P02.05 Yield of Tumor Samples With A Guide-sheath in Endobronchial Ultrasound Transbronchial Biopsy For Non-small Cell Lung Cancer
Naoko KatsuradaMotoko TachiharaNaoe JimboMasatsugu YamamotoJunya YoshiokaChihiro MimuraNaoki TakataHiroki SatoKatsutoshi FurukawaTakehiro OtoshiMasako YumuraTatsunori KiriuYuichiro YasudaTomoko TanakaTatsuya NaganoYoshihiro NishimuraKazuyuki Kobayashi
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Target lesion
Background: Lung cancer is the major cause of cancer related deaths all over the world. CT guided FNAC and/or Biopsy of lung mass is an effective modality to diagnose lung cancer, especially in peripherally situated lesions. This study was planned to compare the role of CT guided lung FNAC and Biopsy in diagnosis of Lung cancer.Methods: This is a cross sectional study, done in department of respiratory medicine of a tertiary care teaching hospital of Rajasthan over a period one year. All the patients with suspected mass lesion on chest X-ray and clinical symptoms suggestive of lung cancer were included in the study. CT guided FNAC and biopsy were done in each patient after explaining the risks.Results: CT guided procedures were done in 81 patients of suspected lung cancer. CT guided FNAC yielded positive results in 75 patients while it was negative in 6 patients. CT guided lung biopsy was positive in all patients. Squamous cell carcinoma was most common type encountered malignancy. Conclusions: CT guided lung FNAC and Biopsy is a simple and safe method with high diagnostic accuracy for diagnosis of Lung cancer.
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Objective To evaluate the influence of lesion size and depth on the diagnostic accuracy and the rate of pneumothorax in patients undergone CT-guided transthoracic aspiration biopsy for pulmonary lesions.Methods CT-guided percutaneous transthoracic biopsy was performed in 398 patients that had surgical resection or clinical follow-up.According to lesion size,lesions were divided into≤2 cm,2～4 cm and ≥4 cm.Lesion depth was measured from the pleura surface to the edge of the lesion.This depth was classified in three categories:≤1 cm,1～3 cm and ≥3 cm.Comparison of the diagnostic accuracy and the frequency of pneumothorax in different size and depth of lesion was performed.Results(1)The overall diagnostic accuracy of CT-guided percutaneous needle aspiration biopsy was 83.2%(331/398).Pneumothorax occurred in 58(14.6%)of 398 biopsy;(2)The diagnostic accurate rate in different size of lesion was 73.3%(44/60),81.5%(176/216)and 91.0%(111/122)respectively,χ2=9.91,P0.01.The occurred rate of pneumothorax in different size of lesion was 20%(12/60),16.7%(36/216)and 8.2%(10/122)respectively,χ2=6.16,P0.05;(3)The diagnostic accurate rate in different depth lesion was 83.0%(117/141),85.9%(122/142)and 80.0%(92/115)respectively,χ2=1.59,P0.05.The occurred rate of pneumothorax in different depth lesion was 2.8%(4/141),14.8%(21/142)and 28.7%(33/115),χ2=34.03,P0.01.Conclusion CT-guided biopsy has less accuracy and high occurred rate of pneumothorax in smaller pulmonary lesion than that in larger lesions.The diagnostic accuracy is similar for different depth lesions.The occurred rate of pneumothorax is increased with increasing depth of the lesion.
Percutaneous biopsy
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Cardiac Imaging
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Neuroradiology
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PURPOSE:
To analyze predictive CT-parameters for lesion detection with Endobronchial Ultrasonography(EBUS) and for diagnostic accuracy of EBUS-guided biopsy of suspected lung lesions.
MATERIALS AND METHODS:
From January 2011 to December 2013, retrospectively, CT images of 437 patients (287 males and 150 females; mean age, 67 years; range age, 5-97) with suspect lung lesion, who underwent EBUS-guided biopsy, were reviewed. Images were evaluated on presence of air-bronchogram, lesion size, distance between lesion and secondary carina, tertiary carina and pleura. The predictive values of these parameters on the detection and on diagnostic accuracy were evaluated using logistic regression analysis.
