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Bilgisayarlı tomografi kılavuzluğunda yapılan kesici iğne akciğer biyopsilerindeki komplikasyonlar ve risk faktörleri. Complications and risk factors in computed tomography-guided cutting needle lung biopsies

Year 2018, Volume: 11 Issue: 3, 195 - 201, 28.09.2018
https://doi.org/10.31362/patd.399675

Abstract

GİRİŞ ve AMAÇ: Bu çalışmadaki amacımız bilgisayarlı tomografi (BT)
kılavuzluğunda yapılan transtorasik kesici iğne akciğer biyopsisinde (KİB)
komplikasyon oranları ve buna bağlı risk faktörlerinin incelenmesidir.

YÖNTEM ve GEREÇLER: BT kılavuzluğunda transtorasik kesici iğne biyopsisi (KİB)
yapılan akciğer nodüllü hastalar geriye dönük olarak değerlendirildi. Bu
hastalardan işlem sırasında ve işlem sonrasında BT görüntüsü olmayanlar ve
kontrol akciğer grafisi olmayanlar çalışmadan çıkartıldı. Toplam 321 hasta
(28-86 yaş aralığı, ortalama yaş 61, %84.1 erkek) çalışmaya dahil edilmiştir.
Komplikasyon oranı ile histopatolojik tanı, lezyon büyüklüğü, lezyonun
akciğerdeki yeri ve lezyonun derinliği arasındaki ilişki araştırıldı.

BULGULAR: En sık görülen histopatolojik tanılar adenokarsinom (% 33.3) ve
skuamöz hücreli karsinom (% 32.3) idi. Lezyonun histopatolojik tanısı ile
biyopsiye bağlı komplikasyon gelişimi arasında ilişki saptanmadı. Pnömotoraks
(%19.7) ve pulmoner hemoraji (%9) en sık karşılaşılan komplikasyonlardı. Lezyon
derinliği arttıkça veya lezyon boyutu azaldığında komplikasyon riski
artmaktadır (p<0.05).

TARTIŞMA ve SONUÇ: Çalışmamızda akciğer lezyonunun patolojik sonucu ile KİB'e
bağlı komplikasyon gelişmesi arasında ilişki olmadığını saptadık. Geçilen
akciğer parankim mesafesi arttıkça ve lezyon boyutu küçüldükçe komplikasyon
riskinin arttığını saptadık.



Anahtar Kelimeler: Akciğer lezyonu, Perkütan
biyopsi, Komplikasyon, Kesici iğne biyopsisi, Bilgisayarlı tomografi
Türkçe Kısa Başlık: Akciğer biyopsilerindeki komplikasyonlar ve risk
faktörleri

INTRODUCTION: Our aim was to evaluate complication rate in computed
tomography (CT)-guided transthoracic cutting needle lung biopsy and associated
risk factors.

METHODS: We were retrospectively evaluated patients with lung nodules who
underwent CT-guided transthoracic cutting needle biopsy. Patients without CT
images during and after the procedure and patients without control chest X-ray
were excluded from the study. A total of 321 patients (aged 28-86 years, mean
age 61, 84.1% male) were included in the study. The complication rate and
histopathologic diagnosis, lesion size, location of the lesion in the lung and
depth of the lesion were investigated.


RESULTS: The most common diagnoses were adenocarcinoma (%33.3) and squamous
cell carcinoma (%32.3). There was no correlation between the histopathological
diagnosis of the lesion and the development of complications due to cutting
needle biopsy. Pneumothorax (%19.7) and pulmonary haemorrhage (%9) were the
most common complications. The risk of complications increases as the lesion
depth increases or lesion size decreases (p<0.05).

DISCUSSION AND CONCLUSION: We found that there was no correlation between the
pathologic diagnosis and complication related to cutting needle lung biopsy.
The risk of complications increased with increasing crossed lung parenchyma
distance and decreased lesion size.

Keywords: Lung lesion,
Percutaneous biopsy, Complication, Core-needle biopsy, Computed tomography
İngilizce Kısa Başlık: Complications and risk factors in lung




References

  • 1- Cardella JF, Bakal CW, Bertino RE et al. Quality improvement guidelines for image-guided percutaneous biopsy in adults: Society of Cardiovascular & Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 1996;7:943-946.
  • 2- Moyer VA. Screening for lung cancer: U.S. Preventive services task force recommendation statement. Ann Intern Med 2014;160:330-338.
  • 3- Kauczor H-U, Bonomo L, Gaga M et al. ESR/ERS white paper on lung cancer screening. Eur Respir J 2015;46:28-39.
  • 4- Manhire A, Charig M, Clelland C et al. Guidelines for radiologically guided lung biopsy. Thorax 2003;58:920-936.
  • 5- Beslic S, Zukic F, Milisic S. Percutaneous transthoracic CT guided biopsies of lung lesions; fine needle aspiration biopsy versus core biopsy. Radiol Oncol 2012;46:19-22.
  • 6- Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol 2017;27:138-148. 7- Tuna T, Ozkaya S, Dirican A, Findik S, Atici AG, Erkan L. Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease. Oncol Targets Ther 2013;6:1553-1557.
  • 8- Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 2003;14:199-202.
  • 9- Wiener RS, Schwartz LM, Woloshin S, Welch HG. Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann Intern Med 2011;155:137-144.
  • 10- Tomiyama N, Yasuhara Y, Nakajima Y et al. CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol 2006;59:60-64.
  • 11- Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 2010;21:969-975.
  • 12- Mendiratta-Lala M, Sheiman R, Brook OR, Gourtsoyianni S, Mahadevan A, Siewert B. CT-guided core biopsy and percutaneous fiducial seed placement in the lung: can these procedures be combined without an increase in complication rate or decrease in technical success? Eur J Radiol 2014;83:720-725.
  • 13- Montaudon M, Latrabe V, Pariente A, Corneloup O, Begueret H, Laurent F. Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions. Eur Radiol 2004;14:1234-1240.
  • 14- Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 2004;126:748-754.
  • 15- Ishii H, Hiraki T, Gobara H et al. Risk factors for systemic air embolism as a complication of percutaneous CT-guided lung biopsy: multicenter case-control study. Cardiovasc Intervent Radiol 2014;37:1312-1320.
  • 16- Lang EK, Ghavami R, Schreiner VC, Archibald S, Ramirez J. Autologous blood clot seal to prevent pneumothorax at CT-guided lung biopsy. Radiology 2000;216:93-96.
  • 17- Tai R, Dunne RM, Trotman-Dickenson B et al. Frequency and Severity of Pulmonary Hemorrhage in Patients Undergoing Percutaneous CT-guided Transthoracic Lung Biopsy: Single-Institution Experience of 1175 Cases. Radiology 2016;279:287-296.
  • 18- Cham MD, Henschke CI, Yankelevitz DF. Handbook of interventional radiologic procedures. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2011;478-485.
  • 19- Patel MV, Ahmed O, Jilani D, Zangan S. Computed tomography-guided percutaneous lung biopsy: impact of lesion proximity to diaphragm on biopsy yield and pneumothorax rate. J Thorac Imaging 2014;29:344-349.
Year 2018, Volume: 11 Issue: 3, 195 - 201, 28.09.2018
https://doi.org/10.31362/patd.399675

