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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
P1.03-012 - Experience with BioSentryTM Tract Sealant System for Percutaneous CT-Guided Lung Nodule Biopsies in an Oncology Population (ID 5727)
14:30 - 15:45 | Author(s): G. Shroff
Tract sealants are being used more frequently to reduce pneumothoraces and chest tube placement in patients undergoing lung biopsy. Use of a sealant plug can produce visible biopsy tracts on follow-up imaging and can mimic the appearance of malignant tract seeding. The purpose of our study was to characterize these tracts and determine the likelihood of malignant seeding to inform further management including localized radiation therapy and/or surgical planning.
Over a 15 month period 407 lung biopsies were performed in patients with known or suspected thoracic and extrathoracic malignancies using a BioSentry Tract Sealant System; 321 cases had follow up CT studies. 4 chest radiologists retrospectively analyzed subsequent imaging to determine the incidence, appearance, temporal relationship and evolution of biopsy tracts. Tracts that decreased or did not change on follow-up were considered benign. 10 surgically resected cases were retrospectively examined by a pathologist for malignant tract seeding.
321 cases were analyzed. 237 (74%) had a visible biopsy tract on CT (95%CI 0.69, 0.78) (primary lung cancer n=90, metastases n=81, benign nodule n=66). All tracts were identified on 1st follow-up imaging at 1-3 months post-biopsy. Tracts were typically serpiginous and smooth or lobulated with a thickness of 2-5 mm. 218/237 (92%) tracts were unchanged over time (mean follow up, 12 months). 15/237 (6.3%) decreased in thickness. Unchanged or decreasing tracts were considered negative for malignant seeding. Increase in tract thickness or nodularity occurred in 4/237 (1.8%), suspicious for malignant tract seeding. 0/90 (0%) biopsy tracts in primary lung cancer showed progressive increase. 4/81 (4.9%) tracts in patients with metastases showed increase (mean, 99 days post-biopsy). 10 resected nodules (5 primary NSCLCs, 5 metastases) had no malignant tract seeding at histology.
An observable biopsy tract on CT is common after lung biopsy using the BioSentry[TM] device. Tracts from biopsy of primary lung cancers using the BioSentry device had no malignant seeding and they should have no impact on surgical resection or localized radiation therapy. In the study population, patients who underwent lung biopsy for metastasis had a higher than expected rate of malignant seeding manifested by increased track thickness over time, requiring further investigation.
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