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MINI 36 - Imaging and Diagnostic Workup (ID 163)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Screening and Early Detection
- Presentations: 1
MINI36.09 - CT-Guided Cutting Needle Lung Biopsy Using 'Liquid Withdraw' Technique: Prominently Reduced Incidence of Pneumothorax (ID 1411)
18:30 - 20:00 | Author(s): R. Li
CT-guided cutting needle lung biopsy is important for the diagnosis of lung cancer. The co-axial method is now widely used. However, co-axial method failed to decrease the incidence of pneumothorax. This study is to investigate whether our new-developed “Liquid withdraw” technique (to inject small amount of lidocaine during withdraw of the needle) can reduce incidence of pneumothorax when combined with co-axial technique. Figure 1 Fig.1.What is liquid withdraw
From Jan 2013 to Dec 2014, We retrospectively studied 38 CT-guided percutaneous lung biopsy using co-axial and liquid withdraw techniques. The pathologies and complications secondary to biopsy procedure (pneumothorax, bleeding and hemoptysis) were noted. Pneumothorax was graded as mild, moderate, and severe.
37 cases was diagnosed out of 38 biopsies, of which 23 cases were adenocarcinoma (21 patients consented EGFR mutation test, and 15 cases had EGFR mutaions)，2 squamous cell carcinoma, 1 non-small cell lung cancer (cannot be further classified after IHC), 1 small-cell lung cancer, 2 primary lung cancer of other types, 5 metastatic lung cancer and 3 benign diseases. 4 cases (10.5%) happened pneumothorax (all were mild pneumothorax)，bleeding during biopsy happened in 1 (2.6%) case, 6 cases with a small amount of hemoptysis（15.8%）. No infection, tumor implantation or aeroembolism happened. Figure 1 Fig.2. A case of CT-guided cutting needle lung biopsy using “Liquid Withdarw” technique A: The co-axial inducer needle is located at the margin of the lesion B&C:after biopsy, the lidocaine can be seen in the needle passage and no pnemothorax is found.
CT-guided percutaneous lung biopsy using co-axial and liquid withdraw is an accurate, safe，reliable technique. Compared to co-axial technique without liquid withdraw, the incidence of pneumothorax was reduced from approximately 35% to 10.5%. More studies according to liquid withdraw technique will be conducted in our future work.
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