Abstract

References

  • 1- Cardella JF, Bakal CW, Bertino RE et al. Quality improvement guidelines for image-guided percutaneous biopsy in adults: Society of Cardiovascular & Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 1996;7:943-946.
  • 2- Moyer VA. Screening for lung cancer: U.S. Preventive services task force recommendation statement. Ann Intern Med 2014;160:330-338.
  • 3- Kauczor H-U, Bonomo L, Gaga M et al. ESR/ERS white paper on lung cancer screening. Eur Respir J 2015;46:28-39.
  • 4- Manhire A, Charig M, Clelland C et al. Guidelines for radiologically guided lung biopsy. Thorax 2003;58:920-936.
  • 5- Beslic S, Zukic F, Milisic S. Percutaneous transthoracic CT guided biopsies of lung lesions; fine needle aspiration biopsy versus core biopsy. Radiol Oncol 2012;46:19-22.
  • 6- Heerink WJ, de Bock GH, de Jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol 2017;27:138-148. 7- Tuna T, Ozkaya S, Dirican A, Findik S, Atici AG, Erkan L. Diagnostic efficacy of computed tomography-guided transthoracic needle aspiration and biopsy in patients with pulmonary disease. Oncol Targets Ther 2013;6:1553-1557.
  • 8- Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 2003;14:199-202.
  • 9- Wiener RS, Schwartz LM, Woloshin S, Welch HG. Population-based risk for complications after transthoracic needle lung biopsy of a pulmonary nodule: an analysis of discharge records. Ann Intern Med 2011;155:137-144.
  • 10- Tomiyama N, Yasuhara Y, Nakajima Y et al. CT-guided needle biopsy of lung lesions: a survey of severe complication based on 9783 biopsies in Japan. Eur J Radiol 2006;59:60-64.
  • 11- Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol 2010;21:969-975.
  • 12- Mendiratta-Lala M, Sheiman R, Brook OR, Gourtsoyianni S, Mahadevan A, Siewert B. CT-guided core biopsy and percutaneous fiducial seed placement in the lung: can these procedures be combined without an increase in complication rate or decrease in technical success? Eur J Radiol 2014;83:720-725.
  • 13- Montaudon M, Latrabe V, Pariente A, Corneloup O, Begueret H, Laurent F. Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions. Eur Radiol 2004;14:1234-1240.
  • 14- Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: multivariate analysis of 660 CT-guided coaxial cutting needle lung biopsies. Chest 2004;126:748-754.
  • 15- Ishii H, Hiraki T, Gobara H et al. Risk factors for systemic air embolism as a complication of percutaneous CT-guided lung biopsy: multicenter case-control study. Cardiovasc Intervent Radiol 2014;37:1312-1320.
  • 16- Lang EK, Ghavami R, Schreiner VC, Archibald S, Ramirez J. Autologous blood clot seal to prevent pneumothorax at CT-guided lung biopsy. Radiology 2000;216:93-96.
  • 17- Tai R, Dunne RM, Trotman-Dickenson B et al. Frequency and Severity of Pulmonary Hemorrhage in Patients Undergoing Percutaneous CT-guided Transthoracic Lung Biopsy: Single-Institution Experience of 1175 Cases. Radiology 2016;279:287-296.
  • 18- Cham MD, Henschke CI, Yankelevitz DF. Handbook of interventional radiologic procedures. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2011;478-485.
  • 19- Patel MV, Ahmed O, Jilani D, Zangan S. Computed tomography-guided percutaneous lung biopsy: impact of lesion proximity to diaphragm on biopsy yield and pneumothorax rate. J Thorac Imaging 2014;29:344-349.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Furkan Ufuk

Publication Date September 28, 2018
Submission Date November 9, 2017
Acceptance Date August 29, 2018
Published in Issue Year 2018 Volume: 11 Issue: 3

Cite

AMA Ufuk F. Bilgisayarlı tomografi kılavuzluğunda yapılan kesici iğne akciğer biyopsilerindeki komplikasyonlar ve risk faktörleri. Complications and risk factors in computed tomography-guided cutting needle lung biopsies. Pam Med J. September 2018;11(3):195-201. doi:10.31362/patd.399675

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