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such as children and pregnant women&#44; and for patients that are difficult to move&#44; such as those admitted to intensive care units&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Estimates suggest that 40&#37; of pulmonary malignancies appear as masses in peripheral lung tissue&#44; and are potentially accessible to US&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> Despite these advantages&#44; US is rarely used in Spain in the study of malignant chest lesions&#44; and in most hospitals the technique of choice is computed tomography &#40;CT&#41;-guided needle biopsy&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In our unit&#44; we have routinely used US since 2010 to detect pleural effusion and to guide thoracocentesis&#46; In 2011&#44; we started to use real-time US imaging to guide needle biopsy in pleural&#44; pulmonary and mediastinal lesions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Most studies involving this technique have been authored by interventional radiologists&#44; and there is scant reference in the literature to the experience of pulmonologists in this context&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;8&#8211;10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">A review of the literature showed no published series from Spanish hospitals&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study was to evaluate the cost-effectiveness and safety of US-guided puncture and&#47;or biopsy in the diagnosis of peripheral chest lesions in an interventional pulmonology unit &#40;IPU&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient Selection and Data Collection</span><p id="par0035" class="elsevierStylePara elsevierViewall">This is a retrospective study of all patients undergoing US-guided needle biopsy with real-time imaging to diagnose peripheral thoracic lesions&#46; The study was conducted from March 1&#44; 2011 to September 1&#44; 2014&#46; Information on the procedure was obtained from records stored in the ENDOBASE<span class="elsevierStyleSup">&#174;</span> database &#40;Olympus&#44; Tokyo&#44; Japan&#41;&#44; and demographic&#44; clinical&#44; histopathological details&#44; together with complications and patient outcomes&#44; were obtained from electronic clinical records&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All patients&#44; except 1&#44; had undergone chest CT scan prior to the procedure&#46; These images were used as a reference to determine the location and size of the thoracic lesion&#46; In the patient with no previous CT scan&#44; the size of the lesion was calculated using US imaging&#46; Lesions were classified according to their maximum diameter as nodules &#40;&#8804;3<span class="elsevierStyleHsp" style=""></span>cm&#41; or masses &#40;&#62;3<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All patients were followed up clinically and radiologically for between 6 and 48 months&#46; Serious complications associated with the procedure were defined as&#58; pneumothorax&#44; clinically relevant bleeding&#44; need for transfusion&#44; need for chest drainage&#44; or emergency hospitalization&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">The Procedure</span><p id="par0050" class="elsevierStylePara elsevierViewall">As a prerequisite for the procedure&#44; platelet count had to be higher than 100<span class="elsevierStyleHsp" style=""></span>000&#47;&#956;l and activated partial thromboplastin time had to be within reference limits&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The US examination and core biopsy or fine needle aspiration &#40;FNA&#41; were performed simultaneously by staff from the interventional unit of the pulmonology department using a General Electric LOGIQ P6 ultrasound system &#40;Solingen&#44; Germany&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Intrathoracic lesions were initially evaluated using a 4<span class="elsevierStyleHsp" style=""></span>MHz convex transducer&#46; If the mass or nodule invaded the chest wall&#44; a linear 7<span class="elsevierStyleHsp" style=""></span>MHz transducer was also used &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Patients were placed supine&#44; prone or lateral decubitus&#44; according to the position which gave greater US access with the best safety profile&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">In 50 cases&#44; puncture was performed using a 22G Chiba<span class="elsevierStyleSup">&#174;</span> biopsy needle &#40;Gallini&#44; Italy&#41;&#44; and 16 and 18 gauge Acecut<span class="elsevierStyleSup">&#174;</span> &#40;TSK&#44; Japan&#41;&#44; Trucut<span class="elsevierStyleSup">&#174;</span> &#40;Biopsybell&#44; Italy&#41; or Surecut<span class="elsevierStyleSup">&#174;</span> &#40;TSK&#44; Japan&#41; needles were used in 14&#44; 8&#44; and 5 needle biopsies&#44; respectively&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Both techniques &#40;core biopsy and FNA&#41; were guided by real-time US imaging&#46; A needle guide was attached to the transducer &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; to ensure precision&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The pathologist was not present during sample collection&#46; All core and needle biopsies were performed under local anesthesia &#40;mepivacaine 2&#37;&#41; of the skin and underlying tissue&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Classification of Results</span><p id="par0080" class="elsevierStylePara elsevierViewall">The results of the cytology and&#47;or biopsy were divided into 3 diagnostic categories&#58; &#40;1&#41; malignant&#59; &#40;2&#41; benign&#59; and &#40;3&#41; non-diagnostic &#40;ND&#41;&#46; The first 2 categories &#40;malignant and benign&#41; were considered conclusive results&#46; The ND category included cases where the diagnosis was inconclusive&#58; non-specific benign without evidence of malignancy &#40;NS&#41; &#40;non-specific cellularity&#47;inflammatory cells or necrosis&#41;&#44; and cases where the size of the sample was insufficient for diagnosis &#40;IS&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Results were classified as malignant when a diagnosis of malignant neoplasm was obtained&#44; and as benign when a specific diagnosis of benign lesion was obtained and the clinical picture was consistent with the pathological diagnosis&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Patients in whom the specimen obtained was non-diagnostic &#40;ND&#41; underwent alternative diagnostic procedures&#58; new cytohistologic biopsy or clinical and radiological follow-up&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">New specimens were collected by various means&#58; by interventional radiologists &#40;CT-guided or US-guided FNA&#41;&#59; by pulmonologists using thoracocentesis or bronchoscopy with transbronchial biopsy&#59; or