RESULTS:
The predictive values of the different CT-parameterson detection of a lung lesion with EBUS and on diagnostic accuracy of EBUS-guided biopsy are mentioned in table 1.
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Table 1
CONCLUSION:
Predictive CT-parameters with a significant influence on lung lesion detection with EBUS are: longest axial and coronal lesion diameter and distance between lesion and secondary or tertiary carina. The longest axial diameter is a predictive parameter for the accuracy of EBUS-guided biopsy.
Target lesion
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This study was performed to identify characteristics of suspicious lesions seen on breast MRI that are most likely to have an ultrasound correlate and to determine how often the presumed ultrasound correlate actually corresponds to the MRI finding.From September 2005 through December 2007, targeted ultrasound was performed for 519 suspicious MRI-detected lesions in 361 women. Retrospective review was performed to determine lesion type (mass vs nonmass), lesion descriptors, lesion size, BI-RADS category, indication for MR examination, patient age, and biopsy outcome. The results of 80 follow-up MRI examinations among 154 cases with concordant benign results on ultrasound-guided biopsy were noted.A presumed ultrasound correlate was found in 290 (56%) of the 519 lesions with masses more likely than nonmass lesions to be seen with ultrasound (62% of masses and 31% of nonmass lesions). Increasing lesion size, assessment of BI-RADS category 5 versus BI-RADS category 4, rim enhancement in masses, and clumped enhancement in nonmass lesions were also significantly more likely to have an ultrasound correlate. On follow-up imaging in 80 benign, concordant ultrasound-guided biopsies, the sonographic lesion did not correspond to the MRI finding in 10. Nine of these 10 lesions underwent subsequent MRI-guided biopsy and five cancers were diagnosed.The MR characteristics of lesions most likely to be seen with an ultrasound correlate were mass versus nonmass, increasing size, and increased level of suspicion of the lesion. Clip placement and follow-up imaging after ultrasound-guided biopsy that yields benign concordant results should be performed to detect cases in which the presumed ultrasound correlate is inaccurate to detect unsuspected false-negative biopsies.
Breast ultrasound
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Objective: To evaluate the appearance and the values of application of lung spiral CT in patients with intrapulmonary metastases from lung cancer.Methods: Analyzed retrospectively the imaging data for forty-five patients with diagnosis of intrapulmonary metastases from lung cancer. Results: Among 45 patients,hematogenous metastases were found in 23 case,lymphatic metastases in 8 case,bronchial spread in 5 cases;mixed metastases in 9 cases. Conclusion: The lung spiral CT scan have different appearance in intrapulmonary metastases and could accurate identify their metastatic paths,and could provide the scientific evidence when diagnosis and clinical intrapulmonary metastases from lung cancer.
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Eight foci of tumourlets of the lung and one allied lesion obtained from autopsy cases were histologically examined. The tumourlet of the lung consisted of epithelial cells and was considered to be a benign lesion. Small sized-lesion, uniformity of proliferating cells with very few mitosis and existence of associated lung lesions were documented as characteristic findings. However, the histopathogenesis of the tumourlet was not fully clarified. It was found that proliferating cells of tumourlets often show argyro-philia and contain numerous neurosecretory-like granules in their cytoplasm. These characteristics are very similar to Kultschitzky-like cells of the lung.
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To determine what factors are associated with unsuccessful needle-localized breast biopsy (NLBB).Findings in 280 consecutive nonpalpable breast lesions in 262 women (age range, 27-87 years; mean age, 55 years) who underwent nonstereotactic, mammographically guided, standardized NLBB were retrospectively analyzed according to mammographic lesion type, lesion size, number of lesions per breast, needle type, proximity of needle to lesion, radiologist, specimen size, surgeon, and histologic findings.Biopsy failed in seven (2.5%) of 280 lesions. Failures were related to lesion type, lesion size, number of lesions per breast, accuracy of needle placement, and volume of tissue removed. Removal of more than one tissue specimen converted failure to success in 14 (67%) of 21 initially missed lesions, all microcalcifications.Unsuccessful NLBB was more likely with two lesions per breast, small lesions, small specimens, and microcalcifications. Piercing such lesions with the localizing needle led to successful biopsy. Removal of more tissue was helpful with missed microcalcifications.
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