Our Summary

This research paper looks at the accuracy and safety of a type of biopsy, guided by a CT scan, used to diagnose if a patient’s primary cancer has spread to their lungs. The researchers looked at 108 cases from their hospital over a five year period.

The biopsy procedure was accurate 83.3% of the time, and lung metastasis (spread of primary cancer to the lungs) was found in just over half of the cases. However, in 27.6% of the cases, the results were unclear. In over half of these unclear cases, lung metastasis was eventually diagnosed, suggesting the biopsy has a high sensitivity and specificity for detecting lung metastasis.

The study found that smaller size of the lesion, pneumothorax (collapsed lung), high-grade pulmonary hemorrhage (severe lung bleeding), and hemoptysis (coughing up blood) were factors that made the results unclear.

The conclusion is that CT-guided core needle biopsy is a highly accurate and generally safe method for diagnosing lung metastasis in cancer patients. However, if the results are unclear, it’s important to repeat the biopsy or follow-up with more clinical or radiological tests because of the high likelihood of lung metastasis.

FAQs

  1. What is the accuracy rate of a CT-guided core needle biopsy in diagnosing lung metastasis in cancer patients?
  2. What factors were found to make the results of a lung biopsy unclear?
  3. What should be done if the results of a CT-guided core needle biopsy are unclear?

Doctor’s Tip

A doctor might tell a patient undergoing a lung biopsy that while the procedure is generally accurate and safe, there is a possibility for unclear results. If the results are unclear, it’s important to follow up with additional tests or a repeat biopsy to ensure an accurate diagnosis, especially if there are factors such as smaller lesion size, pneumothorax, high-grade pulmonary hemorrhage, or hemoptysis present. It’s important to work closely with your healthcare team to monitor and address any concerns that may arise during the diagnostic process.

Suitable For

Patients who are typically recommended for lung biopsy are those who have been diagnosed with primary cancer and are suspected to have metastasis to the lungs. Factors such as smaller size of the lesion, pneumothorax, high-grade pulmonary hemorrhage, and hemoptysis may increase the likelihood of unclear results from the biopsy. In these cases, it is important to follow up with additional tests or repeat the biopsy to ensure an accurate diagnosis.

Timeline

Before the lung biopsy:

  1. Patient undergoes initial consultation with their healthcare provider.
  2. Imaging tests such as CT scans are conducted to identify the presence of any suspicious lung lesions.
  3. Patient may undergo blood tests or other diagnostic procedures to assess their overall health and suitability for the biopsy.

During the lung biopsy:

  1. Patient is briefed on the procedure and given anesthesia.
  2. A needle is inserted into the lung tissue to extract a small sample for analysis.
  3. CT scan is used to guide the needle to the precise location of the lesion.
  4. Biopsy sample is sent to the lab for analysis.

After the lung biopsy:

  1. Patient is monitored for any immediate complications such as pneumothorax or hemorrhage.
  2. Results of the biopsy are usually available within a few days.
  3. If results are inconclusive, further tests or a repeat biopsy may be recommended.
  4. Treatment plan is developed based on the biopsy results and any additional diagnostic tests.
  5. Patient undergoes follow-up appointments to monitor their condition and response to treatment.

Overall, the lung biopsy process involves thorough evaluation, careful procedure, and close monitoring to ensure accurate diagnosis and appropriate treatment for the patient.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a lung biopsy?
  2. How will the biopsy results impact my treatment plan and prognosis?
  3. How long will it take to receive the biopsy results?
  4. Are there any alternative diagnostic tests that could be considered instead of a lung biopsy?
  5. How experienced is the medical team in performing CT-guided core needle biopsies?
  6. What is the likelihood of the biopsy results being unclear or inconclusive?
  7. Will I need to make any special preparations before the biopsy procedure?
  8. How long will I need to stay in the hospital after the biopsy?
  9. Will I experience any pain or discomfort during or after the biopsy procedure?
  10. What follow-up care or monitoring will be needed after the biopsy?

Reference

Authors: Zhu J, Wang X, Qu Y, Wen Z. Journal: Diagn Interv Radiol. 2021 Jul;27(4):534-541. doi: 10.5152/dir.2021.20042. PMID: 34313240