Author of

• 10974

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  P1.21 - Poster Session 1 - Diagnosis and Staging (ID 169)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10981

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    P1.21-007 - Usefulness of Computed Tomography Guided Percutaneous Transthoracic Biopsies in Diagnosing Thoracic Malignancies - Experience from a State Hospital in Malaysia (ID 2648)

    09:30 - 16:30  |  Author(s): C.K. Ong
    • Abstract

    Background
    Computed tomography (CT) guided percutaneous transthoracic biopsy is a minimally invasive procedure that has been widely accepted as an effective, safe and feasible alternative for diagnosis of thoracic lesions. It guides therapeutic decisions, avoiding surgical biopsies in many clinical settings. The diagnosis sensitivity rate for malignant lung lesions was high (88-95%). The study was conducted to evaluate the diagnostic accuracy and complications of CT guided percutaneous transthoracic biopsies of suspected malignant pulmonary lesions.

    Methods
    Retrospective study involving all consecutive patients who underwent diagnostic CT guided percutaneous biopsies of suspected thoracic malignancies on dual slice CT equipment between Jan 2010 and December 2012. Percutaneous core needle biopsies were performed using a 16 / 18 / 20G Temno trucut automatic cutting needle under CT guidance. After the biopsy, a CT slice through the area of biopsy was performed to determine the presence of significant bleeding or pneumothorax. The samples were sent for the histological analysis. Evaluation included clinical data, pathologic results and therapeutic consequences. Statistical analysis of factors related to patient characteristics, lung lesions and biopsy technique was performed to determine possible contribution to the occurrence of pneumothorax.

    Results
    A total of 204 patients (143 males; 61 females) with mean age of 59.5 ± 14.0 years were included in the study. Mean diameter of lung lesion was 44.4 ± 14.5 mm. Mean depth of lung lesion was 14.4 ± 6.9 mm. Biopsies samples were adequate in 198 patients (97.1%) and inadequate in 6 patients (2.9%). Percutaneous transthoracic biopsy had an overall diagnostic accuracy of 93.6%. For malignant lesions, biopsy was positive in 161 patients (sensitivity of 97.6%) and for benign lesions, in 30 patients (sensitivity of 76.9%). Pneumothorax was observed in 30 patients (14.7%) and only 3 of them (1.5%) required a chest drain. The significant risk factors for pneumothorax were lesion depth >20 mm (p<0.0001), pathology type (malignant; p<0.0001), larger needle size (p<0.0001), number of passes >2 (p=0.001), lesion size <30 mm (p=0.009). There were no haemothoraces or major bleeding complications. However, post-interventional local hemorrhages were observed in 9 patients (4.4%) and hemoptysis was reported in 2 patients.

    Conclusion
    Percutaneous transthoracic CT guided biopsies of lung lesions were an effective procedure in the diagnosis of malignant lung lesions. Our study also shows that CT-guided needle biopsy is relatively safe, with only 1.5% of pneumothorax requiring chest drain and no major bleeding complications observed.