by resection performed by thoracic surgeons&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical Analysis</span><p id="par0100" class="elsevierStylePara elsevierViewall">If the analysis of the specimen showed the presence of neoplastic cells&#44; the result was considered a true positive &#40;TP&#41;&#44; and no further confirmatory tests were performed&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">If histology of the specimen &#40;cytology and&#47;or biopsy&#41; was benign&#44; the result was considered a true negative &#40;TN&#41; for malignancy following histology confirmation and&#47;or evidence on CT or positron emission tomography &#40;PET&#41; scan after follow-up of between 6 and 48 months that the tumor had shrunk&#44; was stable&#44; or had disappeared despite receiving no specific antitumor treatment&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Benign histology was considered a false negative when a new specimen was ultimately positive for malignancy&#44; or clinical and radiological follow-up indicated a malignant tumor &#40;on CT or PET scan the tumor was shown to have grown or metastases were identified&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">ND cases were not included in the analysis&#44; as insufficient samples were available for an accurate malignant or benign diagnosis&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Quantitative variables are shown as mean &#40;&#177;standard deviation&#41;&#44; and qualitative or dichotomous variables are shown as absolute percentages and frequencies&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Diagnostic yield was evaluated using a 2&#215;2 contingency table&#44; in which positive or negative results for malignancy were assigned to the rows and presence or absence of definitive diagnosis was assigned to the columns&#46; This method gave the sensitivity &#40;S&#41;&#44; specificity &#40;SP&#41;&#44; positive predictive value &#40;PPV&#41;&#44; negative predictive value &#40;NPV&#41; and diagnostic yield of the test&#46; S and NPV were determined after first considering all specimens&#44; including ISs&#44; and then selecting only specimens suitable for cytology study &#40;excluding ISs&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Diagnoses &#40;procedures with conclusive and inconclusive results&#41; were compared with different categorical variables using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test&#46; Diagnoses were compared with the following categorical variables&#58; size &#40;nodule and mass&#41; and method of collection &#40;core biopsy and FNA&#41;&#46; Diagnosis of histological subtypes in non-small cell lung cancer &#40;NSCLC&#41; was compared with the sample collection method using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In all cases&#44; significance was set at <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Statistical analysis was performed using the Statistical Package for Social Sciences&#44; version 20&#46;0 &#40;SPSS&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0145" class="elsevierStylePara elsevierViewall">In 15 &#40;26&#37;&#41; cases&#44; the lesion measured &#8804;3<span class="elsevierStyleHsp" style=""></span>cm &#40;nodule&#41;&#59; in 43 &#40;74&#37;&#41; cases&#44; it measured &#62;3<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In 51 &#40;88&#37;&#41; cases&#44; the lesion was located in the lung&#44; in the mediastinum in 3 &#40;5&#37;&#41; cases&#44; in the parietal pleura in 2 &#40;3&#46;5&#37;&#41; cases&#44; and supraclavicular region in 2 &#40;3&#46;5&#37;&#41; cases &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows that a conclusive diagnosis &#40;for benign or malignant disease&#41; was obtained in 47 out of 58 &#40;81&#37;&#41; procedures&#46; The most frequent diagnosis was NSCLC &#40;38&#37;&#41;&#46; Of the 11 &#40;19&#37;&#41; non-diagnostic cases &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#44; definitive diagnosis was obtained with CT-guided FNA performed by interventional radiologists &#40;1 case&#41;&#44; US-guided FNA performed by interventional radiologists &#40;2 cases&#41;&#44; thoracotomy &#40;1 case&#41;&#44; bronchoscopy with transbronchial biopsy &#40;1 case&#41;&#44; bronchoscopy with transbronchial biopsy &#40;1 case&#41;&#44; or on the basis of clinical and radiological follow-up &#40;5 cases&#41;&#46; Five cases initially classified as non-diagnostic for malignancy &#40;benign and non-diagnostic&#41; were later definitively diagnosed as malignant by the end of the study&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the diagnostic yield of US-guided needle biopsy in the best &#40;excluding unsuitable specimens&#41; and worse clinical scenario &#40;including unsuitable specimens and specimens with inflammatory cells&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">Lesion size &#40;nodule&#47;mass&#41; did not affect the process of obtaining a definitive diagnosis &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;91&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">No statistically significant differences were found between the specimen collection method &#40;FNA&#44; core biopsy&#44; or FNA&#43;core biopsy&#41; and diagnostic yield &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;96&#41;&#46; Neither were any statistically significant differences found between diagnostic yield from specimens obtained with biopsy &#40;core biopsy alone or with FNA&#41; and those obtained with FNA alone &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;75&#41;&#46; When determining the histological subtype of the 22 patients diagnosed with NSCLC&#44; excluding 2 patients in whom the type of needle used was unknown&#44; no statistically significant differences were found between specimens obtained using FNA and core biopsy &#40;with or without FNA&#41;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">No serious complications were associated with any of the biopsy procedures&#46; One patient died shortly after the biopsy due to progression of malignant disease&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0180" class="elsevierStylePara elsevierViewall">This study shows that US-guided needle biopsy performed by an interventional pulmonologist can be used to obtain a specific diagnosis &#40;benign or malignant disease&#41; of peripheral thoracic lesions in contact with the pleura in up to 81&#37; of cases&#46; Diagnostic yield of malignancy is high when sufficient fluid or tissue is obtained for diagnosis&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Our findings also show that US-guided biopsy can be used to establish a diagnosis of benign disease&#44; such as infectious processes&#44; particularly tuberculosis and abscesses&#46; In 5 cases in which malignancy was not diagnosed&#44; the initial cytohistology of the US-guided core biopsy or FNA was