic accuracy of color Doppler US-guided transthoracic CNB was higher than that of color Doppler US-guided transthoracic fine needle aspiration biopsy (FNAB).
Highlights
As a result of advancements in technology, the imaging capabilities of color Doppler ultrasound (US) have been greatly improved
Core needle biopsy (CNB) is preferred over and superior to fine needle aspiration biopsy (FNAB) because CNB can obtain sufficient diagnostic specimens for histopathologic and cytological studies, and there is no significant difference in the complication rate between the two techniques [4,5,6,7,8]
US is a flexible approach that can guide many biopsy procedures in the chest [16]. This is the first study of color Doppler US-guided transthoracic biopsy entirely using CNB with a high diagnosis accuracy
Summary
As a result of advancements in technology, the imaging capabilities of color Doppler ultrasound (US) have been greatly improved. Color Doppler US is a safe and efficient method for evaluating lesions of the peripheral lung, chest wall and mediastinum [1]. There may be insufficient material for examination with traditional bronchoscopic methods; it is difficult to obtain specimens with bronchoscopy from peripheral pulmonary and mediastinal lesions [2]. Using color Doppler US to guide biopsy can provide real-time imaging of the procedure [4]. Core needle biopsy (CNB) is preferred over and superior to fine needle aspiration biopsy (FNAB) because CNB can obtain sufficient diagnostic specimens for histopathologic and cytological studies, and there is no significant difference in the complication rate between the two techniques [4,5,6,7,8]
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