Technical Note: Positron Emission Tomography- Computed Tomography (PETCT) Guided Lung Biopsy for Better Yield - A Single Center Experience
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 4
Abstract
Tissue diagnosis is mandatory in work up and treatment strategies of lung cancers. There are many techniques in obtaining tumor samples which include less invasive and invasive techniques. Image guided percutaneous biopsy plays an important role in the work up for lung cancers, of which percutaneous computed tomography (CT) guided core biopsy is an important component. Recent advances in target therapies and personalized medicine, the technique of aspiration cytology is not a preferred technique. The need for multiple large cores of tissue for the diagnoses which include histopathology, immuno histochemistry and also formulation studies is the need of hour and CT guided technique is preferred. The procedure is less invasive, often performed under local anesthesia and as a day care procedure. Complications of CT guided lung biopsy have been well documented and include pneumothorax, haemoptysis, pain, air embolism, a trial fibrillation, and tumor seeding of the biopsy tract and, on rare occasions, death. The complication rates vary from center to center, owing to the expertise. It is important for the interventional radiologist to perform the procedure in one go. Even with best of the best practices, improvised techniques and technique modifications in minimizing complications, we quite often we face a situation of inadequate tissue sample. This leads to repeat procedures, cost and exposes the patient for procedure related complications. All these lead to delay in diagnosis and initiation of treatment. A well performed diagnostic CT scan, preferably with intravenous contrast is crucial in planning the procedure. The incidences of repeat procedures are high with necrotic tumors, central hilar masses and when there is presence of adjacent atelectasis.
Authors and Affiliations
Shiva kumar Swamy Shivalingappa, Mahesh Ashok Kumar, Kumar Kallur, G Lohith
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