non-diagnostic &#40;insufficient or indeterminate sample&#41;&#44; and further studies were needed&#46; This is clinically important&#44; as in no patient was the initial specific diagnosis of benign lesion &#40;which ruled out the need for a new&#44; alternative diagnostic procedure&#41; later found to be a false negative&#46; A false negative would have led to a potentially more serious diagnostic error&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Nevertheless&#44; we believe that a diagnosis of benign lesion does not rule out the need for strict clinical and radiological follow-up&#46; This is particularly important in the case of abscesses&#44; as these can also be present in neoplastic lesions&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The safety profile of the study procedure was also excellent&#46; These good results could be due to various factors&#58; &#40;1&#41; the procedure was performed by trained interventional pulmonologists&#59; and &#40;2&#41; ultrasound is a very safe technique&#44; because it allows the technician to puncture lesions that are in contact with the pleura&#44; and to visualize the procedure in real time&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;12&#44;13</span></a> CT-guided biopsy&#44; in contrast&#44; has a higher rate of complications&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">14</span></a> one of the reasons for this being the tendency to pierce or lacerate the healthy lung&#46; &#8220;In US&#44; you see what you are doing&#59; in CT you see what you have done&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Our study has a number of limitations&#44; some of which are related to its retrospective design&#46; Some data&#44; such as the type of needle used&#44; number of punctures made&#44; or the diameter of the lesion as measured by the ultrasound device&#44; were missing from the preliminary procedures&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Diagnoses obtained from US-guided needle aspiration were not later confirmed using the gold standard technique &#40;surgical biopsy&#41; or by other diagnostic procedures &#40;such as CT-guided biopsy&#41; in order to avoid subjecting the patient to invasive procedures that could put them at risk&#46; This is why&#44; despite the intrinsic limitations&#44; final diagnosis was established on the basis of appropriate clinical and radiological follow-up&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Another limitation to our study is the absence during the biopsy procedure of a pathologist capable of making an on-the-spot cytology assessment of the lesion&#46; This would have reduced the number of FNA samples classified as insufficient&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">16&#8211;18</span></a> We recommend that a pathologist be present during the procedure to increase the diagnostic yield&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Many studies have shown ultrasound to be as effective as CT in guiding needle biopsy of peripheral pulmonary lesions&#44; with a diagnostic yield based on confirmatory histology of between 84&#37; and 95&#37;&#44; depending on the study&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">1&#44;4&#44;12&#44;19&#8211;21</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">Most studies in US-guided needle biopsy have been published by interventional radiologists<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;8&#44;9</span></a>&#59; this is one of the first studies describing the results of this technique performed by interventional pulmonologists&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">US imaging has a number of limitations&#44; primarily that the entire pleural area cannot be visualized due to the presence of the ribs&#44; and the technique is only suitable for evaluating lesions in contact with the chest wall&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4&#44;19</span></a> Therefore&#44; only lesions with an good acoustic window can be sampled using this technique&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;12</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Unlike CT&#44; the size of the lesion does not seem to affect US-guided biopsy diagnostic yield&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">20&#8211;24</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">This is because under CT-guided puncture or needle biopsy&#44; the lesion is not punctured in real time&#44; unless a fluoroscopic CT scan is used&#44; and accurate puncture of small lesions is hampered by the ribs and breathing movements&#46; Ultrasound&#44; however&#44; provides dynamic real-time images&#44; thus enabling the technician to more accurately target the lesion while viewing the tip of the needle&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a> US-guided biopsy is a short&#44; easily prepared procedure&#44; and punctures can be repeated as required&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> In our series&#44; as in those reported by other authors&#44; we found that lesion size did not significantly affect diagnostic yield in US-guided biopsy&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Core biopsy specimens are larger than those obtained with needle aspiration&#46; This not only facilitates diagnosis&#44; but also allows pathologists to determine tumor subtypes in the case of malignancy&#44; and to perform molecular analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">19&#44;20</span></a> Despite this&#44; we found no statistically significant differences in either diagnostic yield or tumor subtype determination between FNA and core biopsy&#46; This&#44; however&#44; could be attributed in part to the small size of our sample&#46; In this study&#44; we used different needle sizes&#44; based on the findings of previous authors<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4&#44;25</span></a> who found that needle type did not influence diagnostic yield&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">Much effort has been devoted to the search for ultrasound descriptors that can be used as predictive factors to discriminate between malignant and benign peripheral pulmonary lesions&#46; Evidence suggests that the best US criteria for characterizing these lesions include contour of the lung surface&#44; margins when lung is aerated&#44; destruction of normal pulmonary architecture&#44; vascular displacement&#44; neovascularization&#44; and invasion of adjacent structures&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;13</span></a> Jeon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> showed that the only statistically significant factor affecting diagnostic yield in US-guided transthoracic biopsy was the lesion-pleura contact arc length&#46; Thus&#44; with a contact arc length &#8804;30<span class="elsevierStyleHsp" style=""></span>mm&#44; diagnostic