Safety and Feasibility of Pulmonologists Performing Electromagnetic-Guided Percutaneous Lung Biopsy (SPiN Perc)

Abstract

SESSION TITLE: Interventional Pulmonology SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Percutaneous lung biopsy for diagnostic sampling of peripheral lung nodules has been widely performed by interventional radiologists under computed tomography (CT) guidance. Recently, a new technology utilizing electromagnetic guidance to perform percutaneous biopsies has become available for use by pulmonologists. The goal of this study was to determine the safety and feasibility of pulmonologists performing electromagnetic guidance percutaneous lung biopsy. METHODS: We conducted a retrospective, multicenter, chart review of 129 electromagnetic guided percutaneous lung biopsies that occurred between November 2013 and March 2017. The study consisted of seven academic medical centers, and three community medical centers. Demographics, nodule characteristics, adverse event, and yield data on all patients was collected. RESULTS: The average age of participants was 65.58, 50.4% were female, with an average BMI of 26.3. Of the 129 patients, 17.1% were never smokers, 51.20% former smokers and 31.8% were current smokers, with an average of 33.76 pack-years smoking history. Thirty-eight percent of all patients were previously diagnosed as having COPD. Percutaneous lung biopsy under electromagnetic guidance was feasible and performed in all cases. The majority of lesions were in the right upper lobe (37.2%) and left upper lobe (31.8%). The mean size of the lesion was 27.31mm and 13.2mm from the pleura. Practitioners averaged 1.10 pleural punctures per patient with an introducer needle, and took on average 1.94 fine needle aspirates and 4.99 core biopsies. There were 23 (17.8%) pneumothoraces of which 16 (12.4%) required chest tube placement. There were two minor bleeding events, one COPD exacerbation, two hypercapneic respiratory failures and one patient was transiently hypoxemic. Twenty one patients (16.3%) were admitted to the hospital for observation. Electromagnetic guided percutaneous lung biopsy diagnostic yield was 74.2%, which increased to 83.5% with the addition of electromagnetic guided bronchoscopy. CONCLUSIONS: The use of electromagnetic guidance for percutaneous lung biopsies is both safe and feasible in the hands of pulmonologists. CLINICAL IMPLICATIONS: Pulmonologists are able to safely and effectively use electromagnetic guidance for percutaneous lung biopsies during bronchoscopic procedures. Diagnostic yield in this retrospective cohort shows improved outcomes over bronchoscopic techniques with acceptable complication rates. A multicentered prospective trial to further evaluate the effectiveness of this technology is underway. DISCLOSURE: Hans Lee: Consultant fee, speaker bureau, advisory committee, etc.: Has received consulting fees from Veran Medical Jason Akulian: Consultant fee, speaker bureau, advisory committee, etc.: Has received consulting fees from Veran Medical David Feller-Kopman: Consultant fee, speaker bureau, advisory committee, etc.: Has received consulting fees from Veran Medical Alexander Chen: Consultant fee, speaker bureau, advisory committee, etc.: Has received consulting fees from Veran Medical Lonny Yarmus: Consultant fee, speaker bureau, advisory committee, etc.: Has received consulting fees from Veran Medical The following authors have nothing to disclose: Christopher Mallow, Catherine Oberg, Allen Burks, Branden Luna, Sadia Benzaquen, Hitesh Batra, Jose Cardenas-Garcia, Jennifer Toth, Jay Heidecker, Adam Belanger, Jason McClune, Umar Osman, Venkatesh Lakshminarayanan, Nicholas Pastis No Product/Research Disclosure Information