CT-GUIDED TRANSTHORACIC NEEDLE BIOPSY OF FOCAL THORACIC LESIONS
Abstract
Background. The retrieval of cytological material from small pulmonary lesions and most hilar and mediastinal masses has been made possible by the introduction of computed tomography as guidance for transthoracic needle biopsy.
Material and methods. In a prospective trial we analyzed 12 patients with pulmonary or mediastinal masses inaccessible with the help of fiberoptic bronchoscopy and/or TNB guided fluoroscopically. With the help of CT device we determined the optimal puncture point and the minimal or/and optimal distance to reach the desired lesion. The retrieved material was stained by May-Grünwald-Giemsa stain.
Results. Among 12 patients were 10 men (83%). We confirmed 4 lung cancers (33%), 2 mediastinal tumors (16%), 4 benign lesions of lungs (33%), 1 benign lesion of mediastinum (8%) and 1 undetermined lung lesion (8%). The sensitivity of CT-guided TNB of lungs and mediastinum was estimated 84.6%. The procedures were complicated with 4 pneumothoraces (31%). The radiation dose on the body surface of CT guided procedure was 8 times higher that fluoroscopic guided one.
Conclusions. CT guided TNB is as a replacement procedure to evaluate intrathoracic masses, especially small ones and those in the »shadow« of big mediastinal vessels and heart. Because of higher rate of complications and high radiation dose on the body surface, it should be used only as an upgrade and not change for fluoroscopic TNB.
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