yield fell from 98&#37; to 85&#46;4&#37;&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">The use of ultrasound in respiratory medicine has increased in recent years&#44; in part due to the development of educational programs&#44; such as the Harmonization of Education in Respiratory Medicine for European Specialists &#40;HERMES&#41; initiative&#46; The first syllabus released in connection with this project&#44; in 2006&#44; calls for training in ultrasound imaging techniques to be included in pulmonology training programs&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">26&#44;27</span></a></p><p id="par0255" class="elsevierStylePara elsevierViewall">Despite its advantages&#44; US is rarely used in the study of malignant chest lesions&#44; and in most hospitals the technique of choice is CT-guided needle biopsy&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">Scientific and technological advances in recent years have broadened the scope of application of US&#46; One such example is the development of color Doppler&#44; which&#44; by preventing accidental puncture of large veins&#44; has widened the diagnostic spectrum and improved the safety of ultrasound-guided techniques&#46; Another new strategy involves the use of contrast agent in US&#44; giving a clearer picture of the target tissue in peripheral lung lesions and improving diagnostic outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">Studies in larger series based on variables such as number of punctures per procedure&#44; presence or absence of disease&#44; lesion access&#44; or learning curves&#44; will give further insight into the different factors affecting diagnostic yield associated with US-guided biopsy techniques&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Meanwhile&#44; studies such as ours illustrate the growing importance of ultrasound in anticipation of further developments that will extend its use among interventional pulmonologists&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Based on its good diagnostic yield and excellent safety profile&#44; US-guided needle biopsy performed by a fully trained technician should be the technique of choice for the diagnosis of thoracic lesions in contact with the pleura&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a> provided it is not contraindicated&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of Interests</span><p id="par0280" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The use of ultrasound in peripheral thoracic lesions offers advantages over other radiological guiding methods&#46; This diagnostic procedure has been applied in most studies published by radiologists&#46; Our aim was to determine the diagnostic efficacy of percutaneous ultrasound-guided punctures and biopsies of peripheral thoracic lesions performed by pulmonologists&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methodology</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective analysis of 58 patients who underwent real-time ultrasound-guided transthoracic punctures and biopsy of peripheral thoracic lesions between March 2011 and September 2014 in the pulmonology department of our hospital&#44; was carried out&#46; Cases were classified into the following diagnostic categories&#58; malignant&#44; benign and non-diagnostic &#40;non-specific benign without evidence of malignancy and insufficient specimen&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A conclusive diagnosis was obtained in 47 procedures &#40;81&#37;&#41;&#44; of which 13 &#40;22&#46;4&#37;&#41; were specific benign lesions and 34 &#40;58&#46;6&#37;&#41; cancers&#46; In the remaining 11 &#40;19&#37;&#41; patients&#44; a non-diagnostic result was obtained &#91;non-specific benign in 5 cases &#40;8&#46;6&#37;&#41; and insufficient specimen in 6 &#40;10&#46;3&#37;&#41;&#93;&#46; Sensitivity was 75&#46;6&#37;&#44; negative predictive value was 54&#46;2&#37;&#44; specificity and positive predictive value were 100&#37;&#44; and diagnostic accuracy was 81&#37;&#46; Excluding procedures with insufficient specimens&#44; the results were 87&#46;2&#37;&#44; 72&#46;3&#37;&#44; 100&#37;&#44; 100&#37; and 90&#46;4&#37; respectively&#46; There were no serious complications&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Percutaneous ultrasound-guided puncture and biopsy in the diagnosis of peripheral thoracic lesions performed by pulmonologists is a safe procedure with high diagnostic accuracy&#46; We achieved similar results to those previously obtained by radiologists&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and objectives"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methodology"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "identificador" => "abst0020"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La ecograf&#237;a como gu&#237;a en la punci&#243;n percut&#225;nea de lesiones tor&#225;cicas perif&#233;ricas &#40;LTP&#41; ofrece ventajas frente a otras t&#233;cnicas de imagen&#46; La mayor&#237;a de los estudios con esta t&#233;cnica han sido comunicados por radi&#243;logos intervencionistas&#46; El objetivo de este estudio ha sido analizar la rentabilidad diagn&#243;stica de la punci&#243;n percut&#225;nea guiada por ecograf&#237;a en una unidad de t&#233;cnicas de neumolog&#237;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Metodolog&#237;a</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de 58 pacientes con LTP puncionadas con visualizaci&#243;n ecogr&#225;fica en tiempo real&#44; entre el 1 de marzo de 2011 y el 1 de septiembre de 2014&#46; Los resultados fueron divididos en 3 categor&#237;as diagn&#243;sticas&#58; maligna&#44; benigna y no diagn&#243;stica &#40;ND&#41;&#59; esta &#250;ltima incluye los resultados de benignidad no espec&#237;fica &#40;SD&#41; y los de muestra insuficiente para diagn&#243;stico &#40;MID&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se obtuvo&#58; resultado maligno en 34 &#40;58&#44;6&#37;&#41; de los procedimientos&#44; resultado benigno en 13 &#40;22&#44;4&#37;&#41; y ND en 11 &#40;19&#37;&#41; &#40;SD en 5 &#91;8&#44;6&#37;&#93; y MID en 6 &#91;10&#44;3&#37;&#93;&#41;&#46; En 5 de los casos ND el resultado final fue de malignidad y en 4 de ellos se tratada de una MID&#46; La sensibilidad diagn&#243;stica obtenida fue del 75&#44;6&#37;&#44; el valor predictivo negativo del 54&#44;2&#37;&#44; y la especificidad y el valor predictivo positivo del 100&#37;&#44; con una rentabilidad diagn&#243;stica del 81&#37;&#46; Cuando se excluyeron los casos con MID los valores fueron del 87&#44;2&#37;&#44; 72&#44;3&#37;&#44; 100&#37; y 100&#37;&#44; respectivamente&#44; con una rentabilidad diagn&#243;stica del 90&#44;4&#37;&#46; No hubo complicaciones graves con la t&#233;cnica&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La punci&#243;n percut&#225;nea bajo gu&#237;a ecogr&#225;fica en LTP realizada por neum&#243;logos intervencionistas es una t&#233;cnica segura y con una alta rentabilidad diagn&#243;stica&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n y objetivos"
