Abstract
PurposeTo evaluate diagnostic performance and safety of ultrasound-guided needle biopsy in the diagnosis of peripheral pulmonary nodules (PPLs) ≤ 2 cm, and the influence factors of sample adequacy and safety.Materials and Methods194 patients (99 men, 95 women; mean age, 56.2 ± 13.7 years) who received biopsy for PPLs ≤ 2 cm between January 2014 to January 2019 were included. Variables including patient demographics, lesion location, lesion size, presence of lesion necrosis, presence of emphysema on CT, patient position, biopsy needle size and number of needle passes were recorded. Univariate analysis and multivariate logistic regression analysis were performed to explore the influence factor of sample adequacy and safety.ResultsBiopsy specimens were adequate for diagnosis in 161/194 (83%) cases; the diagnostic accuracy was 81.4% (158/194). The overall complication rate was 8.8% (17/194), including pneumothorax, hemoptysis and pleural effusion, which occurred in 2.1% (4/194), 5.2% (10/194), and 1.5% (3/194) of patients, respectively. The incidence of pneumothorax in the 16-gauge-needle group were significantly higher than that of the 18-gauge-needle group (5.6% vs 0%, P=0.018). Adequate sampling of 16-gauge and 18-gauge needles were achieved in 90.3%(65/72) and 78.7%(96/122) cases, respectively. Multivariate logistic regression analysis revealed needle size (16-gauge vs 18-gauge) was an independent influence factors of sample adequacy (P=0.015, odds ratio=3.419). A receiver operating characteristic curve was plotted and the area under the curve was 0.774.ConclusionUS-guided percutaneous needle biopsy is a feasible and safe technique for small PPLs ≤ 2 cm. Needle size is an independent influence factor of sample adequacy and post-procedure pneumothorax. Sixteen-gauge needle has the advantage of achieving adequate sample for pathological analysis, though the risk of pneumothorax should be alerted.
Highlights
With the application of computed tomography (CT) and advent of lung cancer screening in recent years, peripheral pulmonary lesions (PPLs) has been more frequently detected [1]
Percutaneous core needle biopsy plays an important role in diagnosing PPLs, as a precise diagnostic procedure is necessary for use in determining appropriate management [4]
The current study demonstrated that US-guided percutaneous needle biopsy for small PPLs is feasible and safe, and needle size is the independent influence factor of sample adequacy and postprocedure pneumothorax
Summary
With the application of computed tomography (CT) and advent of lung cancer screening in recent years, peripheral pulmonary lesions (PPLs) has been more frequently detected [1]. PPLs are defined as lesions directly in contact with the chest wall without an intervening aerated lung [2]. PPLs have an echogenic texture and a sharply defined border due to a strong reflective interface between the aerated lung and the lesion on ultrasound (US) [3]. Percutaneous core needle biopsy plays an important role in diagnosing PPLs, as a precise diagnostic procedure is necessary for use in determining appropriate management [4]. Compared with CT-guided procedures, US-guided percutaneous needle biopsy has some advantages such as free of radiation exposure, real-time monitoring, convenience and avoiding vessels with Color Doppler imaging [5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
