Our Summary

This study compares two different methods of doing a needle biopsy (a medical test in which a small amount of tissue is taken from the body using a thin needle) on patients with small lumps in the base of their lungs. The two methods used are fluoroscopy computed tomography (FCT) and cone-beam computed tomography (CBCT).

The researchers looked back at the data of 379 patients who had undergone these procedures between September 2009 and March 2020. They analyzed different factors such as patient details, characteristics of the lumps, success rate of the procedure, diagnosis, any side effects, and the amount of radiation the patient was exposed to.

The results showed that both methods were almost equally successful. For larger lumps (over 2 cm), both methods had similar accuracy, likelihood of causing a collapsed lung (pneumothorax), and radiation exposure. However, for smaller lumps (2 cm or less), while the diagnostic accuracy was similar, the FCT method had a higher chance of causing a collapsed lung and exposed the patient to more radiation than the CBCT method.

The researchers concluded that both methods are similarly effective for larger lumps, but the CBCT method is safer for smaller lumps as it exposes the patient to less radiation and has fewer complications. They suggest that doctors can choose the best method based on the size of the lump and the equipment they have available.

FAQs

  1. What was the aim of this scientific study on lung biopsy?
  2. What were the results of the study comparing FCT-guided and CBCT-guided PTNBs for larger and smaller lung base lesions?
  3. What is the conclusion of the study regarding the use of FCT and CBCT guidance for PTNBs in lung base lesions?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to discuss the guidance method with their healthcare provider. Depending on the size and location of the nodule, fluoroscopy computed tomography (FCT) or cone-beam CT (CBCT) guidance may be more appropriate. CBCT guidance may have lower radiation exposure and fewer complications for smaller lesions, while FCT guidance may be more suitable for larger lesions. It is important to have a thorough discussion with your healthcare provider to determine the best approach for your specific case.

Suitable For

Patients with nodules in the lung base who require a lung biopsy are typically recommended to undergo a percutaneous transthoracic needle biopsy (PTNB) guided by fluoroscopy computed tomography (FCT) or cone-beam CT (CBCT). This study compared the diagnostic performance and safety of FCT-guided versus CBCT-guided PTNB in patients with nodules in the lung base. The study found that PTNBs under both FCT and CBCT guidance had similar technical success rates and diagnostic accuracy for larger lesions (>2 cm in diameter). However, CBCT guidance was associated with lower incidence of pneumothorax and lower radiation exposure for smaller lesions (≤2 cm in diameter). Overall, radiologists may choose to use FCT or CBCT guidance based on equipment availability and lesion characteristics to optimize diagnostic outcomes and patient safety.

Timeline

Before lung biopsy:

  • Patient presents with a nodule in the lung base.
  • Patient undergoes imaging studies to determine the location and characteristics of the nodule.
  • Patient consults with a healthcare provider to discuss the need for a lung biopsy and the risks and benefits of the procedure.
  • Procedure is scheduled and patient receives instructions on preparation for the biopsy.

After lung biopsy:

  • Patient arrives at the hospital or clinic for the procedure.
  • Patient is prepped and positioned for the biopsy, which may be guided by fluoroscopy computed tomography (FCT) or cone-beam CT (CBCT).
  • Biopsy is performed, and tissue samples are collected for analysis.
  • Patient is monitored for any immediate complications, such as pneumothorax.
  • Patient is discharged with instructions for post-procedure care and follow-up appointments.
  • Pathology results are reviewed with the patient to determine the next steps in treatment.

What to Ask Your Doctor

  1. What is the purpose of a lung biopsy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a lung biopsy?
  3. How will the biopsy be performed, and what type of imaging guidance will be used (fluoroscopy computed tomography or cone-beam CT)?
  4. What is the expected duration of the procedure and recovery time?
  5. What information will the biopsy results provide about my condition?
  6. How accurate is the diagnostic performance of the chosen imaging guidance for my specific case?
  7. What are the potential long-term effects of radiation exposure from the imaging guidance used during the biopsy?
  8. How will my pain be managed during and after the procedure?
  9. How soon will I receive the results of the biopsy and what follow-up care will be recommended based on the findings?
  10. Are there any alternative diagnostic tests or treatment options available for my condition?

Reference

Authors: Ren Q, Zhou Y, Yan M, Zheng C, Zhou G, Xia X. Journal: Clin Radiol. 2022 May;77(5):e394-e399. doi: 10.1016/j.crad.2022.02.005. Epub 2022 Feb 25. PMID: 35227506