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            "titulo" => "Metodolog&#237;a"
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            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
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    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Garc&#237;a-Ortega A&#44; Briones-G&#243;mez A&#44; Fabregat S&#44; Mart&#237;nez-Tom&#225;s R&#44; Mart&#237;nez-Garc&#237;a M&#193;&#44; Cases E&#46; Utilidad de la ecograf&#237;a en el diagn&#243;stico de lesiones tor&#225;cicas perif&#233;ricas realizadas en una unidad de t&#233;cnicas de neumolog&#237;a&#46; Arch Bronconeumol&#46; 2016&#59;52&#58;244&#8211;249&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Photo of the convex &#40;a&#41; and linear &#40;b&#41; transducers&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A needle guide &#40;a&#41; was attached to the US transducer during needle biopsy with real-time imaging &#40;b&#41; to ensure greater accuracy and reduce the risk of injury to adjacent tissue&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">FNA&#58; fine needle aspiration&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years &#40;x</span>&#177;<span class="elsevierStyleItalic">SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#46;86&#177;14&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sex &#40;male&#47;female&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#47;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Location &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right upper lobe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;31&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Middle lobe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right lower lobe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;17&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left upper lobe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left lower lobe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Anterior mediastinum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Supraclavicular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Parietal pleura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Size of lesion &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nodule &#40;&#8804;3<span class="elsevierStyleHsp" style=""></span>cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;25&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mass &#40;&#62;3<span class="elsevierStyleHsp" style=""></span>cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;74&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Type of needle</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chiba<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surecut<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acecut<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Trucut<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No data available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Biopsy procedure &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Only FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;48&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Only core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FNA&#43;core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;37&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No data available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Anthropometry&#44; Location and Size of the Lesion&#44; Type of Needle Used and Biopsy Procedure&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final Diagnosis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Non-small cell&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adenocarcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#47;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Squamous carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#47;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Non-small cell<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#47;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Small cell&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Metastasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other cancers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Benign</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tuberculosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Abscess&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pachypleuritis&#47;fibrothorax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pleural fibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Granulomatous lymphadenitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Non-diagnostic</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Insufficient sample</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">AM&#58; anterior mediastinum&#59; BAL&#58; bronchoalveolar lavage&#59; FN&#58; false negative&#44; FNA&#58; fine needle aspiration&#59; LUL&#58; left upper lobe&#59; NS&#58; non-specific&#59; PET&#47;CT&#58; positron emission tomography&#47;computer tomography&#59; PP&#58; parietal pleura&#59; RLL&#58; right lower lobe&#59; RUL&#58; right upper lobe&#59; SC&#58; supraclavicular&#59; TBB&#58; transbronchial biopsy&#59; TN&#58; true negative&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Size Measured by CT &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final Diagnostic Method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LUL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clinical and radiological follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulmonary abscess&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RLL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clinical and radiological follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Malignant neoplasm &#40;patient declined further diagnostic tests&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bronchoscopy with TBB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Small cell carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LUL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">US-guided FNA performed by interventional radiologist&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Squamous cell lung cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Inflammatory cells &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RLL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&#43;core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Negative CT-guided FNA<br>-<span class="elsevierStyleHsp" style=""></span>Benign nodule&#58; radiological follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Benign nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Inflammatory