CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan
Introduction
Transthoracic needle biopsy is a common procedure used mainly to elucidate the nature of pulmonary nodules [1], [2]. CT has rapidly become the guidance modality of choice for performing transthoracic needle biopsy due to technical advances in CT and its better detection of pulmonary lesions, which sometimes cannot be identified on chest radiograph [3].
CT-guided needle biopsy is generally regarded as a safe procedure, although pneumothorax and other rare complications can sometimes occur [4]. There have been occasional reports of deaths due to severe complications, such as, air embolism following lung biopsy [5]. Fortunately, these complications are generally very rare; previously published data shows wide variations in complication rates, making them difficult to generalize [5], [6], [7], [8].
The aim of our study was to update the rate of severe complications following CT-guided needle biopsy in Japan via a mailed survey.
Section snippets
Materials and methods
Postal questionnaires regarding CT-guided needle biopsy were sent out to named radiologists at 101 university hospitals and cancer centers in Japan in August 2001. The radiologists at these hospitals were asked to pass duplications of the questions to other associate hospitals. The questions required information regarding: the total number and duration of CT-guided lung biopsies performed at each hospital, and the complication rates, numbers of pneumothorax, hemothorax, air embolism, tumor
Results
A total of 9783 biopsy data were collected from 124 centers. The average number of biopsies performed per center was 79 cases, and that per center per year was 21 cases. The number of institutions in which hyperbaric oxygen recompression can be performed was 41 of 114 (37%) hospitals. Patients were kept on peripheral intravenous drip infusion in 86 of 92 (93%) hospitals, automatic sphygmomanometer in 38 of 92 (41%) hospitals, pulse oximetry in 32 of 92 (35%) hospitals, and electrocardiography
Discussion
Recently, many small pulmonary lesions, which cannot be detected on chest radiograph, have been easily visualized by CT examination in daily clinical work. These lesions are usually followed with CT, or in some cases these are biopsies using CT-guided technique. CT-guided needle biopsy is a widely accepted technique and is one of the principal methods for evaluating a pulmonary lesion [9]. Although it is not rare to have minor complications due to CT-guided needle biopsy, such as, a small
Acknowledgement
The authors, members of the Japanese lung biopsy conference, dedicate this manuscript to Dr. Junpei Ikezoe, originator of this conference. We are also grateful to those specialists who completed the questionnaire. The authors thank Dr. Javzandulam Natsag for his assistance with manuscript editing.
References (35)
- et al.
Transthoracic needle biopsy
Radiol Clin North Am
(2000) - et al.
CT-guided needle biopsy of lesions
Nucle Med Biol
(1994) - et al.
Air embolus complicating transthoracic percutaneous needle biopsy
Ann Thorac Surg
(1995) - et al.
Coronary artery air embolism complicating a CT-guided transthoracic needle biopsy of the lung
Chest
(2002) - et al.
Percutaneous biopsy in lung cancer
Eur J Radiol
(2003) - et al.
Fatal air embolism during computed tomography-guided pulmonary marking with a hook-type maker
J Thorac Cardiovasc Surg
(2003) - et al.
Dissemination of cancer cells by needle biopsy of the lung
J Thor Cardiovasc Surg
(1972) - et al.
Cell dissemination and implantation of neoplasms through biopsy and excision of malignant tumors
Dis Chest
(1967) Pulmonary neoplasms diagnosed with transthoracic needle biopsy
Cancer
(1979)- et al.
Transthoracic needle biopsy
J Thorac Imag
(1997)