Ultrasound guided transthoracic biopsy performed by respiratory physicians: Diagnostic yield and complications

Abstract

Background: Traditionally image guided tissue sampling have been performed by radiologists. Due to an increased availability of ultrasound (US) machines respiratory physicians now perform transthoracic US guided biopsies. This retrospective study aimed to determine the yield to obtain a malignant diagnosis and complications of US guided transthoracic biopsies performed by respiratory physicians. Methods: Patients with a registered ICD10-code of US guided biopsy performed at the Department of Respiratory Medicine, Odense University Hospital, from January 2012 to August 2014 were identified. The yields of the US guided biopsies were defined as the proportion of patients with a malignant diagnosis achieved by US guided biopsy. Results: A total of 126 US guided transthoracic biopsies had been performed of either the lung (n=107) or the pleura (n=19). 27 of these procedures were omitted from the yield analysis due to the patients receiving a non-malignant diagnosis. Among the remaining 99 performed biopsies the diagnostic yield was 79.1% (95% CI: 69.0-87.1%) for US guided lung biopsy and 76.9% (95%CI: 46.2-95.0%) for US guided pleural biopsy. Complications were rare; three patients (2.4%)(95%CI: 0-5.1%) developed a pneumothorax, two (1.6%)(95%CI: 0-3.8%) developed haemoptysis and in two patients (1.6%)(95%CI: 0-3.8%) incidental tissue sampling of an abdominal organ had been performed. No mortalities (95%CI: 0-2.4%) related to an US guided biopsy were observed. Conclusion: The yield of US guided transthoracic biopsies performed by respiratory physicians to establish a malignant diagnosis is considered acceptable and the risk of procedure related complications seems to be low.