Our Summary

This research paper is about a survey that was conducted to understand how radiologists carry out lung biopsies. The survey was completed by 244 members of the Society of Thoracic Radiology. Out of these, 137 radiologists regularly perform lung biopsies, with most of them working in academic teaching hospitals. The survey found that most radiologists use computed tomography (CT) scans to guide them while performing the biopsy.

When it came to the method of biopsy, the responses were mixed. Some preferred fine-needle aspiration (FNA) alone, some favored core needle biopsy (CNB) alone, and some liked to use both methods together. The majority of the radiologists who had access to on-site cytology services, used these services regularly.

In cases where lung cancer was suspected, 60% of the radiologists sent tissue for molecular analysis more than a quarter of the time. Only 32% of the radiologists used preventive measures during the procedure to reduce the risk of a lung collapsing (pneumothorax).

The findings suggest that education is needed for radiologists about the importance of routinely acquiring and sending more amounts of tissue for molecular/genomic testing when lung cancer is suspected. This is because some of the methods used, like FNA alone, might not provide enough tissue for these tests and could possibly affect the accuracy of the diagnosis.

FAQs

  1. What methods do radiologists typically use to perform lung biopsies?
  2. How often do radiologists use preventive measures to reduce the risk of a lung collapsing during a biopsy procedure?
  3. Why is additional education suggested for radiologists regarding molecular/genomic testing when lung cancer is suspected?

Doctor’s Tip

A doctor might advise a patient undergoing a lung biopsy to ensure they are being treated by a radiologist who uses CT scans to guide the procedure, as this can help to ensure accuracy and safety. They may also recommend discussing with the radiologist the use of both FNA and CNB methods to obtain an adequate amount of tissue for molecular analysis, especially if lung cancer is suspected. Additionally, the doctor may suggest asking about preventive measures to reduce the risk of a collapsed lung during the biopsy procedure.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspected lung cancer, suspicious lung nodules, interstitial lung disease, and other pulmonary conditions that require a definitive diagnosis. Additionally, patients who have undergone previous imaging tests that have shown abnormal lung findings may also be recommended for a lung biopsy to further investigate the underlying cause.

Timeline

Before a lung biopsy, a patient may undergo a series of tests such as chest X-rays, CT scans, and blood tests to determine the need for the biopsy. The patient will also meet with their healthcare provider to discuss the procedure, potential risks, and obtain informed consent. On the day of the biopsy, the patient will be instructed to not eat or drink for a certain period of time before the procedure.

During the biopsy, the patient will be positioned on a table and may receive anesthesia or sedation to help them relax and minimize discomfort. The radiologist will use CT guidance to locate the precise area for the biopsy and then insert a needle into the lung to obtain a tissue sample.

After the biopsy, the patient will be monitored for any signs of complications such as bleeding or pneumothorax. They may experience some pain or discomfort at the biopsy site and could be advised to rest and avoid strenuous activities for a period of time. The tissue sample will be sent to a lab for analysis, and the patient will follow up with their healthcare provider to discuss the results and determine further treatment options.

What to Ask Your Doctor

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

  1. What type of lung biopsy method will be used in my case (FNA, CNB, or a combination)?
  2. Will the biopsy be guided by CT scan or another imaging technique?
  3. How much tissue will be taken during the biopsy, and will it be enough for molecular/genomic testing if needed?
  4. What are the risks associated with the biopsy procedure, such as pneumothorax, and what preventive measures will be taken?
  5. How soon will I receive the results of the biopsy, and what further steps will be taken based on the results?
  6. Are there any specific instructions I need to follow before or after the biopsy procedure?
  7. How experienced is the radiologist who will be performing the biopsy, and how many similar procedures have they done in the past?
  8. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?
  9. What are the potential complications or side effects of the biopsy procedure, and how will they be managed?
  10. Will I need to make any changes to my medication or lifestyle before or after the biopsy procedure?

Reference

Authors: Lee C, Guichet PL, Abtin F. Journal: J Thorac Imaging. 2017 Jan;32(1):63-67. doi: 10.1097/RTI.0000000000000237. PMID: 27753752