Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Thorac Cancer. 2022 Jun;13(11):1577-1582. doi: 10.1111/1759-7714.14413. Epub 2022 Apr 26.
Adequate tissue sampling is fundamental for establishing a definitive diagnosis, assessing prognosis and tailoring therapy. Each of the methods for obtaining tissue (e.g., endoscopic, image guidance and surgical biopsies) results in a different diagnostic yield and complication rate profile.
Present feasibility, and assess safety and efficacy of freehand transthoracic ultrasound-guided core-needle biopsies (USGNB) of thoracic lesions performed by pulmonologist.
A retrospective analysis study of ultrasound-guided core-needle biopsies of thoracic lesions performed at the Pulmonary Institute of Rabin Medical Center was conducted from September 2020 to October 2021. All core-needle biopsies were performed under local anesthesia with guidance of Mindray TE7 2019 US system. Procedural variables including complications and pathological diagnostic yield were the primary end point. IRB 0671-21-RMC.
In total 91 biopsy procedures were analyzed in38 females and 53 males, average age 71.1 years. Twenty-three (25.3%) cases were lung lesions, 7 (7.7%) - mediastinal, 13 (14.3%) - chest wall, 27 (29.7%) - pleural, and 21 (23.1%) supraclavicular lesions. Average lesion size was 51.6 mm, the largest in the mediastinum and the smallest in supraclavicular locations (97.7mm and 28.0 mm, respectively). Overall pathological diagnostic yield was 90%, highest success in chest wall (100%) and lowest in mediastinal biopsies (71.4%). We had only one complication -hemothorax resolved by chest tube drainage- accounting for only 1.1% complication rate.
Safety and efficacy were demonstrated in freehand US-guided core-needle biopsy of thoracic lesions performed by pulmonologists. We suggest thoracic ultrasound and USG-CNB be part of training and clinical practice in interventional pulmonology.
充分的组织采样对于确立明确的诊断、评估预后和制定治疗方案至关重要。获取组织的每种方法（例如内镜、影像引导和手术活检）都会导致不同的诊断率和并发症发生率。
介绍由肺病专家进行徒手经胸超声引导下核心针活检（USGNB）的可行性，并评估其安全性和有效性。
对 2020 年 9 月至 2021 年 10 月在拉宾医学中心肺部研究所进行的经胸超声引导下核心针活检的回顾性分析研究。所有核心针活检均在局部麻醉下进行，使用 Mindray TE7 2019 US 系统进行引导。主要终点是程序变量，包括并发症和病理诊断率。IRB 0671-21-RMC。
共分析了 38 名女性和 53 名男性的 91 例活检程序，平均年龄为 71.1 岁。23 例（25.3%）为肺部病变，7 例（7.7%）为纵隔病变，13 例（14.3%）为胸壁病变，27 例（29.7%）为胸膜病变，21 例（23.1%）为锁骨上病变。平均病变大小为 51.6mm，纵隔最大，锁骨上最小（分别为 97.7mm 和 28.0mm）。总体病理诊断率为 90%，胸壁活检成功率最高（100%），纵隔活检成功率最低（71.4%）。我们只有 1 例并发症——血胸，通过胸腔引流管解决，并发症发生率仅为 1.1%。
由肺病专家进行徒手经胸超声引导下核心针活检的安全性和有效性已得到证实。我们建议将胸部超声和 USG-CNB 纳入介入肺病学的培训和临床实践中。
