Our Summary

This study aimed to understand which factors could affect the risk of experiencing a pneumothorax (collapsed lung) after the first puncture in an ultrasound-guided lung biopsy using a coaxial technique. The research analyzed 180 lung lesions from 174 patients who underwent this procedure at one institution from 2007 to 2018.

The results showed that the procedure was technically successful (meaning it allowed for a diagnosis) in 97.2% of the lesions, and it was accurate in diagnosing the condition in 91.6% of the cases. A pneumothorax occurred immediately after the first puncture in 7 out of the 180 lesions.

The researchers found that the length of contact between the lesion and the pleura (the membrane that surrounds the lungs) was an important factor. If this pleural contact length was less than 9.78 mm, the risk of a pneumothorax happening right after the first puncture was higher. However, whether a pneumothorax occurred or not did not significantly impact the overall success and accuracy of the biopsy.

FAQs

  1. What was the main aim of this study on ultrasound-guided lung biopsies using a coaxial technique?
  2. What factors were found to increase the risk of a pneumothorax occurring during this type of lung biopsy?
  3. Did the occurrence of a pneumothorax impact the overall success and accuracy of the biopsy?

Doctor’s Tip

One helpful tip a doctor might give to a patient about lung biopsy is to follow all pre-procedure instructions carefully, such as fasting before the procedure and informing the doctor about any medications being taken. It is also important to discuss any concerns or questions with the doctor before the procedure to ensure that the patient is well-informed and prepared. Additionally, the patient should follow all post-procedure instructions, such as monitoring for any signs of complications like difficulty breathing or chest pain, and seeking medical attention if needed.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspicious lung nodules or masses, lung infections, lung cancer, interstitial lung disease, or other lung conditions that require further evaluation or diagnosis. Additionally, patients who may not be suitable candidates for surgery or who have a high risk of complications from surgery may also be recommended for a lung biopsy.

Timeline

Before the lung biopsy:

  1. Patient undergoes initial consultation with a healthcare provider to discuss the need for a lung biopsy and potential risks.
  2. Patient may undergo imaging tests such as a CT scan or X-ray to identify the location of the lesion.
  3. Patient may need to stop taking certain medications, such as blood thinners, before the procedure.
  4. Patient may receive sedation or local anesthesia before the biopsy.

During the lung biopsy:

  1. Patient is positioned on their back or side, depending on the location of the lesion.
  2. Ultrasound is used to guide the biopsy needle to the targeted area in the lung.
  3. A small incision is made in the skin, and the biopsy needle is inserted to collect a tissue sample.
  4. Multiple samples may be taken depending on the size and location of the lesion.
  5. The samples are sent to a lab for analysis to determine a diagnosis.

After the lung biopsy:

  1. Patient is monitored for any immediate complications, such as bleeding or pneumothorax.
  2. Patient may experience pain or discomfort at the biopsy site, which can be managed with pain medication.
  3. Patient may need to rest and avoid strenuous activities for a period of time after the procedure.
  4. Results of the biopsy are typically available within a few days to a week, and the healthcare provider will discuss the findings with the patient.
  5. If a pneumothorax occurs, the patient may need additional treatment such as chest tube insertion to remove air from the chest cavity.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. What is the purpose of the lung biopsy and why is it necessary?
  2. What are the potential risks and complications associated with the procedure, such as a pneumothorax?
  3. How will the biopsy be performed, and what type of anesthesia will be used?
  4. How long will the procedure take, and what can I expect during and after the biopsy?
  5. Will I need to stay in the hospital after the biopsy, or can it be done on an outpatient basis?
  6. How soon will I receive the results of the biopsy, and what follow-up care will be needed?
  7. Are there any specific instructions I need to follow before and after the biopsy to ensure the best possible outcome?
  8. What are the alternatives to a lung biopsy, and why is this the recommended course of action?
  9. Can you explain the findings of the biopsy in a way that I can understand, and what are the next steps in my treatment plan?
  10. Are there any signs or symptoms I should watch for after the biopsy that may indicate a complication, such as a pneumothorax?

Reference

Authors: Imamine R, Kubo T, Akuta K, Kobayashi H, Yamamoto Y, Saito A, Sakai N, Shirase T. Journal: Jpn J Radiol. 2022 Apr;40(4):404-411. doi: 10.1007/s11604-021-01213-6. Epub 2021 Nov 5. PMID: 34739655