• The Journal of the Korea Contents Association
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• v.22 no.7
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• pp.676-683
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• 2022

Minimizing patient movement during CT-guided lung biopsy is an important factor in the procedure. To minimize movement, a vacuum cushion was used to evaluate its effectiveness. The subjects of this study were 116 patients aged 40 years or older who had good coordination with postural fixation and breathing control. Posture measurements were performed in the supine position, prone position, oblique position, and lateral position according to each position of the lung lesion biopsy lesion. Measurement positions were measured in the anterior, posterior, right, and left positions based on the anatomical posture. In the prone position, the mean difference between the non-use and the use of the posterior was 1.7905, and t=2.913 (p<0.01), and the mean difference between the non-use/use was statistically significant. The difference between the unused and used averages of left was 2.4105, and the difference between the left averages was also significant with t=3.684 (p<0.01). The difference between the unused and used averages of the right was 2.3263, with t=3.791 (p<0.01). The mean difference between unused and used is statistically significant. As a result of statistical analysis, the biopsy of the lung lesion using a fixation device showed less movement in all postures. It is considered that it is meaningful in that it is possible to conduct a more accurate biopsy procedure and minimize the patient's posture movement by using a fixation device during the CT-guided biopsy of the lung lesion.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.311-317
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• 2023

CT-guided percutaneous transthoracic needle biopsy (PTNB) plays a key role in the diagnosis of pulmonary abnormalities. Although the procedure is considered safe and effective, there exists a potential for complications, such as pneumothorax, hemorrhage, hemoptysis, air embolism, and tumor seeding. However, pneumatoceles after CT-guided PTNB have been rarely reported. Herein, we report two cases of pneumatoceles that developed immediately after PTNB for primary lung cancer. A pneumatocele filled with hematoma should be considered in cases with a newly developed nodule along the needle tract during short-term follow-up CT after PTNB.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1203-1212
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• 2021

Objective: To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. Materials and Methods: In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. Conclusion: The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.579-580
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• 2024

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.127-134
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• 1993

Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well established as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy has been used increasingly in relation to advance and the safty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safety from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle(Manan medical products, USA). A diagnosis was made in 27 of 44 cases(61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required. The sensitivity of PTNB by one session was 61%(27/44). The sensitivity of malignancy was 79%(19/24) and benignancy was 40%(8/20). These results suggest the usefulness of PTNB using fine needles be increased in earlier diagnosis and improved staging of pulmonary nodular lesions without significant complications.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.526-536
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• 2020

Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.330-338
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• 2018

Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.566-578
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• 2024

Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.50-55
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• 2005

Thoracic actinomycosis is a rare, chronic debilitating disease and it is difficult to diagnose and treat. Material and Method: Between March 1990 to December 2003, 17 patients were diagnosed and treated for actinomycosis in our center. Except 4 patients (involving cervicofacial, and abdominopelvic area), we reviewed the clinical characteristics, diagnosis method, and treatment in 13 patients. Result: In 8 patients, the operation was required for diagnosis and treatment. 7 of 8 patients had tumor-like lesions in radiological findings and they were not distinguished as lung cancer, and 1 of 8 patients was non-responsive to the antibiotics therapy. Among the 5 medically treated patients, 4 of 5 patients were diagnosed by bronchoscopic biopsy and one by CT-guided biopsy. All of them was well-responsive by the antibiotic treatment. Conclusion: Thoracic actinomycosis is a chronic inflammatory disease that respond well to antibiotics (penicillin therapy). It should be diagnosed by the repeated biopsy (CT-guided or bronchoscopic) before starting treatment. However, if the lesion is not distinguished as the lung cancer, non-responsive to the medical treatment, and the patients experience the recurrent hemoptysis, we can consider the operation for the diagnosis and treatment.

• Tuberculosis and Respiratory Diseases
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• v.57 no.5
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• pp.480-483
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• 2004

CT-guided transthoracic needle biopsy is a common procedure for the evaluation of pulmonary and mediastinal lesions. The most frequent complications include pneumothorax, hemorrhage, and hemoptysis. Air embolism, and especially cerebral embolism, is a rare but potentially fatal complication after this procedure. Here, we report on a case of cerebral air embolism that occurred after CT-guided transthoracic needle biopsy for the peripheral lung mass.