The role of USS guided biopsy in the investigation of lung cancer.
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Authors
Aujayeb, Avinash
Storey, Claire
Narkhede, Parag
Hill, E.
Carling, Michael
Issue Date
2021
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Abstract
"Background: Northumbria HealthCare NHS Foundation Trust, in the North East of England, is a large centre with high volume of lung cancer and mesothelioma. Services such as CT guided biopsy and local anaesthetic thoracoscopy are well established in the diagnostic pathway. For some patients, Ultrasound (USS) guided pleural or chest wall biopsies also have a role to play. Retrospective reviews help in assessing diagnostic sensitivity and safety of such procedures.
Methods: With local Caldicott approval, a retrospective review of all USS guided chest wall and pleural biopsies was performed. Basic demographics were collected, as well as size of needle, presence of complications, need for re-biopsy and overall pathological diagnoses. The time frame was Jan 2010–Nov 2020.
Results: 50 patients were identified. Mean age was 75.6 years (range 48–92). 21 patients were female, and 29 male. 25 had pleural biopsies and 25 chest wall and/or rib biopsies. A 14Fg needle was used in 1 patient, 16Fg in 9, 18 Fg in 36, 20 Fg in 1 and there was no data available in 3 patients. 49 patients had no immediate complications to the procedure, and none within 30 days either. One patient had an attempt at pleural biopsy but only liver tissue was obtained, probably due to the needle inadvertently crossing the diaphragm, as the biopsy did not use real time guidance. 5 biopsies were non-diagnostic, 3 pleural biopsies, 1 chest wall and 1 rib biopsy. 1 required a re-biopsy, 1 required a bronchoscopy and 3 were not investigated further. Overall diagnostic sensitivity is 90%, 88% for pleural biopsies and 92% for chest wall/rib biopsies. Diagnoses included 13 mesotheliomas, 2 renal cancers, 19 lung cancers, 1 breast cancer, 1 gastro-intestinal cancer, 6 chronic fibrinous pleuritis, 2 lymphomas and 1 cancer of unknown primary.
Conclusions: Overall, the local USS guided biopsy service is safe and has high sensitivity. We have easy access to CT guided biopsy and medical thoracoscopy and thus do not need to perform USS procedures often. We have set up guidance that real time ultrasound guidance should be used for every procedure rather than pre-procedural guidance only."
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Citation
Aujayeb, A., Storey, C., Narkhede, P. et al (2021) 214P The role of USS guided biopsy in the investigation of lung cancer. Journal of Thoracic Oncology, 16(4) : S812
Publisher
Journal of Thoracic Oncology
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ISSN
1556-1380