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Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations

(1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) ex...

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Autores principales: Sperandeo, Marco, Maiello, Evaristo, Graziano, Paolo, Simeone, Annalisa, De Cosmo, Salvatore, Dimitri, Lucia, Di Micco, Concetta, Perrone, Elio, Taurchini, Marco, Ferretti, Gianmaria, Mirijello, Antonio, Varriale, Antonio, Grimaldi, Maria Arcangela, Lacedonia, Donato, Quarato, Carla Maria Irene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468729/
https://www.ncbi.nlm.nih.gov/pubmed/34573981
http://dx.doi.org/10.3390/diagnostics11091641
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author Sperandeo, Marco
Maiello, Evaristo
Graziano, Paolo
Simeone, Annalisa
De Cosmo, Salvatore
Dimitri, Lucia
Di Micco, Concetta
Perrone, Elio
Taurchini, Marco
Ferretti, Gianmaria
Mirijello, Antonio
Varriale, Antonio
Grimaldi, Maria Arcangela
Lacedonia, Donato
Quarato, Carla Maria Irene
author_facet Sperandeo, Marco
Maiello, Evaristo
Graziano, Paolo
Simeone, Annalisa
De Cosmo, Salvatore
Dimitri, Lucia
Di Micco, Concetta
Perrone, Elio
Taurchini, Marco
Ferretti, Gianmaria
Mirijello, Antonio
Varriale, Antonio
Grimaldi, Maria Arcangela
Lacedonia, Donato
Quarato, Carla Maria Irene
author_sort Sperandeo, Marco
collection PubMed
description (1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) examination vs. chest CT (gold standard) in the differentiation between malignant and benign peripheral lung lesions. (2) Methods: A total of 961 consecutive patients with subpleural pulmonary lesions were enrolled. All the patients received a CT scan with contrast; 762 patients underwent TUS-PTNB for suspicion of malignancy, and the remaining 199 enrolled patients underwent only TUS examination as a part of routine follow-up for known non-malignant subpleural consolidations. (3) Results: Among the 762 TUS-guided biopsies, there were 627 (82.28%) malignant lesions, 82 (10.76%) benign lesions, and 53 (6.96%) indeterminate lesions. The overall diagnostic accuracy was 93.04%. The rates of pneumothorax not requiring chest-tube insertion and self-limited hemoptysis were 0.79 and 0.26%, respectively. Patients were divided into two groups based on the benign or malignant nature of the subpleural consolidations. On TUS, both malignant and benign lesions showed mostly irregular margins and a hypoechoic pattern, but no differences were assessed in terms of sonographic margins and pattern between the two groups. There was poor agreement between TUS and chest CT in assessing air bronchograms and necrotic areas. The only finding in the detection of which TUS showed superiority compared to chest-CT was pleural effusion. (4) Conclusions: TUS-PNB was confirmed to be an effective and safe diagnostic method for peripheral pulmonary consolidation, but their sonographic pattern did not allow to rule out a malignant nature. A pre-operative evaluation on CT images, combined with the possibility of performing additional immunohistochemical and cytological investigations and the experience of the medical staff, may improve the diagnostic yield of TUS-guided biopsies.
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spelling pubmed-84687292021-09-27 Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations Sperandeo, Marco Maiello, Evaristo Graziano, Paolo Simeone, Annalisa De Cosmo, Salvatore Dimitri, Lucia Di Micco, Concetta Perrone, Elio Taurchini, Marco Ferretti, Gianmaria Mirijello, Antonio Varriale, Antonio Grimaldi, Maria Arcangela Lacedonia, Donato Quarato, Carla Maria Irene Diagnostics (Basel) Article (1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) examination vs. chest CT (gold standard) in the differentiation between malignant and benign peripheral lung lesions. (2) Methods: A total of 961 consecutive patients with subpleural pulmonary lesions were enrolled. All the patients received a CT scan with contrast; 762 patients underwent TUS-PTNB for suspicion of malignancy, and the remaining 199 enrolled patients underwent only TUS examination as a part of routine follow-up for known non-malignant subpleural consolidations. (3) Results: Among the 762 TUS-guided biopsies, there were 627 (82.28%) malignant lesions, 82 (10.76%) benign lesions, and 53 (6.96%) indeterminate lesions. The overall diagnostic accuracy was 93.04%. The rates of pneumothorax not requiring chest-tube insertion and self-limited hemoptysis were 0.79 and 0.26%, respectively. Patients were divided into two groups based on the benign or malignant nature of the subpleural consolidations. On TUS, both malignant and benign lesions showed mostly irregular margins and a hypoechoic pattern, but no differences were assessed in terms of sonographic margins and pattern between the two groups. There was poor agreement between TUS and chest CT in assessing air bronchograms and necrotic areas. The only finding in the detection of which TUS showed superiority compared to chest-CT was pleural effusion. (4) Conclusions: TUS-PNB was confirmed to be an effective and safe diagnostic method for peripheral pulmonary consolidation, but their sonographic pattern did not allow to rule out a malignant nature. A pre-operative evaluation on CT images, combined with the possibility of performing additional immunohistochemical and cytological investigations and the experience of the medical staff, may improve the diagnostic yield of TUS-guided biopsies. MDPI 2021-09-07 /pmc/articles/PMC8468729/ /pubmed/34573981 http://dx.doi.org/10.3390/diagnostics11091641 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sperandeo, Marco
Maiello, Evaristo
Graziano, Paolo
Simeone, Annalisa
De Cosmo, Salvatore
Dimitri, Lucia
Di Micco, Concetta
Perrone, Elio
Taurchini, Marco
Ferretti, Gianmaria
Mirijello, Antonio
Varriale, Antonio
Grimaldi, Maria Arcangela
Lacedonia, Donato
Quarato, Carla Maria Irene
Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title_full Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title_fullStr Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title_full_unstemmed Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title_short Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations
title_sort effectiveness and safety of transthoracic ultrasound in guiding percutaneous needle biopsy in the lung and comparison vs. ct scan in assessing morphology of subpleural consolidations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468729/
https://www.ncbi.nlm.nih.gov/pubmed/34573981
http://dx.doi.org/10.3390/diagnostics11091641
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