cells &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&#43;core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Positive thoracocentesis<br>Clinical and radiological follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Purulent mediastinitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Necrosis &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RUL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&#43;core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">US-guided FNA performed by interventional radiologist &#40;2 procedures on different days were required for a positive diagnosis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulmonary sarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Necrosis &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Core biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Thoracotomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulmonary echinococcosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RUL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PET&#47;CT follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Scar tissue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insufficient sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">CT-guided FNA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-cell lymphoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#35;57&nbsp;\t\t\t\t\t\t\n
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        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:28 [
            0 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound-guided transthoracic biopsy of the chest"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;C&#46; Yang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiol Clin N Am"
                        "fecha" => "2000"
                        "volumen" => "38"
                        "paginaInicial" => "323"
                        "paginaFinal" => "343"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10765393"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventional chest sonography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Mathis"
                            1 => "S&#46; Beckh"
                            2 => "C&#46; G&#246;rg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Chest sonography"
                        "paginaInicial" => "184"
                        "paginaFinal" => "204"
                        "edicion" => "2nd ed&#46;"
                        "serieFecha" => "2008"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "US-guided transthoracic cutting biopsy for peripheral thoracic lesions less than 3<span class="elsevierStyleHsp" style=""></span>cm in diameter"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46;Y&#46; Liao"
                            1 => "M&#46;Z&#46; Chen"
                            2 => "Y&#46;L&#46; Chang"
                            3 => "H&#46;D&#46; Wu"
                            4 => "C&#46;J&#46; Yu"
                            5 => "P&#46;H&#46; Kuo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiology.217.3.r00dc21685"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2000"
                        "volumen" => "217"
                        "paginaInicial" => "685"
                        "paginaFinal" => "691"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11110929"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intrathoracic tumors in contact with the chest wall-ultrasonographic and computed tomography comparative evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;I&#46; Chira"
                            1 => "A&#46; Chira"
                            2 => "P&#46;A&#46; Mircea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Ultrason"
                        "fecha" => "2012"
                        "volumen" => "14"
                        "paginaInicial" => "115"
                        "paginaFinal" => "119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22675711"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aplicaciones de la ecograf&#237;a pleural"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;V&#46; Villena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2012.02.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2012"
                        "volumen" => "48"
                        "paginaInicial" => "265"
                        "paginaFinal" => "266"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22464045"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ecograf&#237;a tor&#225;cica&#46; Revisi&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46; Vollmer"
                            1 => "A&#46; Gayete"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2008.12.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2010"
                        "volumen" => "46"
                        "paginaInicial" => "27"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19410350"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subpleural lung tumours ultrasonography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Rednic"
                            1 => "O&#46; Orasan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Ultrason"
                        "fecha" => "2010"
                        "volumen" => "12"
                        "paginaInicial" => "81"
                        "paginaFinal" => "87"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21165459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Value of ultrasound in the imaging-guided transthoracic biopsy of lung lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;L&#46; Moreira"
                            1 => "M&#46;D&#46; Guimaraes"
                            2 => "A&#46;D&#46; Oliveira"
                            3 => "M&#46;J&#46;S&#46; Maciel"
                            4 => "A&#46;G&#46; Bitencourt"
                            5 => "F&#46; D&#8217;Almeida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2013.07.105"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2014"
                        "volumen" => "97"
                        "paginaInicial" => "1795"
                        "paginaFinal" => "1797"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24792272"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for radiologically guided lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Manhire"
                            1 => "M&#46; Charing"
                            2 => "C&#46; Clelland"
                            3 => "F&#46; Gleeson"
                            4 => "R&#46; Miller"
                            5 => "H&#46; Moss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2003"
                        "volumen" => "58"
                        "paginaInicial" => "920"
                        "paginaFinal" => "936"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14586042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percutaneous ultrasonography as imaging modality and sampling guide for pulmonologists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Stigt"
                            1 => "H&#46;J&#46; Groen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000362930"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2014"
                        "volumen" => "87"
                        "paginaInicial" => "441"
                        "paginaFinal" => "451"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24853327"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "True negative predictive value of endobronchial ultrasound in lung cancer&#58; are we being conservative enough"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;A&#46; Whitson"
                            1 => "S&#46;S&#46; Groth"
                            2 => "D&#46;D&#46; Odell"
                            3 => "E&#46;P&#46; Briones"
                            4 => "M&#46;A&#46; Maddaus"
                            5 => "J&#46; D&#8217;Cunha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2012.09.057"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2013"
                        "volumen" => "95"
                        "paginaInicial" => "1689"
                        "paginaFinal" => "1694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23245446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transthoracic ultrasound for the pulmonologist"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;H&#46; Diacon"
                            1 => "J&#46; Theron"
                            2 => "C&#46;T&#46; Bolliger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Pulm Med"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "307"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15928497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Sperandeo"
                            1 => "P&#46; Filabozzi"
                            2 => "A&#46; Varriale"
                            3 => "V&#46; Carnevale"
                            4 => "M&#46;L&#46; Piattelli"
                            5 => "G&#46; Sperandeo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jus.2008.02.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Ultrasound"
                        "fecha" => "2008"
                        "volumen" => "11"
                        "paginaInicial" => "39"
                        "paginaFinal" => "46"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23396553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound-guided transthoracic biopsy of peripheral lung&#44; pleural&#44; and chest wall lesions"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Imaging"
                        "fecha" => "1997"
                        "volumen" => "12"
                        "paginaInicial" => "272"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9368222"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "US-guided transthoracic biopsy"
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                            0 => "A&#46; Helio"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Ultrasound"
                        "fecha" => "1996"
                        "volumen" => "3"
                        "paginaInicial" => "141"
                        "paginaFinal" => "153"
                      ]
                    ]
                  ]
                ]
              ]
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            15 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of on-site cytopathology assessment for bronchoscopic evaluation of lung masses and adenopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;B&#46; Diette"
                            1 => "P&#46; White"
                            2 => "P&#46; Terry"
                            3 => "M&#46; Jenckes"
                            4 => "D&#46; Rosenthal"
                            5 => "H&#46;R&#46; Rubin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "1186"
                        "paginaFinal" => "1190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10767258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            16 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utility of rapid on-site evaluation of transbronchial needle aspirates"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;H&#46; Diacon"
                            1 => "M&#46;M&#46; Schuurmans"
                            2 => "J&#46; Theron"
                            3 => "M&#46; Louw"
                            4 => "C&#46;A&#46; Wright"
                            5 => "K&#46; Brundyn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000084050"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2005"
                        "volumen" => "72"
                        "paginaInicial" => "182"
                        "paginaFinal" => "188"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15824529"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0230"
              "etiqueta" => "18"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Aportaci&#243;n del bloque celular en el diagn&#243;stico de adenopat&#237;as y masas mediast&#237;nicas o hiliares realizado por ecobroncoscopia"
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "V&#46; Leiro-Fern&#225;ndez"
                            2 => "A&#46; Tardio-Baiges"
                            3 => "M&#46; Botana-Rial"
                            4 => "M&#46; Nu&#241;ez-Delgado"
                            5 => "M&#46;J&#46; &#193;lvarez-Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2013.11.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2014"
                        "volumen" => "50"
                        "paginaInicial" => "267"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24439256"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "US-guided transthoracic biopsy of peripheral lung lesions&#58; pleural contact length influences diagnostic yield"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;N&#46; Jeon"
                            1 => "K&#46; Bae"
                            2 => "M&#46;J&#46; Park"
                            3 => "H&#46;C&#46; Choi"
                            4 => "H&#46;S&#46; Shin"
                            5 => "S&#46; Shin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0284185113494984"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Radiol"
                        "fecha" => "2014"
                        "volumen" => "55"
                        "paginaInicial" => "295"
                        "paginaFinal" => "301"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23908243"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasonographically guided biopsy of thoracic tumors&#46; A comparison of large-bore cutting biopsy with fine-needle aspiration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;C&#46; Yang"
                            1 => "Y&#46;C&#46; Lee"
                            2 => "C&#46;J&#46; Yu"
                            3 => "D&#46;B&#46; Chang"
                            4 => "H&#46;D&#46; Wu"
                            5 => "L&#46;N&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1992"
                        "volumen" => "69"
                        "paginaInicial" => "2553"
                        "paginaFinal" => "2560"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1568179"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fine needle aspiration biopsy of mediastinal and peripheral pulmonary masses guided by a real-time sonography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46;M&#46; Pedersen"
                            1 => "T&#46;B&#46; Aasen"
                            2 => "A&#46; Gulsvik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1986"
                        "volumen" => "89"
                        "paginaInicial" => "504"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3514165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound fine-needle aspiration biopsy of lung cancers"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;H&#46; Hsu"
                            1 => "C&#46;D&#46; Chiang"
                            2 => "J&#46;Y&#46; Hsu"
                            3 => "P&#46;C&#46; Kwan"
                            4 => "C&#46;L&#46; Chen"
                            5 => "C&#46;Y&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/(SICI)1097-0096(199606)24:5<225::AID-JCU1>3.0.CO;2-G"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Ultrasound"
                        "fecha" => "1996"
                        "volumen" => "24"
                        "paginaInicial" => "225"
                        "paginaFinal" => "233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8723510"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy of CT-guided transthoracic needle biopsy of lung lesions&#58; factors affecting diagnostic yield"
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                        0 => array:2 [
                          "etal" => true
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                            0 => "A&#46;M&#46; Priola"
                            1 => "S&#46;M&#46; Priola"
                            2 => "A&#46; Cataldi"
                            3 => "L&#46; Errico"
                            4 => "M&#46; Di Franco"
                            5 => "P&#46; Campisi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11547-007-0212-y"
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                        "tituloSerie" => "Radiol Med"
                        "fecha" => "2007"
                        "volumen" => "112"
                        "paginaInicial" => "1142"
                        "paginaFinal" => "1159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18074198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors influencing accuracy of CT-guided percutaneous biopsies of pulmonary lesions"
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                          "etal" => false
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                            0 => "M&#46; Montaudon"
                            1 => "V&#46; Latrabe"
                            2 => "A&#46; Pariente"
                            3 => "O&#46; Corneloup"
                            4 => "H&#46; Begueret"
                            5 => "F&#46; Laurent"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-004-2250-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "1234"
                        "paginaFinal" => "1240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14963689"
                            "web" => "Medline"
                          ]
                        ]
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                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound-guided tissue-core biopsy of thoracic lesions with Trucut and Surecut needles"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            2 => "B&#46;L&#46; Hom"
                            3 => "C&#46; Metreweli"
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                        ]
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Chest"
                        "fecha" => "1987"
                        "volumen" => "91"
                        "paginaInicial" => "823"
                        "paginaFinal" => "828"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3556052"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "La formaci&#243;n especializada en neumolog&#237;a en Europa&#46; El proyecto HERMES"
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                        0 => array:2 [
                          "etal" => false
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                            1 => "M&#46; Miravitlles"
                            2 => "J&#46;L&#46; Alvarez-Sala"
                            3 => "F&#46; Rodriguez"
                            4 => "J&#46; Ancochea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2008.05.002"
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                        "tituloSerie" => "Arch Bronconeumol"
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                        "volumen" => "45"
                        "paginaInicial" => "92"
                        "paginaFinal" => "99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19232271"
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                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
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                            5 => "G&#46;D&#46; Di Maria"
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                    ]
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                        "volumen" => "3"
                        "paginaInicial" => "59"
                        "paginaFinal" => "69"
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                  ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sonographically guided transthoracic biopsy of peripheral lung and mediastinal lesions&#46; Role of contrast-enhanced sonography"
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                            4 => "G&#46;Q&#46; Liao"
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                        ]
                      ]
                    ]
                  ]
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                        "tituloSerie" => "J Ultrasound Med"
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                        "paginaFinal" => "1490"
                        "link" => array:1 [
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